Tummy Tuck and umbilical hernia repair at the same time? (photo)

Umbilical hernias are quite common and occur in the setting of a previous surgery, pregnancy, or diastasis recti. We treat umbilical hernias with or without correction of diastasis recti using a combination approach that corrects redundant skin in the lower abdomen and around the belly button. If there is a lot of skin, we would use a tummy tuck scar whereas smaller corrections can be performed using just the belly button incision which is well hidden inside your belly button.


Best,
Dr. Karamanoukian
Realself100 Surgeon

This is a fantastic question!
Keep in mind that many plastic surgeons (not all) have had general surgeon training. Umbilical hernia repair is one of the most common procedures general surgeons do. In addition, plastic surgeons are also reconstructive surgeons and are familiar with reconstructing very difficult hernias. It is not uncommon for plastic surgeons to help general surgeons repair very big and complicated hernias. Therefore, plastic surgeons usually have the background to fix umbilical hernias.
In addition, it is not uncommon for plastic surgeons to come across hernias from other surgeries our patients have had. Some of these surgeries include c-sections, gallbladder removal, hysterectomies and appendectomies. Sometimes the surgeon knows the hernia is there and plans ahead of time. But sometimes hernias are difficult to detect ahead of time because many general surgeons are using very tiny incisions during procedures that use a "scope". These procedures include laparoscopic cholecystectomy, appendectomy, hysterectomy and weight reduction "stomach or intestine" surgery. So it is common for plastic surgeons to come across these small hernias during a tummy tuck. Since plastic surgeons repair the "loose" muscle during a tummy tuck, the repair of "incidental" hernias such as undetected umbilical or laparoscopic hernias is usually done without difficulty.
So, you can see that plastic surgeons usually have the background and skills to fix hernias during a tummy tuck. But let's discuss some of the realities of umbilical hernia repair in the current health insurance arena.
If you have health insurance and want your hernia repair to be covered by your insurance, you are probably going to have to be referred by your primary physician to a general surgeon. You can try to have your plastic surgeon try to contact your insurance company to get coverage for the umbilical hernia repair during the tummy tuck, but my experience is that you will have difficulty finding insurance coverage if your plastic surgeon does the hernia repair. I am not saying it is impossible, but it could be difficult. If you are thinking of trying to get your insurance to pay for the umbilical hernia repair, please be up front about this with your plastic surgeon. Your surgeon can try to help you get coverage. If you wait until after the surgery to inform your insurance company, you will certainly have difficulty getting coverage.
Now, if you don't plan on using insurance to cover your umbilical hernia repair, by all means ask your plastic surgeon if he/she is comfortable doing the hernia repair. In general, for healthy patients, it is better to combine an umbilical hernia repair with a tummy tuck. It not only costs less, but it involves only one anesthetic and recovery time. If your plastic surgeon is not comfortable doing the hernia repair, you may have two options. Your surgeon can either ask a general surgeon to help him repair the hernia during the tummy tuck or the umbilical hernia repair can be done at a separate time from the tummy tuck.
I think there are a lot of things to consider with your question and I think it is a fantastic question.
Good luck!

Thank you for the question. Yes, umbilical hernias  can (and should) be repaired at the same time as tummy tuck surgery. Much will depend on the “comfort level” of your plastic surgeon;  in my practice, I repair hernias routinely during tummy tuck surgery. Some plastic surgeons prefer to  ask for the services of a general surgeon. 

You may find the attached link/video helpful to you as you learn more. Best wishes.