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

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!

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

Dear Mommyextraodinaire,Thank you for your question. It is possible to repair an umbilical hernia during a tummy tuck procedure. Best of luck!

Hello and thank you for your question. Based on your
photograph, you are a great candidate for a tummy tuck with liposuction.  This can be done through a low and short
incision, all completely below the bikini line. 
The belly button can be designed to look natural and have no scars on
the exterior.   Your muscles can also be
plicated resulting in a flat abdomen.  Hernia repair can be performed at the same time. 
Make sure you specifically look at before and after pictures of
real patients who have had this surgery performed by your surgeon and evaluate
their results.  The most important aspect is to find a surgeon you are
comfortable with. I recommend that you seek consultation with a qualified
board-certified plastic surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Yes, we often combine these two procedures provided a patient is a candidate. Best to seek in person exam by an experienced Board Certified PS.

Thank you for your question and photograph.  Yes, you can absolutely repair a small umbilical hernia at the same time as your abdominoplasty.  Be sure to seek a
consultation with an aesthetic plastic surgeon who addresses all
your concerns and discusses the surgery details including the risks and
benefits of the procedure, recovery time, and post-operative course.  When
I perform an abdominoplasty, the necessary skin and fat is removed, any hernias are repaired, the
abdominal muscles are tightened, a small umbilical incision is made that is not
externally visible, and a short, low waistline incision is designed to be easily
hidden by your underwear or bikini.  Please
view plenty of before-and-after pictures in real women (and not just
computer-generated images) who have a similar abdominal appearance to
yours, and preferably at different time frames (3 weeks out, 3 months out,
etc) to more accurately predict your own surgical outcome.  And lastly, I
think the most important component of the consultation is to establish a good
connection with your plastic surgeon.  If you don’t feel you have a good
connection with your plastic surgeon after your consultation, he/she may not be
the best surgeon for you.

Good luck.
Mark K Markarian, MD, MSPH

Harvard-trained Aesthetic Plastic Surgeon

With my background in General Surgery and Plastic Surgery, I do repair hernias at the same time as TT surgery.  It adds little time to the case and no additional recovery time!Look for that background when seeking out your surgeon!Good luck!In good health,Ellen Mahony, MD

Here my opinion:  I'll fix the hernia if it is small (no larger than the tip of my little finger) at the time of a tummy tuck.  If it is larger, I send it to a respected general surgeon for evaluation.  It may need a mesh repair.

Hernia repair and tummy tuck can and are performed at the same time.  Find a board certified plastic surgeon with ELITE credentials who performs hundreds of tummy tucks each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.  Schedule an in-office consultation for an exam, discussion of goals, health history, and any concerns.Kenneth Hughes, MD, Board Certified Plastic Surgeon Los Angeles, CA

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.