Ventral Hernia - When Do Potential Complications of Tummy Tuck Outweigh Cosmetic Concerns?

I have 4 x 6 Proceed mesh from a ventral hernia repair 4 yrs ago. I have no problems but belly still bulges out. My PS examined me & reviewed with a general surgeon - conclusion (prior to GS examining my tummy which is PS advice) is mesh should be removed/replaced to repair. I may still have a hernia. He said they won't know level of complexity until I'm opened up. My concern is safety. I have no other health problems, and certainly do not want to create any. Make sense, or should I let it be?

Doctor Answers 6

It can be better

General surgeons have very little concern about how you look.  They are concerned about things that are dangerous to your health (ventral hernia).  If you want to look better and strengthen your abdomen, I would recommend further surgery to remove mesh, suture muscles/fascia, and support the repair with Strattice, a biological graft to stregthen the repair.

Atlanta Plastic Surgeon
4.2 out of 5 stars 12 reviews

Ventral hernia and tummy tuck

I agree with the recommendation to have a CT scan prior to surgery to delineate the true nature of the problem.  A little more history regarding the necessity for the original hernia repair would be helpful.  Sometimes it is possible to leave the mesh in place and advance the fascia, or muscle covering, over the mesh in order to tighten and strengthen the repair.  This would also likely take care of the bulge.  If you truly have a hernia recurrence, this is a more complicated matter that may entail removing and /or replacing  the mesh.  This is where a CT scan will be helpful.  Generally, it is safe to proceed with both procedures.

Jeffrey E. Kyllo, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 12 reviews

Ventral hernia

do not confuse a bulge with a hernia. a bulge is only a cosmetic concern but a true hernia with a defect in the abdominal wall is serious. a secondary operation in the abdomen is not to be entered lightly. I would recommend a CT scan to determine the integrity of the abdominal wall. if there is a hernia, then a repair will be required. if not, then consider your options carefully as the risks may outweigh the benefit.

Rafael C. Cabrera, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 1 review

Tummy tuck, ventral hernia

This is a difficult question to answer. It depends on what type of repair you had. Is the hernia is centrally located, or off to the sid?. It also depends on the tissue closure over the hernia. Is there your own tissue that covers up the mesh and the mesh is placed under?. Is the mesh simply a patch without your own tissue covering it up.

So this is a difficult question to answer.  If it is a 4x6 size defect, centrally located, you maybe able to do a nice tummy tuck operation and also take care of the hernia/bulge at the same time.

Sometimes, a CT scan maybe useful to look at the anatomy of the abdominal wall.

Good Luck.

Shashidhar Kusuma, MD
Plantation Plastic Surgeon
4.8 out of 5 stars 28 reviews

Tummy tuck when abdominal hernia present

Sounds like you need some kind of revision of your hernia repair even if you don't have an abdominoplasty. This could probably be done without removing the mesh. If all else is fine and if you are not smoking, go for it!

J. Brian Boyd, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 5 reviews

Ventral Hernia - When Do Potential Complications of Tummy Tuck Outweigh Cosmetic Concerns?

This is a question only you can answer.

Having a Prolene mesh ventral hernia repair suggests that there your ventral hernia was the result of a combination of factors including obesity and poor local tissue strength among others. Unless the conditions which predisposed you to the ventral hernia are corrected (ie no longer there - things like frequent coughing, or obesity) your Abdominoplasty may be complicated as well.

Removing a Prolene mesh is not a pleasant surgical procedure because of the intense scarring in and around the mesh. This may weaken the tissues along the midline required to repair the midline muscle separation. Your General surgeon should discuss your particular case with your Plastic surgeon and you need to understand AND accept the potential complications of the procedure.

Good Luck.

Dr. Peter A Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon
4.9 out of 5 stars 108 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.