Are there any doctors who do tummy tucks (abdominoplasty) who can repair an umbilical hernia using the Shouldice technique?

Hi, 
Through the course of my career, I have repaired many umbilical hernias during abdominoplasty. In 2015, I published a scientific paper in the Plastic and Reconstructive Surgery Journal where i reviewed 300 consecutive cases. Approximately 5.6% of our patients who desire abdominoplasty have an umbilical hernia. I routinely repair these by simply reducing the contents of the hernia and close the fascial opening with permanent sutures. We then pull the rectus abdominous muscles over the closure during the muscle plication part of the procedure. This reinforces the umbilical hernia repair and we have never had a single recurrence in over 80 cases. We have never had to use mesh to repair an umbilical hernia. I hope this answers your question. 
Best Regards, 
Dr. Lane Smith
Board Certified Plastic Surgeon 
Las Vegas / Henderson NV

The Shouldice procedure is done for inguinal or groin hernias, not for an umbilical hernia.  Most plastic surgeons are quite comfortable repairing umbilical hernias at the same time as your tummy tuck.  Best wishes

Hello and thank you for your
question.  Most umbilical hernias can be repaired at the time of a tummy tuck without need for mesh.  If you are an appropriate candidate for a tummy tuck, 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.  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. FACS
Harvard-trained plastic surgeon

Dear AmelieLOA,a small umbilical hernia is something that can be fixed during a full tummy tuck procedure. I routinely repair these during my tummy tuck procedures. Not everyone feels comfortably repairing these however. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

but my patients have to allow me to float their belly button to give me complete access to the fascial defect and to allow the most secure repair without any concerns for injuring adjacent tissues.  If you have a lot of tissue, I would pull you belly button down as far as possible, hopefully even removing it if it reached the transverse scar (placed 2 inches above your vagina).  If you don't have a lot of skin, then the belly button would be floated down an inch and resecured to your abdominal wall, producing an 'inny'.  I do belly button reconstructions later if needed and can create belly buttons that look a lot better than those scarred belly buttons you see everywhere.  And I don't charge at all for the hernia repair.

The Shoulidce repair is a repair done to repair inguinal hernias  and hernias fixed during a tummy tuck are usually an umbilical or a venrtal hernia. A larger hernia requires mesh to decrease the risk of recurrence. If you have a usual umbilical hernia, or peri-umbilical hernia, than it can be fixed at the time of abdominoplasty very easily with the direct repair without using mesh.

Most umbilical hernias are small and can be repaired at the time of tummy tuck surgery by any qualified plastic surgeon with experience in body contouring surgery. The main risk of attempting repair of the hernia is the potential devascularization of the blood supply to the stalk of the belly button that occurs from dissecting into the base to reduce the contents of the hernia and close the defect, but most surgeons will leave a cuff of fat around the belly button to try to guard against this.Regarding the "Shouldice technique," you may be using that term to mean "hernia repair without mesh." Most small umbilical hernias do not require mesh. "Shouldice" is a term usually applied to a specific multi-layer technique of repairing INGUINAL hernias without mesh, and isn't usually a term used by surgeons when talking about UMBILICAL hernia repair, notwithstanding that both share the concept of trying to close the defect without using mesh.

Most plastic surgeons would
repair the umbilical hernia at the time of the tummy tuck without using mesh.
Keep in mind that following
the advice from a surgeon on this or any other website who proposes to tell you
what to do without examining you, physically feeling the tissue, assessing your
desired outcome, taking a full medical history, and discussing the pros and
cons of each operative procedure would not be in your best interest. I would
suggest you find a plastic surgeon certified by the American Board of Plastic
Surgery and ideally a member of the American Society for Aesthetic Plastic
Surgery (ASAPS) that you trust and are comfortable with. You should discuss
your concerns with that surgeon in person and follow his or her advice.
Robert Singer, MD FACS
La
Jolla, California

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 (with the need for mesh) routinely during tummy tuck surgery. Some plastic surgeons prefer to  ask for the services of a general surgeon.
Generally I suggest that patients start with the American Society of Plastic Surgery and/or the Aesthetic Society of Plastic Surgery to obtain a list of well experienced board-certified plastic surgeons.  Additional certification by the American Board of surgery (General Surgery) should give you additional peace of mind.
Then, I would suggest you visit a few surgeons whose practices concentrate on aesthetic surgery. 
***Ask to see lots of examples of their work and preferably speak/see patients who have had similar procedures done.  Ultimately it will be important that you feel comfortable that your plastic surgeon have a significant/demonstrable experience consistently achieving the types of outcomes you will be pleased with.   
Besides appropriate training and experience (and certification by the American Board of plastic surgery), looking at before/after photographs (and  preferably talking to previous patients) can be very helpful in this selection process.
 Basically, patients should look at the overall "quality" of the outcomes achieved;  in other words, it will be important that patients see lots of examples of outcomes that they would be pleased with.  In doing so patients will be able to get an idea of each  plastic surgeon's "aesthetic sensibilities".
I hope this helps.
 

Most umbilical hernias can easily be repaired without mesh at the time of a full tummy tuck.  Unless your situation is unusual, your plastic surgeon should be able to provide this service for you.  Best wishes,Jon A. Perlman, M.D., FACS
Certified, Am. Board of Plastic Surgery
Member, ASAPS ASPS LASPS
Extreme Makeover Surgeon, ABC TV
Best of Los Angeles Award 2015 2016
Beverly Hills, CA