Yes, your plastic surgeon can advise you
Milan123: You describe a fairly common situation following pregnancies. The abdominal wall consists of both layers of muscle and fibrous support layers. After pregnancies, you may be able to achieve some return of tone by exercise, but stretched midline fibrous support is difficult to recover. If this is bad enough, surgeons call this diastasis, or separation of the muscles. All people have the potential for a weakness at the base of the umbilicus (belly button), but pregnancy puts extra stretch on this area and can develop obvious weakness or an actual hernia. When abdominoplasty (tummy tuck) is done, it is common for the surgeon to suture tighten the fibrous support and muscles in the midline. This may eliminate the weakness at the base of the umbilicus. If a hernia is present, your plastic surgeon may decide it is reasonable to repair it. Most plastic surgeons have complete training in general surgery and are well qualified to do such repairs. If your surgeon feels a general surgeon should do the repair, he or she should explain this to you during your consultaiton. Combining umbilical herina repair and standard tummy tuck may increae the risk of poor healing of the umbilicus itself. The other risks should be minimally different than abdominoplasty alone. One final comment; you are young enough that additional pregnancies and children should be considered. I would advise delaying or modifying abdominoplasty if there is any possibility you would have future children.
Always keep your safety in mind in hernia repair
Thanks so much for your questions. An umbilical hernia repair and a tummy tuck can be performed at the same time… this is commonly done for simple hernia repairs. Most plastic surgeons have their background training in general surgery and are very competent in evaluating an umbilical hernia. I think it is reasonable to say, who repairs the hernia will depend upon the comfort level of the plastic surgeon and his/her level of proficiency.
If the umbilical hernia is small, many plastic surgeons would repair these themselves at the same time of the tummy tuck. If the umbilical hernia is moderate to large or complicated (not reducible), most plastic surgeons would pass this on to their general surgery collogues.
Additionally, the severity of the hernia would dictate whether a single or multiple-staged procedure is performed. Keep in mind that it is not so important who performs the hernia repair but rather you having a safe experience with a happy outcome. To minimize potential risks and complications, I would strongly advise that you see a board certified/eligible plastic surgeon who is experienced in body contouring and tummy tucks. I hope you find this advice helpful!
Abdominoplasty and Umbilical Herniorrhaphy
A protruding belly button is not always a hernia. It can be the result of a rectus muscle diastasis. In this instance the protruding belly button is easily repaired by one surgeon: the plastic surgeon.
However, assuming that it is a true umpbilical hernia and you are planning to have a full tummy tuck (not a mini), there is one primary concern:
- A full tummy tuck generally leaves the umbilicus on a little attachment or stalk.
- Performing an true umbiolical hernia repair requires surgical elevation and exposure of the base of the umbilicus which if done in conjunction with a tummy tuck will detach and compromise the blood supply.
In these instances, I work with a general surgeon who has experience performing laparoscopic ("inside out") repair of the umpbilicus through little incisions made after I elevate the skin so that these incisions are made in the muscle and not visible on the upper abdomen where they are typically placed. In this instance I do not performe the umbilical repair.
In terms of major complication rates, there may be an elevated risk of DVT with PE which ranges in the literature from 1 out of 3.500 to 40,000.
Combining Multiple Procedures With a Mommy Makeover
The Mommy Makeover is a combination of procedures to bring a woman’s body back to the way she looked prior to pregnancy. Most commonly some variation of a #TummyTuck and #BreastSurgery are performed. Additional procedures can include liposuction, umbilical hernia repair. The most common #breastprocedures include #mastopexy or #breastlift, #breastaugmentation, or #breastreduction.
Healing after a #tummytuck will require time. Some patients are out of bed and walking the night of surgery and every hour while awake. I allow my patients to return to work at one to two weeks with 14 days preferred. However, no lifting or straining. At three weeks, increased level of activity and full with no restrictions, at 6 weeks. #MummyTummy is a term given to modified tummy tucks which can use liposuction and skin tightening with radiofrequency such Vanquish, Vela3, thermage, thermiRF and others. The actual fat contouring can be done non-surgically as well with #UltraShape or Cool-Sculpting.
The costs of a #Mommy Makeover will depend on several factors. Such include the geographic location, the skill and experience of the surgeon, and operating room and anesthesia fees. Also, such #combined operations are often performed with our Gynecology colleagues. Tubal ligation is a common post pregnancy procedure which is done at the time of many of the surgeries included with Mommy Makeovers. Therefore, if you require a gynecologic operation or study (laparoscopy) and are considering a plastic surgery procedure, discuss these issues with your doctor.
If your surgeon feels you are a candidate, it may be possible to add additional procedures such as those you mention. #Combining these procedures decreases anesthetics, costs, and recovery time. Most importantly, your procedures should be performed by a #PlasticSurgeon who is board-certified and has a great deal of experience specializing in cosmetic #surgery. You will then greatly improve your chances of getting the result you desire, and, without the need for a revision surgery. It is suggested that you look at before and after photos of the surgeons actual patients, and read patient reviews. Gathering all of this information will help you make a well-informed decision.
Yes, rectus diastasis, umbilical hernia, and tummy tuck at the same time
Rectus or ventral hernia and umbilical hernia are common findings in women that also need a tummy tuck following pregnancy. All three procedures can be performed at the same time by your plastic surgeon. Mesh is rarely if ever needed in these common scenarios and sometimes insurance can cover a portion of the hernia repair. I would advise you to seek consultation with board certified plastic surgeon with experience in tummy tuck surgery.
All the best,
Dr. Remus Repta
Tummy Tuck & Hernia Repair Can be Done at the Same Time (Depending on Some Factors)
not unusual for patients undergoing abdominoplasty to have associated abdominal
wall hernias. The treatment of
these hernias is dependent upon a variety of factors including the size and
location of the hernia and the overall health of the patient.
hernias are large and recognized in the pre-operative period, most plastic
surgeons refer these cases to a general surgeon. Depending on the situation the plastic surgeon may elect to
stage the procedure or perform a combined procedure with the general
surgeon. In many cases hernia
repair is complicated and may require synthetic mesh. In other cases the procedure may require inpatient
abdominal wall hernias are small, they may not be recognized
pre-operatively. Under these circumstances
they are usually encountered during elevation of skin flaps. When this scenario arises most plastic
surgeons repair these hernias at the time of the abdominoplasty. If the hernia is complicated they may
consult a general surgeon.
you know that an abdominal wall hernia is present and you’re considering
abdominoplasty it’s important that this issue be discussed with your plastic
surgeon. Your surgeon should be
able to formulate a coordinated treatment plan so both procedures can be performed
Can Tummy Tuck and Hernia Repair Be Done at the Same Time by One Doctor?
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. Sometimes, hernia repairs are covered by insurance companies; you will need to check with your specific insurance company. Your plastic surgeon's office may be able to assist you with this inquiry. Best wishes.
Tummy Tuck and Hernia Repair Done at the Same Time
In my practice, I routinely perform a tummy tuck and a hernia repair at the same time. Of course the necessity of performing both procedures is determined during the initial in person consultation. It is important to seek the advice of a board certified plastic surgeon who has experience in performing both procedures.
Tummy tuck with umbilical hernia repair
The two can be combined. If they are not done by the same surgeon, it is important that the plastic surgeon be involved or at least watch the hernia repair in order to maintain a healthy umbilicus.
Hernia surgery and tummy tucks can be done at the same time sometimes by the same surgeon.