I Have an Umbilical Hernia & Want 400cc Implants. 2 Big? Need a Tummy Tuck & All 3 Together? (Photo)

Question

I am a 40 yr. old mother. I am 5’6” 110 lbs. I would like breast augmentation with 400 cc silicone. The implant width for Mentor high profile is 12.3cm. (My breast width is 11.5 cm) Would this implant size fit? I need an umbilical hernia repair (was approved by insurance with a general surgeon). I am considering a tummy tuck at the same time with a plastic surgeon in my network. Do I need a modified tummy tuck? The general surgeon wants to put in a mesh for the hernia.

Lewis Albert Andres, MD · Answer

Hello! Thank you for your question! These procedures can be effectively and safely performed in one setting.  Fading an umbilical hernia is also reasonable - it is already in the surgical field and will provide great access for repair, while not adding much additional time or risks to the procedure itself. The breasts and tummy tuck are commonly performed together, often referred to as the "mommy makeover". If you are healthy and your surgeon decides that s/he could perform the procedures in a safe time for you, these procedures certainly can be done in one stage. Staging the procedures to have them performed at various times will likely not have any cost benefit for you. When you combine procedures, there is often a discount that is provided by the surgeon for multiple procedures. Also, when having multiple procedures performed at the same time, you save on anesthesia and facility fees, which otherwise are paid for with each individual procedure. In addition, you may benefit by the single recovery time. It is your decision as to whether you have your procedures performed in one or multiple stages, but your surgeon will give his/her recommendations. I would consult with a plastic surgeon well-versed in these procedures and discuss your concerns with your surgeon and see what your options are as well as have an examination. Your safety is ultimately the most important factor and is always on the mind of your surgeon when making such decisions. Hope that this helps! Best wishes for a wonderful result!

Richard J. Bruneteau, MD · Answer

It’s not unusual to perform
breast augmentation, tummy tuck, and umbilical hernia repair during the same
operative procedure. This approach offers the patient significant advantages
including lowered cost, improved results because of synergy and a single
recovery.

When this approach
is utilized patients need to be done having children. They should also be in
good health with no significant risk factors for surgery. It’s also important
that the plastic surgeon and general surgeon have a good working relationship,
so the procedure is well coordinated.

It’s difficult to
know what type of procedure you will ultimately need without performing a
physical exam. Your pictures suggest that a full abdominoplasty would be
appropriate, but a mini abdominoplasty might also be an option.

Your choice of
implant size and style doesn’t seem unreasonable but again it’s difficult to
say without an examination. This decision is based on the patient’s anatomic
findings and unique aesthetic goals.

It’s important that
you consult a board certified plastic surgeon. This surgeon should be able to
make an appropriate recommendation.

Larry S. Nichter, MD, MS, FACS · Answer

Breast implants/Breast Lift and Tummy Tuck as well as smaller procedures like an umbilical hernia repair are  Often Performed Together.Different surgeons will recommend different procedures including doing more than one at a time. Some surgeons also differ in ability, time it takes to do the same procedure and general. It makes this a difficult choice for patients. Based on my own experience I would do all at once as long as it takes 4 or less hours. Surgeons should never perform elective operations that they are uncomfortable performing or feel unwise for them, nor should t)hey be faulted for doing so. However, for me, I typically perform a tummy tuck and breast augmentation  at the same time and usually takes about 3-4 hours so I recommend this be done in one surgery and this is what many refer to a Mommy Makeover.Not only that,if you did not need a breast lift, I usually place breast implants through the Tummy Tuck incision but I prefer this technique. Tummy Tuck and Breast Augmentation Combination makes sense and is safe. Contrary to some of the answers I have found that the recovery time is not delayed and is the same as the tummy tuck procedure by itself. That is because you are healing simultaneously and not sequentially - both heal at the same time. The procedure only takes me about a half hour to 45 minutes longer than the tummy tuck alone. Best of all, I usually put in the breast implants through the tummy tuck incision so that there are no scars on the breasts.I have performed many of these combination procedures over the past few decades and think it is a great idea without significant increased complications

Tom J. Pousti, MD · Answer

Thank you for your question and pictures.

	From the photos it does look like you would be a good candidate for breast augmentation surgery as well as tummy tuck surgery and hernia repair.

	It would be in your best interests to be examined by well experienced board-certified plastic surgeons; you will receive the best advice after an examination and a full discussion of your goals, treatment options, and the pros/cons of each option.

	A hernia by definition is a full thickness defect in the abdominal wall whereas a diathesis recti refers to a separation/spreading of the abdominal wall muscles.

	The size and model of breast implant used may  make a  significant difference in the final outcome. Therefore, it is very important to communicate your size goals with your surgeon.  in my practice I find the use of goal pictures to be very helpful.  in your case you could use your own before breast-feeding pictures as the goal. I have found that the use of words such as “natural” or “C cup” or "fake looking" or "top heavy" means different things to different people and therefore prove unhelpful. 

	
	Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate. I use  intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the breast implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison. I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible.

Jeffrey E. Schreiber, MD, FACS · Answer

400cc looks like a good size for you.  As for your tummy, you'll most likely need a full tummy tuck to get rid of all of the excess skin and to tighten your abdominal muscles.

I Have an Umbilical Hernia & Want 400cc Implants. 2 Big? Need a Tummy Tuck & All 3 Together? (Photo)

Answers (10)

Answer: Breast Augmentation and Tummy Tuck with Umbilical Hernia Repair

Answer: Breast Augmentation and Tummy Tuck with Umbilical Hernia Repair

Answer: Choosing the size of your implants

Answer: Choosing the size of your implants

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I Have an Umbilical Hernia & Want 400cc Implants. 2 Big? Need a Tummy Tuck & All 3 Together? (Photo)

Answers (10)

Answer: Breast Augmentation and Tummy Tuck with Umbilical Hernia Repair

Answer: Breast Augmentation and Tummy Tuck with Umbilical Hernia Repair

Answer: Choosing the size of your implants

Answer: Choosing the size of your implants

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Recommended reading

Everything you need to know about Mommy Makeover

Our mission is to create a world where every investment in modern beauty is Worth It.