Umbilical hernia and Diastasis repair, mesh or no mesh?

Question

I have some ab muscle separation and umbilical hernia. I thought about a tt but the time and risk associated seems like overkill. I started looking at hernia repair and all general surgeons I spoke with use mesh. With all the stories around mesh and difficulties finding a general willing to do another method I am wondering if a plastic surgeon would do an umbilical hernia repair and “remake” my belly button with out mesh. Is that just as risky as tt or mesh?

Kenneth Hughes, MD · Answer

In most cases, I can repair an umbilical hernia at the time of the tummy tuck without the aid of mesh, but I would need to examine you to make a better determination.  I have not used a mesh in about 1000 tummy tucks, but there may be need in certain instances for mesh. "Remaking" the belly button will not present a challenge for an experienced surgeon.

Ronald Friedman, MD · Answer

Umbilical hernia repairs can almost always be accomplished without mesh if you are undergoing a full tummy tuck at the same time.  Why?  The fascia (fibrous tissue) between the rectus abdominis (sit up) muscles is generally tightened 4 to 6 inches with a tummy tuck.  So any tension on the hernia repair will be counteracted by the fascial tightening.  The removal of the skin around the belly button with tummy tuck also allows for a much more attractive belly button in most patients.Umbilical hernia repairs performed alone may require mesh for hernias more than about 3/4" in diameter because the tissues may simply tear again (causing a recurrent hernia) if too much tension is placed upon them.  Although an umbilicoplasty may be performed to remove a small amount of excessive skin above the belly button, the results will fall far short of those accomplished with simultaneous tummy tuck.

Robert Applebaum, MD · Answer

Repairing an umbilical hernia can be done without mesh if the hernia defect is under 1.5-2.0 cm.  If the defect is larger and that is a good sized hernia then mesh is indicated to prevent recurrence.  Your umbilicus appearance cannot be changed much with the exception of the fullness form the hernia will be gone.  With a tummy tuck the umbilicus can be redone to look more youthful.  Without a tummy tuck your umbilicus appearance will remain very similar after a simple hernia repair.

Umbilical hernia and Diastasis repair, mesh or no mesh?

Answers (3)

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