What is the Best Way to Get an Umbilical Hernia Fixed with Least Amount of Scaring?

Most umbilical hernias (i.e. the straightforward, previously unoperated hernias) can be repaired primarily through a small incision along the inside rim of the upper portion of your belly button. The incisions are barely perceptible once fully healed. Check out the hernias repaired at the link below:

When I repair umbilical hernias, I typically use a semicircular scar inside the rim of the belly button.  It allows be to repair the hernia with a scar that is difficult to detect. 

I am a board certified plastic surgeon as well as board certified general surgeon so I perform lots of umbilical hernia repairs for patients.  Sometimes by themselves, sometimes in combination with other procedures (breast or tummy).  In my practice, I generally fix this type of hernia through an infra-umbilical (below the belly button) incision.  Usually direct repair with sutures is possible.  Sometimes, if the skin is very stretched, some skin contouring of the belly button may be necessary to improve the aesthetic outcome.  Make sure you check credentials of your surgeon and make sure that they have performed this procedure before.

a periiumbilical incision is the  preferred exposure and it won't effect your  tattoo. do not do a laparoscopic approach with 3 incisions and a plug instead of actual repair. this needs old school approach. good luck

Hey Jen,

  This is a question I often get from my patients.  Not all plastics surgeons will fix a hernia, especially if it is not in combination with an abdominoplasty or tummy tuck procedure.  If your PS doesn't routinely do these you should seek the help of a general surgeon.  However, there are many PS, such as myself, that do. 

   From your pictures, it is obvious that you do not need a tummy tuck.  Therefore, the best way to fix your hernia is by making a small incision at the inside base of you belly button and using this small incision as an access point to fix your small umbilical hernia.  The incision is nicely concealed on the inside of the button.  This will take care of the hernia without leaving an unsitely scar.  Good luck, Erez Sternberg, MD.

Your umbilical hernia can be fixed with small incision around belly button. I would recommend a general surgeon or board certified plastic surgeon. Make sure that the incision would not go outside belly button.

This hernia looks pretty big, but the real issue is how big the hole in the fascia is that is letting the contents of the hernia out of your peritoneal cavity.

Often, when an umbilical hernia is present at the time of abdominoplasty, the plastic surgeon will repair it at the same time, especially if they are also board certified by the American Board of Surgery.  However, when no abdominoplasty is to be done, a general surgeon will do the repair.  

Sometimes, depending on the findings, it may be best to have a general surgeon there to fix the hernia even when an abdominoplasty is being done.  That is especially true if the hole in the fascia is larger, the skin is adherent to the hernial contents, or the plastic surgeon did not do a complete general surgery residency.  When an abdominoplasty is being done in the presence of an umbilical hernia, your plastic surgeon will tell you whether they are comfortable treating the hernia.

In this case, since you are not planning an abdominoplasty, you should consult with a general surgeon.  Your umbilical repair may be covered by insurance, especially when abdominoplasty is not being done.

You should be aware that general surgeons do the umbilical hernia repair differently.  They usually make the incision near the umbilicus, usually separate the skin of the umbilicus from the stalk of the umbilicus (which may complicate abdominoplasty should you decide to do it in the future), and and may use mesh and tissue overlapping to deal with larger hernias.

So if you are worried about the scar, be sure to discuss that with your surgeon.

Dear Jen,

You can have this corrected without any problem by the direct approach with a small incision at the depths of your umbilicus. I have done this many times. You will need the defect closed and some of the excess skin removed and you should be fine.

Dr. Romano