If my Umbilicus Dies from Hernia Repair What Would Be the Problem with Implants?

I'm having a full tt with muscle and hernia repair along w/ BL and BA. My PS mentioned that if he thought my belly button would die that he wouldn't do the breast procedures b/c of possible infection. My question is: is there anyway to get around this, such as just taking antibiotics or is there something more serious that could happen? I really don't want to have 2 operations b/c of time off work. What would you normally do in this situation?

Doctor Answers 7

Augmentation with TT and umbilical loss

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Dear lotsobabies,

The loss of a belly button during abdominoplasty surgery is very rare.  However, you never mentioned the size of the hernia you have and/or it's location.  If it is an umbillical hernia or a large ventral (abdominal) hernia the possible loss of your belly button increases.  If your surgeon is concerned enough to ask you to seperate the procedures it is my advice that you listen to him/her as they have examined you.  An infection of a breast augmentation case is a complication that you definitely do not want.

West Palm Beach Plastic Surgeon

Belly button necrosis after Tummy Tuck and Hernia repair

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It is rare for a belly button to die after a Tummy tuck and hernia repair.  If it were to happen, it is hard to tell until a few days after the surgery.  I would think it would be fine to place breast implants at the same time as the tummy tuck. This is a common procedure to be done together.  However, your surgeon may be advising you against this since you may have a large umbilical hernia or a ventral hernia.  The complication of belly button necrosis would be higher in this case. 

Stanley Castor, MD
Tampa Plastic Surgeon
4.8 out of 5 stars 129 reviews

If my Umbilicus Dies from Hernia Repair What Would Be the Problem with Implants?

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Once the belly button stalk is separated from the skin, its survival depends on small blood vessels that run along the stalk. The same vessels may have been damaged by a previous or concurrent repair of an umbilical hernia. This is a known but uncommon complication which may be more commonly seen in cases of re-do tummy tucks or where there has been dissection around the belly button stalk.

Caution is to be appreciated in a surgeon and risk taking is not justified in most cases because they are you would suffer the risks a lot more than the surgeon.

The thinking that a dead belly button MAY allow the growth of bacteria which may then infect your breast implants is theoretically possible but I have never experienced it in any of my patients nor heard of it from my colleagues. This makes it possible but unlikely.

If you disagree with your surgeon's caution, discuss it with him. Just be aware that avoiding complications is A LOT cheaper than trying to correct them.

Peter A Aldea, MD

Peter A. Aldea, MD
Memphis Plastic Surgeon

Breast implants after umbilical necrosis

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Umbilical tissue loss after abdominoplasty wit a hernia repair is a risk and totally unrelated to any risks associated with breast augmentation.

Neal Goldberg, MD
Westchester Plastic Surgeon

Breast augmentation with abdominoplasty and hernia repair

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Your concern is reasonable but unfounded. If you asked most surgeons umbilicus death or necrosis is somewhere betweeen rare and uncommon after abdominoplasty. In most of those cases the skin death is not apparent on the operating room table. Your cases is different because of the hernia repair which I suspect is an umbilical hernia. In which case you will need to trust your surgeons judgement since you picked your surgeon and it sounds like he/she is being conscientious. To make you feel more comfortable just ask your surgeon how often he/she has to abandon the breast augmentation in such cases. I will bet you that the answer will be not very often.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Aaron Stone, MD
Los Angeles Plastic Surgeon

Tummy tuck and Combined Procedures

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Your surgeon considers your safety a highest priority, and if he feels that there may be a potential risk, I would definitely trust his judgement. Although the situation he describes would be unlikely, you can't fault him for being conscientious. There isn't much you can do to prevent this issue as it is a factor of blood supply to the umbilicus. Good luck with your surgery!

Derek Lou, MD
Houston Plastic Surgeon
5.0 out of 5 stars 11 reviews

If your plastic surgeon has concern about the combined procedure , I would follow it.

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The risk of belly button loss is rare but it does happen more in patients with hernia. If your surgeon wants to do it separate steps, I would follow.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.7 out of 5 stars 152 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.