How Do I Get Rid of Looking Pregnant and Umbilical Hernia?

Question

I am 30 yrs old two kids second pregnancy left me with a umbilical hernia. Both delivered by c-section and i just can't get rid of this belly. I look pregnant still. What can help me get a flat tummy again. I dont have extra skin just a pop belly. Help

Gary M. Horndeski, MD · Answer

The best technique is an abdominoplasty with mesh reinforcement.  This technique provides mechanical strength by using a large piece of mesh sewn side to side to create a more hourglass figure and flat stomach.  The reason you look pregnant is because your fascia (the strength layer) has stretched out.  Your muscle is only functional when it is contracting, so it is your fascia that determines your shape.  Pregnancy has damaged your fascia irreversibly and mesh is used to reinforce the fascia.  Extra skin can also be resected as in ordinary tummy tucks but that is not the only problem if you look pregnant.  The umbilical hernia is a tear in the fascia which needs to be corrected.  There have been recent articles published in Plastic and Reconstructive Journal describing this technique.

	Best Wishes,

	Gary Horndeski, M.D.

Jed H. Horowitz, MD, FACS · Answer

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.

#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 a #MommyMakeover. If you require a gynecologic operation or study (laparoscopy) and are considering a plastic surgery procedure, discuss these issues with your physician and board-certified plastic surgeon. Also, combining these #procedures may decrease anesthetics, costs, and recovery time.

In addition to a one-on-one consultations with a board certified Plastic Surgeon, patients always need to be seen by their primary care doctor prior to such procedures.  We screen every patient and their medical records for risks of blood clots (DVT) and then take appropriate measures.  MWL (massive weight loss patients of  75 lbs or more) tend to have poor skin elasticity and will frequently need additional tightening even afte 6 -12 months regardless of who or how their surgery is performed. This is simply the nature of such body tissues and the ability to heal with the lack or limited elasticity.

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.

Kevin Tehrani, MD, FACS · Answer

While few patients are good candidates for a mini abdominoplasty, your description is one that fits. This can be done through your c section scar and slightly bigger if necessary. Your abdominal wall muscles are then plicated (best endoscopically) and your umbilical hernia repaired at the same time. Best of luck.

Douglas L. Gervais, MD · Answer

Many women have weakened abdominal walls and umbilical hernias after pregnancy with little or no excess skin. There are several ways to approach this problem including umbilical incisions and mini or limited incision abdominoplasties. You need a thorough exam by a board certified plastic surgeon to determine what is best for you. Good luck.

Brent Moelleken, MD · Answer

For selected patients, there are short incision techniques to tighten the fascia (the bulge), repair the umbilical hernia, and remove varying amounts of skin.

	There is actually a range of procedures available depending on the patient's tolerance for scar length and position, etc.

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