Hernias are a medical condition that can cause severe pain and health complications. In fact, they can prove to be nearly fatal, if not treated both immediately and appropriately. One of the main risk factors for hernia development is obesity and losing a significant amount of weight can leave people with excess skin that may require surgical excision.
Removal of this excess skin from your abdominal region along with tightening of the abdominal muscles, if needed, is referred to as an abdominoplasty procedure. Moreover, this procedure can result in a hernia – specifically, an incisional hernia that can occur at the site of the incision. It is important to note that this is not a common complication of the abdominoplasty procedure.
As these conditions may occur together, we can combine the hernia repair surgery and abdominoplasty procedure. An abdominoplasty procedure involves tightening of skin and muscle. This results in changes to the natural contours of the abdomen, which also provides an opportunity for hernia repair as this condition arises due to weakness in muscle tissue.
What is an abdominoplasty procedure?
The purpose of an abdominoplasty is to remove excess skin. This is common after you have; lost a lot of weight, undergone multiple pregnancies, or if your abdominal wall muscles have weakened and separated from overlying loose skin.
An abdominoplasty procedure is a major surgical procedure. It should be performed by a specialist, board-certified plastic surgeon. The surgery will be done using either general anaesthesia or local anesthesia and intravenous sedation.
Fortunately, you will be able to go home either the day of or the day after your surgery. Your recovery period for this procedure will last for about 4 weeks to 6 weeks.
Thinks to consider before Abdominoplasty Surgery
In order to be considered for an abdominoplasty, you should be;
- Finished having children.
- At your ideal weight. This needs to be stable to avoid interfering with the results of the procedure.
- Aware of the risks and complications.
- Sure that you are undergoing this procedure for yourself and not to meet anyone else’s expectations.
Your surgeon will discuss all of these points with you during your consultation to ensure you meet the criteria.
Benefits of an abdominoplasty procedure
An abdominoplasty procedure can significantly alter the appearance of your abdomen. It aims to reduce loose skin while tightening your abdominal muscles.
What is a hernia?
A hernia is a large area of tissue that protrudes out of a weak spot in the muscles, which can either be present from birth or develop gradually.
Some of the most common causes of hernia in adults, (meaning hernias not present at birth) include;
- Straining while defecating
- Obesity
- An increase in abdominal pressure due to persistent coughing.
All the above cause muscles to weaken. Internal organs such as the intestines then begin to push against this weak spot, breaking through and protruding through the break in the muscle wall.
A hernia presents as a protruding area that may disappear on laying down and reappear in specific situations like coughing, laughing, and straining. It may come with pain that becomes so severe that it affects your ability to perform your daily tasks. Hernias, based on their location, are classified into different types with the statistics varying greatly per type.
Types of hernia and their repair
The three most common hernia types are inguinal hernia, femoral hernia, and umbilical. All of these hernias can occur in adults as a result of a triggering factor. However, umbilical and inguinal hernia, (specifically the direct subtype of inguinal hernia) have higher incidence rates as congenital hernias, or hernias present at birth.
Another interesting fact is that hernias are a common occurrence in males but not so much in females. The only exception to this statement is femoral hernias which occur mostly in females.
Other types of hernias include; incisional, epigastric, sliding Hiatal, and Spigelman hernias. Incisional hernias are a rare yet possible side effect of the abdominoplasty procedure. This is because the incision can be a “weak spot” in the muscle through which internal organs can protrude out.
As the symptoms and statistics for each hernia type differ, so does the treatment. Minimally invasive laparoscopic surgery is preferred for inguinal hernias, whereas most abdominal hernias, like acquired umbilical hernias, require open surgery.
Moreover, umbilical hernia present at birth does not require immediate medical treatment. In fact, just a follow-up is sufficient for up to five years of age, by which it generally treats itself. However, a femoral hernia should be treated immediately as there is a risk of the hernia compressing nearby blood vessels which are crucial for the blood supply of the legs.
Treatment is almost always surgery. Either a plastic surgeon or general surgeon can perform the surgery.
Can I have an abdominoplasty and hernia repair together?
Yes, you can have abdominoplasty and hernia repair done together. If you are suffering from both an umbilical hernia and excess skin or separation of abdominal muscles, then you could be eligible for an umbilical hernia repair procedure combined with an abdominoplasty.
While a plastic surgeon will perform the abdominoplasty procedure you will need a referral to a general surgeon first to ensure that the hernia is repairable during the abdominoplasty procedure. This is because not all hernia types are easy to fix with an abdominoplasty. We want to minimise complications, not extend the duration of surgery by performing two major, time-consuming procedures together when it’s not recommended. So, once your general surgeon gives the all-clear, both surgeons then perform the procedure.
The combined abdominal hernia repair and abdominoplasty procedure are performed in such a manner because both procedures focus on similar aspects of strengthening the muscles and the aesthetics of the abdomen.
Book a Consultation
Before you undergo this combined procedure, you need to book a consultation with a board-certified, skilled specialist plastic surgeon. During this consult, the surgeon will assess you and see if you are a good candidate for the procedure.
Your surgeon, before referring you to a general surgeon, will ask for either MRI or CT scan to figure out:
- How the hernia came to be
- The hernia location
- The exact location of the muscular weak spot.
- This can help determine if a surgeon can combine the hernia repair and abdominoplasty together.
- If the location of the weak spot is far away from the abdominoplasty incision site, then it’s most probably not possible to combine the procedures.
Frequently Asked Questions
Can an abdominoplasty help a hernia?
- Yes, you can combine an abdominoplasty procedure with a hernia repair procedure, especially umbilical hernia repair.
- However, it is not possible for an abdominoplasty procedure alone to help improve the symptoms or treat your hernia.
- Patients must opt for either a hernia repair with the abdominoplasty procedure or have the procedures done separately.
Will insurance cover hernia surgery and abdominoplasty?
- Insurance providers generally do not cover any procedure that isn’t medically necessary, such as elective procedures and cosmetic surgery procedures.
- Usually, an abdominoplasty is not eligible for coverage by private health insurance.
- A panniculectomy, on the other hand, may be covered. It basically includes the removal of a large amount of loose skin in the lower abdomen.
- Hernia repair surgery is medically necessary. In other words, insurance providers will most likely cover some of the cost, if you fit the criteria.
- If performed with an abdominoplasty, part of the cost that pertains to the costs of hernia repair may be covered.
Speak to your insurance providers beforehand so as to not stress out during the recovery period.
Do plastic surgeons fix hernias?
- Yes and no. Plastic surgeons and general surgeons both can fix and treat hernias. However, it is usually a general surgeon who performs the hernia repair procedure.
- Plastic Surgeons can perform Hernia repair in conjunction with other plastic surgery procedures, in the presence of a general surgeon for the hernia repair.
How long does it take to recover from abdominal hernia surgery?
- Abdominal hernia surgery is a major surgery.
- However, in most cases, it only requires a day or two in the hospital.
- Recovery after that may last for a couple of weeks.
Is a hernia operation a major surgery?
- The hernia repair procedure is a major surgery.
- General anesthesia is necessary for the procedure.
- It requires a couple of weeks for recovery.
What qualifies you for an abdominoplasty?
- To qualify for an abdominoplasty procedure, you must be:
- Physically and mentally healthy
- Mentally ready for an abdominoplasty procedure
- At your ideal weight, with no plans of losing a significant amount of weight
- A non-smoker or willing to quit smoking at least 8 weeks prior to the procedure
- Not planning on getting pregnant again
- Ready to maintain your weight as fluctuations of weight can impact the results of the procedure
- Concerned about abdominal skin as a result of losing a significant amount of weight or undergoing multiple pregnancies
What does an incisional hernia look like?
- An incisional hernia basically looks like a lump or protrusion at the site of an old incision like an abdominal surgery incision or cesarean section incision.
How big can a hernia get in your stomach?
- Hernias, if not treated, will keep increasing in size and can even begin to compress the nearby structures.
- Most commonly, enlarged hernias begin to compress the small intestines, resulting in a condition known as small bowel obstruction.
- This obstruction can cause severe pain and gastric distress, often requiring surgical treatment.
Moreover, hernias that have gotten so big that they cannot easily move in and out of the weak spot in the muscle can become strangulated and incarcerated.
The above are medical terms for hernias that are stuck and the protruding part is not receiving blood supply. This results in tissue and organ death, which can be a fatal complication of a large hernia. This is why early treatment of hernia is important.
