Can I Have a Hernia Repair with Tummy Tuck (Abdominoplasty)?

Combining a Hernia Repair with Tummy Tuck – Abdominoplasty Procedure

When considering a tummy tuck, known medically as abdominoplasty, you might not immediately consider the possibility of addressing another common issue at the same time: repairing a hernia with a Tummy Tuck. A hernia occurs when an organ or fatty tissue squeezes through a weak spot in a surrounding muscle or connective tissue. While hernias can appear in various body parts, they are most commonly found in the abdomen.

Abdominoplasty, on the other hand, is a cosmetic procedure aimed at creating a firmer, smoother abdominal profile. It involves the removal of excess skin and fat and may include tightening of the abdominal muscles. However, for some, a hernia is beneath the surface, potentially complicating aesthetic aspirations. Combining hernia repair with tummy tuck (abdominoplasty) can be a practical solution, offering a dual benefit that addresses both functional and cosmetic concerns in one surgical intervention.

In this blog, Sydney Specialist Plastic Surgeon Dr Bish Soliman will explore what a hernia is, discuss the specifics of abdominoplasty and the advantages of combining these two procedures.

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What is a Hernia?

A hernia is a condition that occurs when internal organs or other body parts protrude through the wall of muscle or tissue that normally contains them. This can happen due to a variety of reasons, including congenital weak spots, strain on the abdominal muscles, or after surgical procedures that weaken the abdominal wall.

The most common types of hernias are inguinal (occurring in the groin), umbilical (around the navel), and incisional (through a scar or site of previous surgery). Symptoms can range from a noticeable bulge or lump to pain or discomfort, particularly when coughing, bending over, or lifting heavy objects. In some cases, hernias may be asymptomatic and only discovered during medical examinations for other conditions.

Understanding the nature of hernias is important because they don’t resolve on their own and can lead to complications if left untreated. Surgical intervention is the only definitive treatment for a hernia.

Abdominoplasty (Tummy Tuck) Procedure

Abdominoplasty, commonly referred to as a tummy tuck, is a surgical procedure that aims to reshape and firm the abdominal region. This is accomplished by removing excess skin and fat, and in many cases, restoring weakened or separated muscles. The result is a smoother, firmer abdominal contour that is more proportionate with your body type and weight.

The procedure is particularly beneficial for individuals who have gone through significant weight loss, pregnancy, or have a protruding abdomen that doesn’t improve with diet and exercise. During the procedure, an incision is made from hip to hip just above the pubic area, and the abdominal muscles are tightened with sutures. Excess skin is trimmed away, and the remaining skin is pulled tight and sutured in place.

Abdominoplasty can be tailored to the needs of the individual, with variations such as the mini-tummy tuck (abdominoplasty) or extended abdominoplasty being available depending on the extent of the surgery required.

The Dual Benefit – Hernia Repair with Tummy Tuck (Abdominoplasty)

Hernia repair with abdominoplasty is a synergistic approach that maximises the impact of a single surgery. By correcting the hernia and simultaneously performing abdominoplasty, you not only achieve the desired cosmetic alteration but also address any health issues associated with the hernia.

The dual benefit is particularly valuable for patients who have an umbilical or ventral hernia, where the abdominal wall has weakened, often exacerbated by pregnancy or obesity. Combining hernia repair with a tummy tuck – abdominoplasty allows for the correction of the hernia while taking advantage of the already planned abdominal surgery to improve the overall appearance of the abdomen.

In this combined procedure, Dr Soliman will repair the hernia by returning the displaced tissues to their proper position and reinforcing the weak area, often with the use of a mesh. Following the hernia repair, the abdominoplasty is performed as usual. This approach reduces the overall recovery time compared to having two separate surgeries, and it also means a single recovery period.

Advantages of Combining Hernia Repair with Tummy Tuck (Abdominoplasty) Procedure

Integrating hernia repair into your abdominoplasty offers some advantages.

• It’s cost-effective because you are combining two procedures into one surgery, which means one anaesthesia fee, one facility fee, and one surgical team fee. It also means a single period of time off work and other daily activities for recovery.
• Another advantage is the reduced risk of complications. Any surgery carries risks, but by combining procedures, you reduce the cumulative risk associated with having multiple surgeries. Also, since the abdominal wall is already being addressed in the tummy tuck – abdominoplasty, Dr Soliman can more easily access and repair the hernia, often with greater precision and effectiveness.

Who is a Good Candidate for Hernia Repair with Tummy Tuck (Abdominoplasty)?

Good candidates for hernia repair with abdominoplasty are individuals who have both a hernia and the desire for abdominal contouring. Candidates should be in good general health, non-smokers, or willing to quit smoking, as smoking can impede the healing process. It’s important that candidates have realistic expectations about what the surgery can achieve and are committed to maintaining a stable weight post-surgery.

Patients who have experienced significant weight loss, women who have had multiple pregnancies, or individuals who have a ventral or umbilical hernia alongside excess skin and fat in the abdomen, may especially benefit from this combined approach. It is also important that candidates are not planning future pregnancies, as this could reverse the effects of the abdominoplasty.

What to Expect During a Combined Hernia Repair and Abdominoplasty

When undergoing a combined hernia repair and abdominoplasty, the procedure typically follows these steps: anaesthesia is administered, Dr Soliman makes an incision across the lower abdomen, and the hernia repair is performed first. If a mesh is required for the hernia repair, it is placed and secured. Following this, the abdominoplasty is carried out as it would be in a standalone procedure.

The entire operation can take several hours, depending on the complexity and size of the hernia and the extent of the abdominoplasty. The incision is then closed with sutures, and the area is bandaged. Drains may be placed to prevent fluid accumulation, and you will be fitted with a compression garment to minimise swelling and support the repaired tissues.

It’s important to follow Dr Bish Soliman’s instructions on how to prepare for the surgery, including guidelines on eating, drinking, and which medications to avoid. You should also arrange for someone to drive you home and stay with you for at least the first night after the procedure. (nts done go home the next day after an abdominoplasty, they stay 3-5 days)

Recovery and Aftercare – Hernia Repair with Abdominoplasty

Recovery from a combined hernia repair and abdominoplasty takes several weeks. During the initial recovery phase, it is normal to experience discomfort, swelling, and bruising. Pain can be managed with prescribed medications.

You will need to limit physical activity, especially heavy lifting, for several weeks to allow your body to heal correctly. Gradually, you will be able to resume normal activities, but full recovery can take several months.

It is also important to maintain a healthy lifestyle after recovery to preserve the results of your surgery. This includes eating a balanced diet, engaging in regular exercise once fully healed, and avoiding any activities that could strain the abdominal area.

Potential Risks and Complications

As with any surgical procedure, combining hernia repair with abdominoplasty carries potential risks and complications. These can include infection, bleeding, blood clots, poor wound healing, and reactions to anaesthesia. There is also the risk of hernia recurrence or complications related to the use of mesh in hernia repair.

Specific to abdominoplasty, there may be issues with scarring, numbness, or changes in skin sensation. It is also possible for asymmetry or unsatisfactory aesthetic results to occur, which may necessitate additional surgery. It is important to have a thorough discussion with Dr Soliman about these potential risks and how they apply to your particular case.

FAQs about Hernia Repair with Tummy Tuck Abdominoplasty

Does Medicare Australia cover hernia repair with abdominoplasty?

• Medicare Australia can cover some of the costs of the hernia repair surgery when it is deemed medically necessary, as hernias can pose significant health risks if left untreated. However, abdominoplasty is generally considered a cosmetic procedure and is not usually covered by Medicare unless it is part of a medically necessary operation, such as significant abdominal reconstruction following major weight loss or pregnancy. When abdominoplasty is combined with hernia repair, Medicare may cover the hernia repair component of the surgery, but patients are likely responsible for the costs associated with the abdominoplasty portion. It’s essential for patients to consult with Dr Soliman’s team directly to understand the extent of the Medicare coverage and the out-of-pocket costs they may incur.

How long is the recovery time after abdominoplasty with hernia repair?

• The recovery time after undergoing abdominoplasty with hernia repair can vary depending on the extent of the surgery, the patient’s overall health, and how well the patient follows post-operative care instructions. In general, patients can expect a recovery period of 4 to 6 weeks before they can return to their normal daily activities. During the first few weeks, patients may experience swelling, discomfort, and the need to wear a supportive abdominal garment. It’s crucial to avoid strenuous activities and heavy lifting during the recovery period to ensure proper healing.

How much is a tummy tuck – abdominoplasty with hernia repair in Sydney?

• The cost of abdominoplasty with hernia repair in Sydney can vary widely depending on several factors, including the surgeon’s experience, the complexity of the procedure, and the facility where the surgery is performed. On average, patients might expect the cost to range from AUD 10,000 to AUD 20,000 or more. This price includes surgeon fees, anaesthesia, hospital or surgical facility costs, and post-operative care. It’s important to note that these estimates do not include potential Medicare rebates for the hernia repair portion of the surgery. Patients should consult with Dr Soliman’s team for a detailed quote and inquire about any available financing options or payment plans. Need to make it clear that cost depends on whether the patient is a candidate for an item number and whether they have private insurance etc as then the hospital cost will be covered.

What should I know before getting an abdominoplasty with hernia repair?

• Before undergoing abdominoplasty with hernia repair, patients should be well-informed about the procedure, the recovery process, and the potential risks and complications. It’s important to have a thorough consultation with Dr Soliman who can assess your medical history, discuss your aesthetic goals, and explain the expected outcomes and limitations of the surgery. Patients should also be aware of the importance of having realistic expectations and the commitment to maintaining a stable weight post-surgery to ensure lasting results. Preparing for the recovery period by arranging for help at home, taking time off work, and following Dr Soliman’s pre- and post-operative care instructions can impact the success of the surgery and the smoothness of the recovery.

Further Reading about Abdominoplasty Surgery with Sydney Specialist Plastic Surgeon Dr Bish Soliman

• Read Dr Bish Soliman’s How to Sleep Better After Tummy Tuck – Abdominoplasty Blog
• Read Dr Bish Soliman’s Preparing for Tummy Tuck Surgery (Abdominoplasty) Blog
• Read Dr Bish Soliman’s Lipoabdominoplasty for a Contoured Stomach Blog
• Read Dr Bish Soliman’s Medicare for Abdominoplasty Blog
• Read Dr Bish Soliman’s Abdominoplasty vs. Liposuction or Combined Procedures Blog

Medical References about Hernia Repair with Abdominoplasty

• Abdominoplasty repair for abdominal wall hernias
• Incisional abdominal hernia repair with concomitant abdominoplasty: Maintaining umbilical viability
• Abdominoplasty repair for abdominal wall hernias
• Abdominoplasty with simultaneous laparoscopic umbilical hernia repair
• Recognition and repair of an incidental umbilical hernia repair during abdominoplasty