Abdominoplasty Hernia Repair


Dr Bernard Beldholm

A tummy tuck with hernia repair provides a two-in-one solution for patients who wish to repair a hernia while at the same time removing unwanted loose skin on the tummy from pregnancy or major weight loss. A single surgery can fix both, reducing pain and downtime for the patient.

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What is a hernia?

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A hernia develops when there is a tear in the tissue or muscle that normally encases the intestines or fatty abdominal tissue. This causes a lump or bulge in the abdomen or groin, which can be painful. The protruding intestine or fatty tissue is encased in a thin membrane that lines the body cavity. Certain activities can worsen a hernia, such as bending over or lifting something heavy.

Visit this page to learn more about the abdominal wall anatomy.

Common hernia causes

Different kinds of hernias have different causes. What they all share in common is that it starts with pressure on the organs or intestines. Straining or lifting something heavy are two common activities that can lead to a hernia. While the body can normally withstand internal pressure, some patients have a weakness in the muscle or tissue that causes a break or tear. When this happens, the intestine or underlying fatty tissue gets pushed forward, causing a lump that is often painful.

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Hernia symptoms

If you notice a lump in your abdomen or groin, one of your first thoughts might be “Is it a hernia?”. And you may be right. While hernias can be painful, it is possible to have an asymptomatic hernia.

Common hernia signs and symptoms include:

  • Bulge or lump on stomach or pubic region
  • Tenderness near the lump
  • Difficulty lifting heavy objects
  • Pain when bending, coughing or straining
  • Nausea, vomiting or constipation (severe or infected hernias)
  • Minor hernias may have no symptoms

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Types of hernias

Hernias of the abdominal wall are common. Common hernia types include:

  • Incisional hernia: A weakness in the muscle or tissue may follow after abdominal surgery, resulting in a hernia near the old incision site.
  • Umbilical hernia: A weakness where the abdominal layers join near the belly button can cause a tear and lead to a protruding belly button. This is one of the most common hernias that are repaired during tummy tuck surgery.
  • Inguinal hernia: This hernia affects the groin and is more common in men. An abdominal weakness near the inguinal canal in the pubic region is the reason for its name.
  • Femoral hernia: A lump just above the thigh where it meets the groin is known as a femoral hernia. It commonly occurs in older women.
  • Spigelian hernia: A rare type of hernia affecting less than 2% of all patients, the spigelian hernia occurs near the surface abdominal muscles or lateral obliques.
  • Epigastric hernia: A lump above the belly button but below the sternum is often an epigastric hernia. This is one of the most common hernia repairs during a tummy tuck.

Are hernias dangerous?

The severity of a hernia can vary. While hernias don’t always require immediate medical attention, it is a good idea to get checked out by your doctor anyway. In some cases, a hernia can cause the organs or tissue to become infected or obstructed. Aside from that, a hernia can be painful and worsen as time passes. If you think you have a hernia, schedule a visit to your doctor as soon as possible. It’s better to be safe than sorry.

Many patients want to know, will a hernia go away on its own? Often, hernias do not simply go away.

Hernia treatments include open or laparoscopic surgery. However, if you are interested in getting a tummy tuck to remove loose skin, this provides a good opportunity to repair the hernia since abdominoplasty gives easy access to common hernia sites. That means you can fix two problems at once in a single surgery.

Tummy tuck with hernia repair

It’s not unusual for tummy tuck patients to present with a hernia. Women and men who want cosmetic surgery to get rid of loose skin on the tummy often do so because of a recent pregnancy or major weight loss (i.e. bariatric surgery). Both pregnancy and obesity weaken the abdominal muscles, which may lead to a hernia.

A tummy tuck with hernia repair gives patients a two-in-one solution. Abdominoplasty provides easy access to the abdominal cavity, making hernia repair possible. Click here to learn more about how abdominoplasty surgery exposes the abdominal wall.

The only hernias that would be difficult to repair during a tummy tuck are hernias that are very high in the abdomen, such as an incisional hernia from open gallbladder repair, for example. The recommended treatment for incisional hernias is mesh placement, however this can be tricky as part of a tummy tuck.

Hernia treatments

There are two methods used in hernia repair surgery.

Stitching hernias

It is possible to stitch hernias closed. However, in many cases this creates tension that can result in hernia recurrence. Unfortunately, hernia stitches have a high hernia recurrence rate compared to using mesh in many instances.

But hernia stitches should not be ruled out. In fact, they are very useful for repairing epigastric hernias and other ventral hernias during a tummy tuck. That is because during a tummy tuck, the muscles are plicated (stitched), thereby reducing tension that would normally result in hernia stitch failure. So, for epigastric and certain ventral hernia repairs as part of a tummy tuck, stitches may be all that are needed to treat the patient successfully.

Hernia mesh repair

The second method is mesh hernia repair. This is often the preferred method to treat hernias. The principle is that the mesh provides strength and reduces tension on the wound, preventing hernia recurrence. Mesh repair is almost always better for treating incisional hernias in particular.

Using mesh offers a versatile solution to hernia repair. There are absorbable and non-absorbable meshes that come in many different brands and mesh shapes. A mesh can be placed atop, inside or under a hernia, depending on the surgeon’s approach.

As you can see, both stitches and mesh can be used to treat hernias performed during a tummy tuck. 

Special considerations in hernia repair

A special consideration for hernia repair is the umbilicus. When performing a tummy tuck, it is important to preserve the blood supply of the umbilicus. Normally, umbilical hernia repair is done by detaching the umbilicus. However, in tummy tuck surgery, the umbilicus should be preserved. This is accomplished by placing mesh underneath the umbilicus through an incision away from the umbilicus itself.

Tummy tuck with hernia repair gives relief in 1 surgery

Getting a hernia repaired as part of a tummy tuck is a great way to solve two issues at once and get a great outcome. Not only will patients enjoy a slim, attractive physique after major weight loss or pregnancy, but they will also improve their health by removing the hernia once and for all. All it takes is one surgery. That means less downtime, pain, expense and time off work — which many patients appreciate.

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30 Belmore Rd
Lorn NSW 2320


This website contains adult content. You must be 18 years or over to read. All surgery carries risks. You should seek a second opinion before proceeding. Results vary from patient to patient. See our disclaimer.
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