Umbilical or belly button hernias are common following pregnancy. This is because during pregnancy the abdominal wall stretches across the midline to accommodate your growing baby. As a result, the midline can be left with spreading, which is referred to as diastasis recti. The umbilical ring can also be stretched since it is a natural weakness in the abdominal wall. As a result of this stretching at the umbilical cord, a hole can be created through which abdominal and fat contents can bulge through to form what is then called an umbilical hernia. An umbilical hernia can also be a result of previous surgery in this region, such as a laparoscopy, which would make this area prone to weakness.
The danger with an umbilical hernia is that either an incarceration or a strangulation can occur. The former refers to when the contents of the hernia get trapped within the hernia while the latter refers to when the contents of the hernia get squeezed. Both these situations can lead to intestinal blockage and injury to the intestine. You may, therefore, need urgent and emergency surgery to correct the condition. Additionally, the abdominal fat and skin is stretched during pregnancy leading to excess wrinkled skin and diastasis recti. These two are the main indications for abdominoplasty.
An umbilical hernia can be safely and successfully repaired during an abdominoplasty/tummy tuck. This is, however, in the event that it is a small and not a secondary hernia. The main risk of repairing an umbilical hernia during a tummy tuck is injury to the umbilical skin’s blood supply. The umbilical cord has three blood supplies and after incision around the umbilicus during an abdominoplasty, one or two of the blood supplies are routinely severed. When moderate to large umbilical hernias are being dissected, the remaining blood supply may be injured leading to a belly button with no ability to survive. As a result, umbilical skin can be lost yet this is how the umbilicus forms. If it does not survive, the underlying repair could be jeopardized leading to infection if mesh is used. Conservative umbilical hernia repairs using suture techniques can be performed by larger repairs, and they should also be performed before any tummy tuck procedure.
A mini tummy tuck procedure, however, preserves the blood supply to the umbilicus. This allows for umbilical repairs to be carried out without the risk of umbilical issues. Any umbilical hernia repairs should be discussed at the time of your tummy tuck consultation. This way, an individualized and safe plan can be determined which can then be incorporated into your tummy tuck surgery and recovery. Getting your umbilical hernia repaired together with your tummy tuck is highly convenient and rewarding. It is also an awesome idea because for women who not only need their umbilical hernias repaired, having both at the same time makes dual use of just one incision.
As you consider having your umbilical hernia repaired, you should know that this is seen as a medical necessity by insurance companies. You may be eligible for reimbursement. The minute you add a tummy tuck to go with the umbilical hernia repair, you will need to pay for the tummy tuck out of your pocket as this is viewed as cosmetic surgery. To combine both procedure, your plastic surgeon has to fax a pre authorization sheet to your insurance company for the hernia repair. It may take up to six weeks to get a response from the insurance company. Your plastic surgeon will also be under pressure from the insurance company to show that you do need the medical procedure. Additionally, some insurance companies may insist that you have the procedure done by a specific surgeon. This eliminates the aspect of convenience for having both a hernia repair and a tummy tuck done at the same time. Weigh your options carefully and determine what works best for you even as you have both your tummy tuck and umbilical hernia repaired.
Dr. Gregory H. Croll is the owner of his own practice, and the leading doctor for tummy tucks in Columbia, MO.