Incidental Anterior Abdominal Hernias During Abdominoplasty

Anterior abdominal wall hernias, especially umbilical, are a relatively common finding among patients undergoing abdominoplasty. These individuals are usually postpartum or massive weight loss patients seeking abdominal contouring surgery. Incidentally discovered hernias include umbilical, periumbilical, epigastric, and incisional hernias. There is a plethora of literature discussing the repair of these hernias, alone, using general surgical standards of care. However, the literature is lacking as to the discussion of these hernia repairs when combined with abdominoplasty. Many times, these hernias may be repaired without the use of reinforcing mesh, especially when performing simultaneous rectus diastasis plication. By using an algorithmic approach to incidental hernias found at the time of abdominoplasty, repair can be performed to allow the best results of cosmesis and function with a recurrence rate on par with standard techniques. We will concentrate on umbilical, epigastric, and some incisional hernias. Large ventral and/or incisional hernias will not be covered here, as those generally need abdominal wall reconstruction or very large pieces of mesh.