Diastases Repair with Umbilical Hernia Repair with Tummy Tuck, Raleigh,NC*

Umbilical hernia is a fairly frequent outcome after pregnancies and patients with extensive diastases frequently will suffer from these hernias. These patients are frequently cared for by general surgeons who repair the hernia and perhaps even place mesh . Recurrence is fairly common when the diastases is not addressed. This patient was a 32-year-old mother of 3 children had 3 C-sections and large babies. She had an umbilical hernia repair performed by the general surgeon but ultimately this recurred. She felt she still looked pregnant well after delivery of her last child and had significant laxity and loose skin of her abdomen. She underwent a full abdominoplasty with liposuction as well as repair of her umbilical hernia at the time of the diastases repair. She had significant improvement and flattening of her abdomen and successful repair of the hernia without the need for mesh. The patient still had some muscle laxity, and it was recommended that she do abdominal strengthening exercises to improve this. No amount of diastases tightening will improve poor muscle tone, so this frequently has to be worked on postoperatively. Diastases repair is an integral part of abdominoplasty. Umbilical hernias frequently can be repaired during abdominoplasty although special caution has to be taken as the blood supply to the umbilicus can be threatened. Loss of the umbilicus is a possibility. The diastases repair is a second layer of enforcement to prevent recurrence