Tummy Tuck with Hernia Repair- Experience Matters when Encountering Surprises*

A key component an abdominoplasty is the repair of diastases rectus. This is the stretching of the fascial covering of the rectus muscle which occurs after weight gain and pregnancies. Diastases recti is almost always encountered in women desiring tummy tucks. Because of the weakening of the fascia in the midline (linea alba), protrusion of abdominal contents can occur known as a hernia. Umbilical hernia is often found. Epigastric hernia occurs when a small opening in the midline linea alba results in protrusion of the patient's intra-abdominal contents. Usually, it is just some fatty tissue called preperitoneal fat. When intestine protrudes, it can lead to a dangerous condition. The intestine may be entrapped and lead to a life-threatening strangulated hernia. When evaluating the patient for abdominoplasty careful attention to any possible hernias has to be made. This 53 -year-old woman -year-old woman presented for abdominoplasty and noted a slight bulge in her upper abdomen. It was difficult to tell if this was a hernia, but Dr. Lyle suspected it was. In cases where potential complicated hernias are expected, preoperative imaging with a CAT scan may be necessary. In this case, during abdominoplasty, he encountered a very small epigastric hernia with preperitoneal fat contained within it without intestinal entrapment. Dr. Lyle was fully trained general surgery and was comfortable with the repair of this defect and reinforcement with diastasis repair.