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umbilical hernia in abdominoplasty

Fereydoun Don Parsa, Justin Cheng, Michael S Hu, Leslie Kim, Nikki Castel, Alan A Parsa
The umbilicus is an important aesthetic landmark of the abdomen. It possesses a dual blood supply that allows it to survive either on its stalk if the skin surrounding the umbilicus is incised, or through the surrounding subdermal circulation if the stalk is transected. This is an important concept to consider in order to avoid umbilical ischemia and necrosis during abdominoplasty, especially if there is any past surgical history suggesting alteration to its blood supply. This case study depicts this importance and the importance of the use of delay in order to improve perfusion to the umbilicus prior to secondary abdominoplasty...
January 11, 2018: Aesthetic Surgery Journal
Horacio F Mayer, Hugo D Loustau
Background: Postpregnancy full-length diastasis of the recti abdominis muscles is a common condition occasionally associated with atrophy of the subcutaneous fat located at the midline above and below the umbilicus. Objectives: The authors report a preliminary clinical experience with the suprapubic flap to prevent the late postoperative contour deformities of the postpregnancy abdomen. Methods: Between January 2005 and January 2015, all female patients undergoing abdominoplasty with the suprapubic flap were included in the present study...
October 14, 2017: Aesthetic Surgery Journal
Hristo D Shipkov, Ali Mojallal, Fabienne Braye
BACKGROUND: Umbilical hernias (UH) are common in postpartum patients seeking abdominal contouring surgery and the question of simultaneous abdominoplasty and UH repair is raised. This presents, however, a risk to the umbilicus vascularisation with possible umbilical necrosis. To minimize this risk we associated abdominoplasty with laparoscopic UH repair. The aim of this study was to present the technique of simultaneous abdominoplasty and UH repair and the first results. MATERIALS AND METHODS: Simultaneous abdominoplasty and laparoscopic mesh UH repair was analysed in the first 10 cases...
June 1, 2017: Folia Medica
Aravind Menon, Alagesan Ganapathi
The umbilicus contributes significantly to the cosmetic appearance of the abdomen especially in women. Loss of umbilicus may result not only in cosmetic disfigurement but also in significant psychological effects. Omphalectomy may accompany certain surgical procedures like ventral hernia repairs and abdominoplasty. For such patients, many techniques have been described by various authors in literature for creation of a neoumbilicus for good cosmetic appearance. In this report, we describe how a laparoscopic port site was utilized to create a neoumbilicus in a patient who required omphalectomy as a part of large umbilical hernia repair...
March 2017: Journal of Clinical and Diagnostic Research: JCDR
H Le Gall, N Reibel, A De Runz, J Epstein, M Brix
INTRODUCTION: Abdominoplasty procedures sometimes reveal the presence of ventral hernias (umbilical or trocar-site hernias). Our objective is then to deal with the excess abdominal skin and fat tissue at the same time as the ventral hernia. This can be done with a single surgical procedure combining abdominoplasty with umbilical transposition and laparoscopic ventral hernia repair (LVHR) with mesh. The main objective of our study is to assess the outcome of the combined procedure of abdominoplasty and LVHR with mesh, compared to abdominoplasty alone...
April 2017: Annales de Chirurgie Plastique et Esthétique
Ryan M Neinstein, Alan Matarasso, David L Abramson
BACKGROUND: Patients requesting abdominoplasty often have concomitant umbilical hernias and may request simultaneous treatment. The vascularity of the umbilicus is potentially at risk during these combined procedures. In this study, the authors present a technique for treating umbilical hernias at the time of abdominoplasty surgery using the Ventralex hernia patch. METHODS: A total of 11 female patients with a mean age of 39.4 years (range, 28 to 51 years) undergoing abdominoplasty with umbilical hernia repair with the Ventralex patch were included...
April 2015: Plastic and Reconstructive Surgery
Gilbert Zakine, Jean Baruch, Jean-Claude Dardour, Gérard Flageul
BACKGROUND: Perforation of one or several intraperitoneal organs during a liposuction procedure is an exceptional but underestimated complication. Knowledge of this complication is essential because of frequent delay in diagnosis and possible dramatic consequences. METHODS: Nineteen cases were evaluated by experts and are presented in a retrospective analysis. Sixteen women and three men, aged 24 to 72 years, were operated on in France between July of 2001 and January of 2012...
March 2015: Plastic and Reconstructive Surgery
Ioannis Petrakis, Sofia Xenaki, Alexandros Andreou, Georgιοσ Panagiotakis, George Chalkiadakis
BACKGROUND: Abdominoplasty is a surgical procedure which is commonly used for cosmetic purposes. However, there are very few reports in the world literature describing the abdominoplasty procedure for therapeutic purposes rather than for cosmetic reasons. METHODS: A 58 year old female presented with an excessive drooping belly and a concomitant minor umbilical stoma hernia, who suffered from chronic back pain, urinary incontinence, nerve atrophy of the low extremes, central-type obesity, gastric disorders, and spinal osteophytes who underwent abdominoplasty and umbilical hernia repair...
2015: International Journal of Surgery Case Reports
Pieter G L Koolen, Ahmed M S Ibrahim, Kuylhee Kim, Hani H Sinno, Bernard T Lee, Benjamin E Schneider, Daniel B Jones, Samuel J Lin
BACKGROUND: Massive weight loss following bariatric surgery causes unwanted excess skin and subcutaneous tissue. Intraoperative abdominal wall exposure during abdominal contouring surgery provides the possibility for concurrent ventral, umbilical, or inguinal hernia repair. The authors evaluated the incidence of postoperative complications following abdominal contouring surgery with or without concurrent hernia repair and the impact of surgical specialty. METHODS: Analysis of patients undergoing abdominal contouring surgery with or without concurrent hernia repair was performed using the American College of Surgeons National Surgical Quality Improvement Program from 2005 to 2011...
October 2014: Plastic and Reconstructive Surgery
Francisco J Villegas
BACKGROUND: Lipoabdominoplasty can be associated with complications, particularly tissue necrosis, wound dehiscence, epigastric bulging, high transverse scar, low positioning of the umbilicus, and seroma. METHODS: Modified abdominoplasty characterized by (1) transverse elliptical plication of the lower abdominal wall, (2) no undermining of the flap above the navel, (3) unrestricted liposuction, (4) umbilical amputation and neoumbilicoplasty by skin graft, and (5) low transversely placed abdominal scar (TULUA) was performed for 42 patients...
June 2014: Aesthetic Plastic Surgery
Catherine L McKnight, James L Fowler, William S Cobb, Dane E Smith, Alfredo M Carbonell
Concomitant mesh repair of large umbilical hernias and abdominoplasty pose a serious risk of devascularizing the umbilical stalk. A technique of placing mesh in a sublay manner, deep to the fascial defect, for an umbilical herniorrhaphy to avoid damage to the deep umbilical perforators during an abdominoplasty is described.
2012: Canadian Journal of Plastic Surgery, Journal Canadien de Chirurgie Plastique
J Kulhanek, O Mestak
PURPOSE: Postpartum rectus diastasis eventually combined with umbilical hernia is a condition that is frequently treated by plastic surgeons and general surgeons. Standard treatment of this condition is abdominoplasty with a periumbilical incision, which often results in an umbilical incision or an inverted-T scar. Limited incision abdominoplasty differs from traditional abdominoplasty by disconnecting the umbilical stalk from the abdominal wall during flap dissection, thus allowing the resection of excess skin above and under the umbilicus without causing periumbilical scarring...
August 2013: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Lindsay Damkat-Thomas, Nicholas Hodgins, Khalid Khan
Abdominoplasty is often requested by patients following massive weight loss or multi-gravida. We report the cases of three patients who had incidental asymptomatic hernias diagnosed intra-operatively during abdominoplasty. All patients had previously undergone laparoscopic procedures and two had subsequent massive weight loss. Routine pre-operative clinical examination may not identify a small trocar related hernia. Prior knowledge of such hernias would aid in operative planning and reduce the risk of potential complications...
March 2013: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Ming Bai, Meng-Hua Dai, Jiu-Zuo Huang, Zheng Qi, Chen Lin, Wen-Yun Ding, Ru Zhao
OBJECTIVE: To investigate the feasibility and clinical benefits of umbilical hernia repair in conjunction with abdominoplasty. METHODS: The incision was designed in accord with abdominoplasty. The skin and subcutaneous tissue was dissected toward the costal arch, and then the anterior sheath of rectus abdominus was exposed. After exposure and dissection of the sac of umbilical hernia, tension-free hernioplasty was performed with polypropylene mesh. After dissecting the redundant skin and subcutaneous tissue, the abdominal wall was tightened...
September 2012: Zhonghua Zheng Xing Wai Ke za Zhi, Zhonghua Zhengxing Waike Zazhi, Chinese Journal of Plastic Surgery
Aa Al-Shaham
BACKGROUND: Neoumbilicoplasties are indicated in congenital conditions associated with umbilical agenesis, umbilical loss due to inflammatory destruction, excision of skin cancer involving the umbilical stump and in surgical procedures for herniorrhaphy, as well as in the rare condition of umbilical endometriosis. OBJECTIVE: Neoumbilicoplasty is an adjuvant procedure that may be necessary during abdominoplasty with wide myofascial plication, or repair of concomitant hernias of the abdominal wall...
2009: Canadian Journal of Plastic Surgery, Journal Canadien de Chirurgie Plastique
Tara L Huston, Robert T Grant
A 71-year-old woman, one year following a fleur-de-lis abdominoplasty and incisional hernia repair, presented with two chronic, draining peri-umbilical sinuses. Her immediate postoperative course was complicated by a superficial surgical site infection with central skin breakdown that was treated with vacuum assisted closure (VAC). After the wound had closed completely, two midline sinus tracts developed. A CT scan demonstrated an 8x3x1.6cm thick-walled collection along the anterior abdominal wall containing numerous air bubbles...
May 2010: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Gilberto Guzmán-Valdivia, Teresa Soto Guerrero, Hilda Varela Laurrabaquio
INTRODUCTION: Parastomal hernia occurs in 35%-50% of patients who have had a stoma formed, whether for the digestive tract or the urinary tract. There are many repair techniques including primary repair and repair using different types of mesh prosthesis, and the surgical approach may be open or laparoscopic. However, all techniques suffer the disadvantage of a high index of hernia recurrence. PATIENTS AND METHODS: This study included 125 patients from the stoma clinic at our hospital...
March 2008: World Journal of Surgery
Robert H Caulfield, Atoussa Maleki-Tabrizi, Farrukh Khan, Venkat Ramakrishnan
Abdominoplasty is a procedure commonly performed by the modern reconstructive plastic surgeon, but despite its apparent routine nature complications are well documented in the literature and should be respected by even the most experienced plastic surgeon. Seroma is one of the most common complications known, however, most seromas usually occur within a few months following the primary procedure, are easily identifiable clinically as seroma and respond to simple aspiration, or resolve without any further intervention...
January 2009: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Luiz Fernando da Costa, Alan Landecker, Anísio Marinho Manta
In morbid obesity, contour deformities of the abdomen are common after bariatric surgery and radical weight loss. Traditional abdominoplasty techniques often fail to maximally improve body contour in these cases because adjacent sites such as the hip rolls and flanks are not treated, leaving the patient with large lateral tissue redundancies and dog-ears. In an attempt to solve these challenging problems, the authors present the modified vertical abdominoplasty technique, a single-stage procedure that involves a combined vertical and transverse approach in which an "en bloc" resection of the redundant tissues is performed without undermining, drainage, or reinforcement of the abdominal wall...
December 2004: Plastic and Reconstructive Surgery
Zol B Kryger, Neil A Fine, Thomas A Mustoe
The use of conscious sedation is rapidly gaining acceptance and popularity in plastic surgery. At the present time, many procedures are performed using intravenous sedation and local anesthesia. The purpose of this article was to examine the safety and outcome of full abdominoplasties performed under conscious sedation at the authors' institution. Over a 6-year period from 1997 to 2002, 266 abdominoplasties were performed by the two senior authors. One hundred thirteen of these (42 percent) were performed under a general or regional anesthetic because a concurrent procedure was performed that precluded the use of conscious sedation (64 hysterectomies, 18 hernia repairs, six urogynecologic procedures, 10 breast reductions, and one laparoscopic cholecystectomy) or because of patient and surgeon preference (14 cases)...
May 2004: Plastic and Reconstructive Surgery
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