Question:
Can you achieve a flat tummy after hernia repair with mesh?

I am 22 months post-op from open RNY. In October of last year I had a hernia repair with mesh. I had two c-sections using the same vertical incision, and had developed a hernia behind that incision. The hernia became very painful and my bowel became incarcerated, requiring immediate surgery. I wanted to combine this surgery with a tummy tuck, but did not qualify for my insurance to pay for the tummy tuck at that time. Anyway, once they opened me up they found out I had this large hernia and an umbilical hernia as well. Rather than repairing them seperately and leaving a weak spot between them, the surgeon felt it best to cut the tissue and deal with one large repair. So I now have a very large piece of mesh in my abdomen that goes from hip to hip. Just this month I was approved for abdominoplasty. I am wondering, since I have this huge piece of mesh in my tummy, will the surgeon be able to do any muscle tightening? I am afraid that I will come out of this surgery and lose the apron, but have a round basketball belly and look like I am 7 months pregnant all the time! I know everyone is different and I plan to ask my doctor about this when I see him in June, but if you have had a tt after hernia repair could you please share your experience with me? Thanks in advance!    — Jenny S. (posted on May 13, 2004)

May 13, 2004
I dont know about your indivual circumstances BUT I just had a abdominoplasty and hernia repair with NO muscles done and my tummy is FLAT.
   — star .

May 13, 2004
My doctor told me when there is roundness after a tt, that's because there is fat there and in order to get rid of the roundess you would have to lose belly fat or have lipo. I had a hernia and a completely flat tummy after her tt, but now it is rounded because she has gained weight. I had a hernia repair with mesh and the top part of my stomach protrudes more then the bottom part. It comes and goes as my weight fluctuates.
   — Lisa N M.

May 14, 2004
Hi Jessica, I had a large incisional hernia which required a 30 cm x 10 cm piece of mesh. If you hold your hands together with thumbs in that is approximately 10 cm. The surgeon who did the hernia repair went first and did his part then the plastic surgeon came in and did a panniculectomy. Eight lbs of skin and fat were removed. The PS would not do any muscle tightening as he did not want to go anywhere near the hernia repair. He said that because of the size of the hernia repair he had a very difficult time making a new belly button. It did work out and I have a tiny belly button. My stomach is not completely flat but that is ok with me. It doesn't look like I am pregnant at all and with clothes on I look flat. I can tuck in my shirts now! Cool. Wouldn't you know it that now untucked shirts are "in".....My twin sister, Carolyn, had a full TT 6 wks ago (mine was in January). She had a small hernia and her PS did the muscle tightening. BUT we can't see any difference in our tummies. Truthfully, she is probably still swollen and will end up flatter than I am. But I didn't have near the pain with the panni that she did with the TT. I am having a lot of burning pain still from the mesh though. We both have similar scars but she did have lipo on her tummy and I did not. We are exactly the same weight now. I was always the fatter twin, the one with the "rounder face" lol! Anyways, I can't do any crunches or any type of resistance weight training to flatter my tummy and build muscles. Maybe I will be able to do that someday but not until I am fully healed. That could be a year. I do not have any type of overhanging skin now in the pubic area so I won't have rashes, etc this year. I am thankful for that. Good uck with your surgery. Please keep us informed. Don't be disappointed if you can't have muscle tightening because just removing the excess skin is a 100% improvement. I will put pictures on my profile soon of me and my twin so you can see there is not that much difference in our tummies. Blessings,
   — Mylou52

May 15, 2004
It is much harder to tighten and sculpt the muscles with mesh in place. Sometimes mesh is needed to cover very large hernias, however. It is my preference to avoid the possible complications of mesh (extrusion, infection, recurrence of the hernia) which happen in a large percentage of patients over time, and use the patient's own muscles to cover the hernia.
   — DrL

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