Ventral Hernia and Obesity: A Contemporary Surgical Challenge.

Ventral hernias are abdominal wall defects classified as primary or incisional. Obesity is a significant risk factor, contributing to wound healing impairment and abdominal wall weakness. We present a 37-year-old female patient with obesity (body mass index (BMI) 48.9) who developed incisional hernia (IH) one year after laparoscopic sleeve gastrectomy. Imaging revealed infraumbilical and paraumbilical IHs, leading to surgical repair with anterior component separation, unilateral transverse muscle release, and retromuscular mesh placement. Abdominoplasty was performed for functional and esthetic improvement. The patient had a favorable postoperative course. Managing IH in obese patients requires a multidisciplinary approach, considering specialized surgical techniques and long-term follow-up to minimize recurrence. This case highlights the interplay between bariatric surgery, hernia development, and the need for tailored preventive and therapeutic strategies.