Combining Abdominal Hernia Repair With Abdominoplasty-Is it Safe?

BACKGROUND

Increasing obesity rates, GLP-1 receptor agonist adoption, and demand for body contouring procedures have created a population requiring both functional hernia repair and aesthetic abdominoplasty.

OBJECTIVES

To evaluate the safety and feasibility of concurrent abdominoplasty and hernia repair using a standardized approach.

METHODS

We conducted a retrospective case series on patients undergoing simultaneous abdominoplasty and ventral hernia repair at a single academic center (2018-2024). Primary outcomes included 30-day surgical site occurrences (SSOs), hernia recurrence, and reoperation rates. Secondary outcomes included operative efficiency metrics and patient-reported satisfaction. Statistical analysis used chi-square and 2-sided t-tests; P < .05 was significant.

RESULTS

This cohort included 20 patients. Mean age was 58.2 years, 75% were female, and there was substantial comorbidity burden (mean BMI 30.8 kg/m2; majority overweight or obese; 60% had prior hernia repair). Midline ventral/incisional, umbilical, inguinal, and complex/recurrent hernias were represented. Mesh reinforcement was utilized in 50% of cases. At a mean follow-up of 27.3 months, SSO occurrences were observed in 3 patients (15%): 2 seromas (10%) and one case (5%) of chronic drainage that resolved with bedside care. No hematomas, mesh infections, or hernia recurrences were identified. Mean total operative time was 306 minutes; reconstructive and aesthetic components averaged 115 and 167 minutes, respectively.

CONCLUSIONS

In this limited cohort of carefully selected patients, concurrent abdominoplasty with ventral hernia repair demonstrated an acceptable safety profile, with complication rates comparable to historical abdominoplasty alone benchmarks and no recurrences at intermediate follow-up. Larger prospective studies are warranted to refine patient selection and standardize best practices.

LEVEL OF EVIDENCE 4 THERAPEUTIC: For image description, please refer to the figure legend and surrounding text.