LAUSR

BACKGROUND Patients seeking cosmetic abdominoplasty often have umbilical hernias. Optimal management and safety of concomitant umbilical hernia repair with abdominoplasty is not well described. OBJECTIVES The goal of this study was to compare complication rates following abdominoplasty with or without umbilical hernia repair. METHODS A retrospective propensity score-matched cohort study of patients who underwent an abdominoplasty at Massachusetts General Hospital was performed. Direct umbilical hernia repair was performed using a fascial slit inferior or superior to the umbilical stalk. The fascial edges were approximated with 1-3 0-Ethibond sutures (Ethicon; Raritan, NJ) from the preperitoneal or peritoneal space. Propensity-score matching was used to adjust for confounding variables. RESULTS The authors identified 231 patients with an average age 46.7(SD 9.7) and BMI 25.9(SD 4.4). Nine (3.9%) had diabetes, 8 (3.5%) were active smokers, and the median number of prior pregnancies was 2. Two hundred twenty-three (96%) had a traditional abdominoplasty while 8(3.5%) underwent a fleur-de-lys approach. 90% had liposuction and 45.4% had simultaneous breast or body contouring surgery. The overall complication rate was 6.9%. Propensity-scores matched 61 pairs in each group (n = 122) with closely aligned covariates. There was no significant difference in total complication rates between abdominoplasty alone vs abdominoplasty with hernia repair. There were no cases of skin necrosis or umbilical necrosis in either group. CONCLUSIONS Performing umbilical hernia repair with abdominoplasty is safe utilizing the technique reported in this series.