A Retrospective Comparison Of Postoperative Complication Rates In Combined Versus Separate Ventral Hernia Repair And Abdominoplasty

Purpose: Ventral hernia repairs and abdominoplasties are common procedures in the United States. Given the prevalence of each operation, there is a separate population of patients who desire both to be performed concomitantly. Ventral herniorrhaphies often leave patients with excess soft tissue and muscle laxity, for which many seek secondary surgery, such as abdominal wall reconstruction, to correct. Despite its advantages, there is concern that combining both operations may increase the risk of postoperative complications, including hernia recurrence. There is limited literature describing outcomes of combining both procedures, and the conclusions drawn from these studies vary regarding the durability of hernia repair and the overall safety of the combined surgery. The purpose of this study is to determine whether combining the two operations carries increased morbidity. Methods: A retrospective review of cases performed by a combined Plastics and General Surgery team at a single institution between October 2016 and April 2025 was performed. Forty-two patients who underwent simultaneous ventral hernia repair and abdominoplasty were identified, with an average follow-up appointment at 25.8 weeks. Each operation utilized the Rives-Stoppa retrorectus sublay technique, a catheter-based cutaneous pain relief system and placement of closed-incision negative pressure wound therapy. The overall complication rate and rate of hernia recurrence were individually calculated and compared to data extrapolated from pre-selected literature using the Chi-Square test with Yates' correction. Search parameters focused on single-institution retrospective case reviews that included both the overall complication rate and the hernia recurrence rate following either abdominoplasty or ventral herniorrhaphy alone. Two articles matched the criteria of this study, the first of which is a retrospective review of 1,008 abdominoplasties by Neaman, et al. 2 and the second, a retrospective analysis of twenty-one ventral herniorrhaphies using self-adhering mesh by Bashian, et al. 1 Statistical analysis was performed using GraphPad, with a value of p0.05 deemed to be statistically significant. Results: This study calculated an overall complication rate of 29% and zero hernia recurrences. The complications identified included hypertrophic scar formation, with an occurrence of 13%, hematoma at 8%, seroma at 8%, and superficial surgical site infection at 5%. We compared our study's complication rate to those described in the aforementioned articles, the first of which evaluated the complication rate following abdominoplasty alone and the second, after hernia repair alone. This analysis did not yield a statistically significant difference between the complication rate of the combined surgery to that of each individual procedure. A comparison was also made between our study's rate of hernia recurrence and that in the literature; no statistically significant difference was found Conclusion: The results of this study suggest that combining ventral herniorrhaphy and abdominoplasty carries a statistically equivocal morbidity when compared to either procedure alone. Moreover, the addition of abdominoplasty to ventral herniorrhaphy was not found to increase the rate of ventral hernia recurrence. In conclusion, ventral hernia repair and abdominoplasty can be safely performed in a single procedure without significantly increasing the risk of post-operative complications, including ventral hernia recurrence.