Umbilical hernias occur due to a weakness in the abdominal wall that dates back to birth. The umbilicus is the connection between the growing fetus and the mother, and blood vessels travel through the umbilical stalk. The abdominal muscles tend to close off this weak area at the umbilical stalk by age 5. In some patients with increased abdominal pressure due to pregnancy or due to other reasons, this weak area enlarges over time to reveal an umbilical hernia. Incisional hernias from laparoscopies can also occur exactly at the umbilicus. Umbilical hernias often occur in association with rectus diastasis (diastasis recti), a separation between the rectus muscles. Umbilical hernias can be painful, and can contain either fat or bowel. The medical reason to treat umbilical hernias is to prevent bowel obstruction and strangulation, and to treat pain.
Treatment of umbilical hernias can be performed with an incision in the curved part of the umbilical stalk. Some sort of mesh is typically used. The procedure is performed generally as an outpatient and under local anesthesia. An alternative is to have a full abdominoplasty, with an incision near the underwear line, a repair of the umbilical hernia, and a complete tightening of the linea alba. However, a full abdominoplasty is a larger surgery, has longer recovery, and would have additional out of pocket costs. In addition, the skin of the umbilical stalk has a greater chance of not remaining alive with this combined umbilical hernia/abdominoplasty procedure.