There are three side muscles–the external oblique, the internal oblique, and the transversus abdominis. The most common version of the components release hernia repair cuts the external oblique muscle as it inserts onto the vertical rectus abdominis muscles. The side muscles become more compliant (stretchy) with the external oblique cut, allowing the rectus abdominis muscles to be brought to the midline for the hernia repair.
Immediately after surgery, the external oblique muscle is not attached to anything, and theoretically the abdomen could feel weaker. However, with the repair of the hernia the abdomen once again can increase its internal pressure. This new sense of a “core” for the patient is a bigger gain than the loss of the external oblique function. Most patients feel improved immediately after a components separation hernia repair, despite the pain of surgery.
Over time, the external oblique sticks back down to the underlying internal oblique muscle, and regains some of its function. The two intact muscles hypertrophy or bulk up over time, becoming stronger to compensate for the loss of the external oblique.
