Brandon Fadner, MDSurgery · Sugar Land, Texas

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Patient education

A bulge that keeps coming back.

A hernia is a weak spot in the muscle wall of your belly that lets tissue push through. Some are small and simple. Others, especially after past surgeries, need the wall rebuilt.

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The short version
  • Hernias don't heal on their own. They usually grow slowly.
  • Small, painless ones can sometimes be watched.
  • Larger or recurring hernias may need abdominal wall reconstruction.
  • Many repairs are done laparoscopically or robotically.

What's going on

The front of your belly is held together by layers of muscle and tough tissue called fascia. Where those layers are thin, at the belly button, the groin, or an old incision, pressure from inside can push fat or intestine through a gap. That's the bulge you see or feel.

Common types include umbilical (belly button), inguinal (groin), and incisional (at the site of a previous surgery). When an incisional hernia is large, or has come back after an earlier repair, the muscles may have pulled apart and need to be brought back together.

In plain EnglishThink of a tire with a weak spot in the sidewall. The bubble won't go away on its own. A small patch works for a small spot. A bigger weak area means rebuilding the sidewall.
SKINFATBULGE THROUGH THE GAPMUSCLESKINFATMESH REINFORCESGAP CLOSEDMUSCLE
A hernia, in cross section. Left: tissue pushes through a gap in the muscle. Right: the gap is closed and reinforced with mesh.

Signs to watch

  • A bulge that gets bigger when you cough, strain or stand, and smaller when you lie down
  • Aching or pulling, especially by the end of the day
  • A belly that looks uneven after a past surgery
  • A hernia that is getting larger over time
Don't wait if: the bulge becomes hard, painful, red, or won't go back in, especially with nausea or vomiting. The tissue may be trapped, and that is an emergency.

How we fix it

Simple repair

Small hernias can often be closed with stitches, sometimes reinforced with a piece of mesh. Usually outpatient.

Small hernias

Laparoscopic & robotic repair

Through small incisions, the gap is closed and reinforced from the inside. Less pain and a quicker return to activity for many patients.

Minimally invasive

Abdominal wall reconstruction

For large, complex or recurrent hernias. The muscles are released and moved back to the middle, the wall is rebuilt, and it's reinforced with mesh. The goal is a strong, functional core.

Complex hernias

Getting you ready

Weight loss, stopping smoking and controlling blood sugar make a repair last. For larger hernias we often plan these steps first.

Before surgery

What recovery looks like

Simple repair

Home the same day. Light activity right away, no heavy lifting for a few weeks.

Minimally invasive

Usually home the same day or next day. Back to desk work in 1 to 2 weeks.

Reconstruction

A hospital stay of a few days. An abdominal binder for support, and a gradual return to lifting over about 6 weeks or more.

Long term

Core strength and a healthy weight help keep the repair strong.

Common questions

Can I just leave my hernia alone?

Sometimes. A small hernia that doesn't bother you can be watched. Hernias don't go away, though, and repair is easier when they're smaller.

My hernia came back after a previous repair. Can it still be fixed?

Yes. Recurrent hernias are a big part of abdominal wall reconstruction. Planning matters, so bring your old operative reports if you can.

Is mesh safe?

Mesh lowers the chance a hernia comes back and is the standard of care for most repairs. We'll talk about which type and where it goes, and why.

Can a hernia be fixed at the same time as weight-loss surgery?

Sometimes, depending on size. Often it's better to lose weight first and repair the hernia afterward, so the repair lasts.

General information to help you understand your options. It isn't a diagnosis. The right plan for you comes from an in-person visit.

Your first visit

Come talk it through. No pressure, and no surgery you don't need.

A consult is a conversation. You'll leave knowing what's going on, what your options are, and what I'd do in your shoes. Whether you have surgery is your decision.

  1. We go through your symptoms, history and goals. Bring your medication list and any scan or scope reports.
  2. I explain what's happening in your body, usually with a drawing, and we decide whether any tests are needed.
  3. You leave with a clear plan: medication, lifestyle, a procedure, or a mix. We check insurance before anything is scheduled.
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