Primary incisional hernia repair is rarely successful, with recurrence rates ranging from 18% to 62%. We describe the integration of “components separation” herniorrhaphy with panniculectomy.

Twenty-two patients were treated. Standard panniculectomies and component separation were performed. Intravesical pressure was measured preoperatively, intraoperatively, and postoperatively. Measurement variations were compared using the Wilcoxon test. Complications or hernia recurrence were evaluated. The clinical appearance of the abdomen was subjectively evaluated by patients.

Secure abdominal defect closure with midline approximation of the fascia was achieved in all patients. No major early complications occurred. Hernia recurred in 1 patient (4.5%). Intra-abdominal pressure increased in all the patients in our series but remained well below the danger level. Fifteen patients were fully satisfied with the appearance of their abdomen, whereas 7 were satisfied.

Abdominal component separation provides a reliable autologous reconstructive option. Hernia repair combined with abdominoplasty provides functional and esthetic benefits.