What are NOT ‘Hernia Complications’ After Hernia Surgery?

I want to start by differentiating expected post operative changes and issues with the word ‘hernia complication’. Every patient after hernia surgery is likely to encounter a number of expected things:

• bruising – sometimes this can occur in areas well outside of the surgical area
• swelling- most patients will have moderate to significant swelling for 1-2 weeks after surgery
• nausea – although uncommon, some patients react to anesthesia differently than others
• pain – all patients should expect some level of pain and discomfort after any type of surgical procedure
• difficulty urinating – a small percentage of patients will have difficulty urinating after surgery due to anesthetics
• allergic reaction – rashes, hives, or other manifestations of an allergy to a medications

These findings are not considered hernia complications because they are expected in a majority, or even a small but reasonable percentage of patients. They also are self limiting, meaning that they will resolve on their own without any specific additional treatment. In addition, they do not cause any long term sequela, or any long term ‘complications’.

What ARE Complications?

A hernia complication is something that is not expected to happen after hernia surgery. Keep in mind that even though it isn’t ‘expected’, all complications are know to be a possibility, no matter how rare. Some complications may require a follow up procedure to be performed to help treat the complication. Complications can sometimes cause long term problems, or can lead to a prolonged recovery after surgery.

The following table demonstrates the known hernia complications that can occur after hernia surgery and their associated chance of occurring. Keep in mind that this table only provides the incidence of complications in normal, healthy patients. Some patients with obesity, diabetes, large chronic hernias, recurrent hernias, or prior infected hernias may have a higher incidence of having a complication after surgery.

(the ‘Expected Incidence’ is the number of hernia surgeries performed for this to happen one time. These numbers are averages based on the best available medical data and are not absolute.)

Hernia Complication	Expected Incidence
Mild Skin infection	1:100-200 (<1.0%)
Deep mesh infection	1:1000-2000 (<0.1%)
Recurrent hernia	1:50-100 (1-2%)
Seroma	1:100-200 (<1.0%)
Hematoma	1:200-400 (<0.5%)
Chronic Pain	1:50-100 (1-2%)
Loss of testicle (inguinal hernias)	1:1000-2000 (<0.1%)
Anesthesia complication – heart attack, stroke	1:5000 (<0.02%)

Although I take a personal responsibility for patients who develop any of these complications, I also discuss with my patients that complications can occur after ANY surgery. Patients who have knee surgery, back surgery, shoulder surgery, or ANY surgery for that matter, have a risk of developing a complication like the ones listed above. Thus, complications are NOT limited to just hernia surgery. There is no way that any type of surgeon can guarantee that 100% of their patients are going to have a 100% perfect outcome. The goal that I have, and most high volume surgeons have, is to minimize the factors that we know can affect the outcome for our patients, including everything from reducing pain to infections.

Timeline for Hernia Complications

The various hernia complications occur at different times after surgery. This table shows when the complication is most likely to occur. Sometimes, these complications can present over a very long period of time.

Complication	Expected Onset
Mild Skin infection	3-10 days
Deep mesh infection	10 days to years
Recurrent hernia	immediate to years
Seroma	2-4 weeks
Hematoma	1-3 days
Chronic Pain	6-12 months
Loss of testicle (inguinal hernias)	variable
Anesthesia complication – heart attack, stroke	Immediate

Our Framework for Mitigating Surgical Risk

In modern surgery, the goal is not simply to complete a procedure, but to proactively manage and mitigate the potential for complications. While medical science acknowledges that no surgeon can guarantee a 100% complication-free outcome, we believe that specialized focus and high-volume expertise are the primary tools for ensuring patient safety.

At California Hernia Specialists, we achieve a complication rate significantly lower than national averages by following a rigorous three-pillar framework:

1. The Specialist’s Mindset: Hernia Repair as a Priority

Many general surgeons treat hernia repair as a secondary “routine” procedure. In our practice, it is our singular focus.

• Absolute Care: We approach every case with the understanding that surgical success is built on meticulous attention to detail. This philosophy is the foundation of our private practice, where hernia surgery is never an afterthought.
• Specialized Infrastructure: Every member of our team—from our dedicated surgical nurses to our specialized anesthesia partners—is trained exclusively in the nuances of abdominal wall health.


2. Patient Partnership: Data-Driven Post-Operative Protocols

A successful outcome is a collaborative effort between the surgeon and the patient. We provide a structured roadmap to minimize the risk of post-surgical issues such as hematomas, seromas, or recurrence.

• The “10-20 lb Rule”: Following our strict 3-week lifting restriction is essential for the biological integration of the repair.
• Recovery Tracking: Our standardized recovery charts and post-operative instructions are designed to reduce patient-driven variables, ensuring that the body has the ideal environment for rapid, stable healing.


3. Technical Expertise: The Advantage of High-Volume Care

Experience matters. Through the performance of 500–600 hernia repairs annually, Dr. Harris has developed the specialized “surgical eye” necessary to identify subtle anatomical variations that can lead to complications.

• Nerve Preservation: We utilize advanced nerve-identifying techniques to protect sensory structures, significantly reducing the risk of chronic post-operative discomfort.
• Precision Biomaterials: By utilizing modern, lightweight meshes and tension-free techniques, we minimize the inflammatory response and the risk of “meshoma” or mechanical irritation.
• Refined Routine: By following a clinical routine that is successful 99% of the time, we provide a level of reliability that only a high-volume specialist can offer.

How to Minimize Recurrent Hernias

Although patients often cannot affect their risk of developing a primary (first time) hernia, they actually can impact their development of a recurrent hernia. Recurrent hernias are ones that form after a surgeon has already attempted to repair the primary hernia. This can happen as early as days/weeks after the first surgery, or as long as decades. Regardless, there are important steps a patient can take to minimize their chances of having a recurrent hernia. The best way a patient can help prevent a hernia recurrence is to find a surgeon who performs a high volume of hernia surgeries. This volume of surgeries clearly imparts a high level of surgical experience which can reduce a patients chance at developing a recurrent hernia. The risk factors for recurrent hernias your choice of surgeon can influence includes:

• Low surgical volume of hernia repairs by the surgeon performing the initial operation
• Surgical inexperience of the initial surgeon
• Open hernia surgery under local anesthesia
• Insufficient surgical technique of the surgeon including:
  1. lack of mesh overlap
  2. improper mesh choice
  3. lack of proper mesh fixation

The HerniaSurge group’s International Guidelines point to at least 4-5 different risk factors for hernia recurrence which are influenced by a patients surgeon. The best way a patient can help prevent a hernia recurrence is to find a surgeon who performs a high volume of hernia surgeries. This volume of surgeries clearly imparts a high level of surgical experience which can reduce a patients chance at developing a recurrent hernia.

Patients can read more from the International Guidelines for Inguinal Hernias here:

What is Your Next Step?

The most important aspect of decision making for patients, is to balance the risks and benefits of each option. Some patients would feel that avoiding surgery and just watching their hernia would provide to serious a limitation on their lifestyle and activity. Thus, the benefit of observation would far outweigh the risks. Another patient may feel that their hernia is causing no issues and that any possible complication is too risky to warrant surgery. Those patients should choose to just observe their hernia. Regardless of what direction you want to take, it’s important to know what the true incidence of complications are in hernia surgery so that you can make an educated decision!

Hernia Surgery Costs and Insurance: Scheduling Your Consultation and Procedure

Dr. Todd Harris explains the steps for scheduling hernia surgery, insurance verification, and affordable cash pricing options for patients without insurance.