Hernia Surgery With Mesh: How It Works, Benefits, Risks and Recovery

If your surgeon has recommended hernia repair with mesh, you may have more questions about the mesh than about the surgery itself. What exactly is being placed inside your body? Does the mesh stay there permanently? Can you feel it afterward? And perhaps most importantly, is hernia mesh safe?

Hernia surgery with mesh is one of the most commonly used ways to reinforce a weakened area of the abdominal wall. Instead of relying only on stitches to hold the surrounding tissues together, the surgeon places a specially designed surgical material across or behind the weak area to strengthen the repair.

Mesh can reduce the chance of the hernia returning, but it is not necessary for every patient or every type of hernia. The decision depends on the hernia itself, the surgical approach, the condition of the surrounding tissue, and individual medical circumstances. The mesh is positioned around or behind the hernia defect so that the repair is supported by a broader area of healthy tissue. You can read more about the overall surgical approaches in our guide to hernia repair.

What Is Hernia Mesh?

Surgical mesh is a medical implant designed to provide additional support to weakened or damaged tissue. Imagine repairing a weakened section of fabric. Simply stitching the edges together may work in some situations, but the repaired area remains under tension. Adding reinforcement across the weak section can distribute that tension over a wider area.

Why Do Surgeons Use Mesh for Hernia Repair?

The main reason is to create a strong, durable repair while reducing excessive tension on the patient's own tissues. If a larger hernia is repaired using stitches alone, the tissues may need to be pulled tightly together. Over time, tension on those stitches can contribute to the repair failing and the hernia returning. Mesh helps reinforce the area instead of asking the surrounding tissue to provide all of the strength by itself.

Potential benefits include:

• Lower risk of recurrence for many types of adult hernia
• Reinforcement of weakened abdominal wall tissue
• Ability to cover an area larger than the actual hernia opening
• Reduced tension on some tissue repairs
• Support for more complex abdominal wall reconstruction

This does not mean that mesh guarantees the hernia will never return. Recurrence is still possible after any type of hernia surgery.

Which Hernias Are Commonly Repaired With Mesh?

Mesh is widely used for several types of adult abdominal wall hernia.

Inguinal Hernia

Mesh-based repair is commonly used for adult inguinal hernias. It can be placed during either an open repair or a minimally invasive laparoscopic or robotic procedure.

Umbilical Hernia

For many adult umbilical hernias, particularly defects larger than very small openings, mesh reinforcement may reduce the likelihood of recurrence compared with stitches alone.

Ventral Hernia

Mesh is commonly used for ventral hernia repair because these abdominal wall defects may be exposed to considerable pressure.

Incisional Hernia

An incisional hernia develops through or near the scar from a previous abdominal operation. Because the tissue has already weakened once, mesh reinforcement is commonly an important part of the repair, particularly for larger defects.

How Is Hernia Mesh Put in Place?

The exact procedure depends on whether surgery is performed through an open, laparoscopic, or robotic approach. But the general principle is similar:

1. The surgeon reaches the hernia.
2. The protruding fat, intestine, or other tissue is returned to its normal position.
3. The abdominal wall defect is assessed and may be closed with sutures.
4. A piece of mesh is positioned so that it extends beyond the weakened area.
5. The mesh is secured or positioned according to the surgical technique.
6. The surgical incisions are closed.

The mesh is normally larger than the visible hernia opening because the aim is to reinforce the surrounding tissue rather than simply plug the hole.

Where Is the Mesh Placed?

This is an important question because “mesh repair” does not describe one single operation. Mesh may be placed in different layers of the abdominal wall depending on the type of hernia. Possible positions include:

• Onlay: over the abdominal wall tissue
• Preperitoneal: in a deeper layer just outside the abdominal cavity
• Retromuscular: behind the abdominal muscles
• Intraperitoneal: inside the abdominal cavity, using mesh designed for that position

For midline incisional hernias, modern guidelines generally favour retromuscular positioning where appropriate because this location can provide good reinforcement while keeping the mesh away from the abdominal organs.

What Is Hernia Mesh Made Of?

Not all surgical meshes are the same. Most are designed with a porous or woven structure that allows tissue to grow around or through the material as healing takes place. Broadly, meshes may be:

Permanent Synthetic Mesh

These meshes are made from synthetic materials and are designed to remain in the body to provide long-term reinforcement. They are commonly used in many routine adult hernia repairs.

Absorbable Synthetic Mesh

Absorbable mesh gradually loses strength and is broken down by the body over time. It does not provide permanent reinforcement, so its use depends on the particular surgical situation.

Animal-Derived or Biologic Mesh

Some meshes are made from specially processed animal tissue. These materials are designed for particular clinical situations rather than being automatically better than synthetic mesh. Your surgeon chooses the material according to factors such as the type of hernia, wound condition, risk of infection, and planned repair.

Does Hernia Mesh Stay in the Body Forever?

It depends on the type. Permanent non-absorbable mesh is intended to remain in the body long term. Over time, your own tissue grows around and through the mesh, incorporating it into the repair.

Absorbable meshes behave differently. They gradually lose their strength and are absorbed while healing tissue is expected to provide support. If permanent mesh is functioning normally and causing no problem, it generally does not need to be removed simply because it has been in the body for many years.

Is Hernia Mesh Safe?

For most appropriately selected patients, mesh can be used safely and has an important role in modern hernia surgery. However, no surgical implant is completely free of risk. 

The appropriate question is therefore not simply, “Is mesh safe?” but rather: “Do the expected benefits of using mesh outweigh the risks for this particular hernia?” For many adult hernias, reducing recurrence and creating a stronger repair makes mesh an appropriate choice. For other patients, a non-mesh repair may be reasonable.

What Problems Can Occur After Hernia Surgery With Mesh?

Most patients do not develop serious mesh complications, but it is important to understand the possibilities before surgery. Potential complications include:

• Pain or persistent discomfort
• Wound or mesh infection
• Seroma, which is a collection of fluid around the surgical area
• Bleeding
• Adhesions or internal scar tissue
• Hernia recurrence
• Mesh contraction or shrinkage
• Mesh movement or migration
• Rare injury or abnormal connection involving nearby organs

Several of these complications can also occur after hernia repair without mesh, so developing pain or swelling after surgery does not automatically mean that the mesh itself is responsible.

Can Hernia Mesh Become Infected?

Yes, although mesh infection is uncommon. Possible warning signs include:

• Increasing redness around the wound
• Persistent or worsening pain
• Drainage from the incision
• Fever
• Persistent swelling
• A wound that is not healing normally

Some infections can be managed with antibiotics and drainage, but a deep or persistent mesh infection may occasionally require removal of the mesh. Factors such as smoking, poorly controlled diabetes, obesity, previous wound infection, and the complexity of the operation can influence wound-related risk.

Can You Feel the Mesh After Hernia Surgery?

Most patients are not continuously aware of the mesh once healing is complete. During the early recovery period, however, it is common to experience pulling, tightness, tenderness, swelling, or a sensation that the repaired area feels different.

This usually relates to the operation and healing process as a whole rather than simply to the mesh. Persistent pain, a new lump, severe tenderness, or symptoms that worsen rather than improve should be assessed by the surgical team.

Is Mesh Always Necessary?

No. Some hernias can be repaired using the patient's own tissues and sutures. A non-mesh repair may be considered in selected situations such as:

• Certain small hernias
• Selected primary inguinal hernias
• Situations where contamination or infection affects the surgical plan
• Patients specifically choosing an appropriate non-mesh technique after discussing benefits and risks

For inguinal hernias, the Shouldice technique is one established non-mesh repair when performed in appropriately selected patients by surgeons experienced in the technique.

Avoiding mesh should not automatically be considered safer, just as using mesh should not automatically be considered better. Each approach involves its own balance of recurrence, pain, wound problems, and technical considerations.

Can Hernia Mesh Be Removed?

Yes, mesh can sometimes be removed when there is a clear medical reason, such as persistent deep infection or another significant mesh-related complication. But mesh removal is not necessarily a simple procedure. 

Once tissue has grown around the implant, removing it may require careful dissection and can sometimes involve nearby nerves, blood vessels, muscles, or organs. Removal may also leave the abdominal wall weakened again, meaning another form of reconstruction could be required. For this reason, mesh is not normally removed simply because a patient is worried that it has been inside the body for a long time.

What Is Recovery Like After Mesh Hernia Repair?

Recovery depends more on the overall operation than on the presence of mesh alone. A small open inguinal repair and a major incisional hernia reconstruction may both use mesh but have completely different recovery periods. During the first days or weeks, patients may experience:

• Incisional pain
• Bruising
• Swelling
• Tightness around the repair
• Tiredness after surgery

Walking is usually encouraged relatively early, while the timing of heavier lifting, exercise, driving, and return to physical work should follow the surgeon's instructions. Do not judge healing only by how the skin incision looks. Deeper tissues continue healing after the wound appears closed.

The Bottom Line

Hernia surgery with mesh uses a surgical implant to reinforce weakened abdominal wall tissue and reduce the chance that many types of hernia will return. Mesh is commonly used for adult inguinal, ventral, umbilical, and incisional hernias and can be placed during open, laparoscopic, or robotic surgery.

Permanent mesh is intended to remain in the body, while absorbable materials gradually lose strength over time. Mesh has important benefits, particularly in reducing recurrence, but complications such as infection, persistent pain, migration, contraction, or recurrence can occur in a minority of patients.

Most importantly, mesh is a tool—not the entire operation. A successful hernia repair also depends on choosing the right surgical approach, positioning the mesh appropriately, reconstructing the abdominal wall correctly, and matching the repair to the individual patient.