The abdominal wall is composed of multiple layers, including skin, fat, and muscle. Repetitive stress on the abdominal wall and changes in pressure cause small tears in the muscle. In time, the tissue weakens, and a hernia can result. This weakness is exacerbated after surgery as tissue strength never rebounds completely. At best, it is only about 80 percent as strong as it was pre-surgery and 64 percent as strong after a second surgery.

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