Umbilical hernias generally happen because of the way the umbilical cord heals when a baby. For some of us, we are left with a weak spot and lifting definitely exposes it. Strangulation typically doesn't happen because it's a large enough hole and unlike other hernias, there's not tear in the muscle to heal back together and strangle it. Umbilical hernias are usually fixed with mesh. Best method to ensure it doesn't happen again. My dr made about a 1.5" incision above my belly button, put some mesh in, stitched it to my abdomen, and then it pretty much fuses itself there.
I do remember seeing one of those law firm tv commercials about surgical mesh and complications. That was prior to my surgery, wonder if that has anything to do with these failed procedures.
Mine would cause me some pain and discomfort if I was full or bloated and would bend over. My wife also thought it was grotesque and couldn't stand looking at me with my shirt off. I too didn't like the look of it but waited several years for surgery because I didn't want to take time off from the gym. I wish I would've had it done sooner.