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Is Drainless Tummy Tuck a Safe Procedure?

After consulting a board certified plastic surgeon, I was told that some physicians do not do the drainless procedure because it takes additional time in the O.R. (hence higher cost) or that the same risks exist when using drains. Is it safe?

I have heard conflicting views and am a bit concerned/confused about this. I must admit, no drains sounds very appealing to me as a patient.

Asked 28 months ago by nomorebigbelly in Crown Point, IN

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abdomen costs drainage plastic surgeon

Tummy tuck can be done safely without a drain

According to answers posted on this site it seems that performing a tummy tuck without a drain is seldom recommended. There was a similar debate concerning drains after a facelift many years ago, and again surgeons divided into those that did drain and those that did not. Today very few surgeons consider using a drain in a facelift procedure, and my feeling is that in tummy tuck too in the future few surgeons will continue placing a drain. In our practice for the past nine years we have... more

Peter E. Johnson, MD

Des Plaines Plastic Surgeon

ASAPS ASPS

Drainless works in experienced hands

Drain less Tummy Tuck operations are performed by Plastic Surgeons who use a quilting technique. In this procedure, multiple sutures are placed between the muscle and fat layer to quilt the skin like a down comforter. It requires a lot more time in the OR and needs an experienced physician. We perform more than 100 Tummy Tucks a year and still use drains. Our complication rate with drains is extremely low, so I see no reason to add the time to the procedure. While the idea of no drains... more

David A. Dreyfuss, MD

Chicago Plastic Surgeon

ASPS

Tummy Tucks Without Drains

The drainless technique is based on putting stitches to "quilt" the skin down to the abdominal wall, called "progressive tension sutures" (PTS). I started using them about 2 years ago because on bigger cases like body lifts they help prevent any bleeding from one area spreading to another. I also use drains. I keep an ultrasound in my office and saw that even with the PTS in place, there were still little collections of fluid, and the drains still drained fluid... more

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John LoMonaco, MD

Houston Plastic Surgeon

ASPS

Still a controversy

Joderbug, I would venture to say that very few plastic surgeons perform tummy tuck surgery without drains at this point in time. The concept of "drainless" tummy tucks has been proposed by the aforementioned father and son team (Pollack and Pollack), however, even they are not so dogmatic as to say drains are never necessary, only that the use of drains and quilting sutures together has no added benefit. They do state that the use of progressive tension sutures increases... more

Kenneth R. Francis, MD

Manhattan Plastic Surgeon

ASAPS ASPS

Drainless Tummy Tuck

Drainless tummy tuck is safe. If your surgeon has used the procedure and has sticked with it it has probably worked for him. Surgeons tend to do those things that have been reliable and predictable for them and many are not willing to change until clear benefits have been shown for a new or different technique.

John P. Stratis, MD

Harrisburg Plastic Surgeon

ASAPS ASPS

Drainless Tummy Tuck

The vast majority of Plastic surgeons wish they could do their tummy tucks without drains AND 100% of our patients wished we could do it this way. Over the years, multiple colleagues came with various suggestions on how to prevent the use of drains or be able to remove them a day or two after the operation. The longest claimant in this series was by a father / son surgical team from Dallas who have published several papers on the use of space obliterating "quilting" stitches... more

Peter A. Aldea, MD

Memphis Plastic Surgeon

ASPS

Drains in a tummy tuck

I personally would not do a TT without drainage because of the risk of a seroma. Interestingly though, about 4 years ago I switched from using 2 rather large drains to using only 1 which is about the size of a piece of spaghetti and just slides out painlessly. The seroma rate has gone to essentially zero with the new system and it is very well tolerated. Don't let the drain issue be the deciding point on where to have your tummy tuck done. Go with the doctor who is going to give you... more

Richard P. Rand, MD, FACS

Seattle Plastic Surgeon

ASAPS ASPS

Progressive Tension Suture technique for tummy tuck without drains

The procedure you are describing usually goes by the term "progressive tension suture" abdominoplasty because of the sutures that are placed inside, which distribute the tension instead of placing it all at the edge. The other benefit is that the internal stiches close off the space where fluid accumulates. The first one to report this was Dr. Harlan Pollock, who has been doing it without drains with good success for many years. I had also started doing something similar, and... more

Richard Baxter, MD

Seattle Plastic Surgeon

ASAPS ASPS

Drains are more common than not in abdominoplasty

We perform all of our tummy tucks with a drain. In general, the drain allows fluid to be removed rather than reabsorbed by your body. There are ways to do tummy tucks without drains, but it would have to be an ideal candidate (fairly thin) and then the patient would need to wear some compression garment to help prevent fluid accumulation. The drain should not be your foremost decision. Make sure you look at enough photos (especially of non-drain tummy tucks) and make sure you are... more

Francisco Canales, MD

Santa Rosa Plastic Surgeon

ASAPS ASPS

Drainless Tummy Tuck

I personally would not do a tummy tuck without drains. I think that the risk of developing a seroma is very high without drains. At my facility, the use of drains adds no cost and little, if any, time. Some surgeons place quilting sutures to try to prevent seromas, but I feel a drain is still indicated.

John Whitt, MD

Louisville Plastic Surgeon

ASAPS ASPS

Drains a plus and a must for Tummy Tuck

I wouldn't judge a procedure on having a few drains. Drains prevent the complication of seroma (fluid) in your abdomen or blood (hematoma). If you are looking for a complication then go for it. We use pain pumps which helps post op pain relief and this fluid can also accumulate. I have seen surgeons in Mexico do a tummy tuck with no drains and i see them in the Emergency Room at Cedars Sinai crying and infected with huge collections of fluid in their abdomen. Here in Amercian we adhere to a... more

Andrew T. Cohen, MD

Beverly Hills Plastic Surgeon

ASAPS ASPS

Drainless tummy tucks

Dear Joderbug A drainless tummy tuck is a very acceptable procedure and safe in the right hands. I have done them at times myself but most times do use drains because I also use an implantable pain pump that delivers local anesthetic into the wound for several days Don't let the drain be your only consideration but look at the surgeons results and ask to speak to a patient or two if possible. Even without the drains you will have several days where you will be at the very least out of... more

Steven Schuster, MD

Boca Raton Plastic Surgeon

ASAPS ASPS

Drainless tummy tucks

In spite of new techniques developed to try and eliminate postop seromas and the use of drains, seroma formation remains a problem without drains. I continue to use drains because of this.

Daniel R. Knight, MD

Shreveport Plastic Surgeon

ASPS

I would not take the risk in drainless Tummy Tuck

Hello, The risk of a collection of fluid that could relax an otherwise tight tummy is too high for me to recommend tummy tuck surgery without drains. While I would love to offer this to my clients, I would not want to have to explain why my results were less tight than they are right now using drains.

John P. Di Saia, MD

Orange Plastic Surgeon

Drainless tummy tuck (abdominoplasty)

I have performed this procedure that involves using a series of "quilting" sutures to collapse and eliminate the space where drains are placed and potentially eliminate fluid collection. In my experience, it does not always prevent fluid accumulation. see video

Otto Joseph Placik, MD

Chicago Plastic Surgeon

ASAPS ASPS

Drains After a Tummy Tuck

Most surgeons use drains after a tummy tuck to minimize post-operative swelling. Placing drains takes a minimal amount of time while placing quilting sutures to collapse the tissues onto the muscle takes much longer. The quilting sutures are what is used to decrease the need for a drain. After a tummy tuck, whether drains were placed and then removed, or no drains used at all, fluid collections can occur that have to be drained with a needle. At times, that procedure needs to be repeated as... more