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Opinions On No Drain Tummy Tuck?

I read more and more about people getting a "no drain tummy tuck" but I don't see comments from Doctors as to if this is recommended over the regular tummy tuck. Are there Doctors in Illinois that perform a "no drain tummy tuck"? Are there additional risks to this procedure? Is there an additional cost to this procedure?

Doctor Answers 29

Opinions On No Drain Tummy Tuck?

There ha been a quoted risk of about 20% for developing a seroma following a tummy tuck, using traditional techniques and WITH the use of drains.  In recent years a "quilting technique" was proposed where multiple dissolvable sutures are placed between the undersurface of the tummy "flap" and the underlying abdominal wall fascia prior to closure to reduce the large open space that could potentially fill with seroma fluid.  Some surgeons who starting using this technique stopped using drains as they did not think they were necessary.  I personally use the quilting technique AND use drains long enough until the drainage has lessened and the drains can be removed, usually averaging about a week after surgery.  I have not had a seroma following a tummy tuck in many years, in fact, since I started using the quilting technique. Since dealing with a seroma is not always fun (it requires frequent office visits for the fluid to be drained with a needle and syringe, and in some cases may lead to taking the patient back to surgery for a drain to be placed), I have decided to use the "belt and suspenders" approach...quilting sutures AND drains.

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No drain tummy tuck is a great improvement over the old technique

I have been using the no-drains tummy tuck for two years now and I am very happy with it.  For patients the biggest thing is the lack of drains, so less hassle and discomfort after the surgery.  However I like this technique because the tighter abdominal closure allows me to place the scar lower and have less tension on it which leads to a better looking, more hidden scar.  The extra time it takes to do is about 10 minutes.  Well worth it.

Sincerely,

Martin Jugenburg, MD

Martin Jugenburg, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 244 reviews

Opinions On No Drain Tummy Tuck?

Great question. Very different opinions. After over 30 years of TT's, trying both methods I find the following: It takes 30 to 50 minutes longer to use the "quilting" suture techniques so add extra fees for operating room, staff, anesthesia, drugs approx $400 to $800 more. Next, If a seroma or hematoma occurs I would be very concerned of an issue of falling below the "standard" in TT's. But I use the "no drain" option if the patient signs a full release/disclosure in an additional informed consent. Next, I chose the candidate for the "no drain" TT as more slender vs fatty, seems less chance of fluids accumulating. Finally, recently I have used a very thin, skinny drains in my "no drain" TT (so the term does not apply) with removal in a few days or a day. Thus I feel better and the risk of fluids decreases. I like this combination of the very thin drains + the "quilting" sutures. Maybe I will call it the "Thin Drained" TT? But best to be seen by a boarded PS and discuss your options in detail. Regards. 

Drains or No Drains for TT

The use of drains in a tummy tuck is a little controversial at the moment. i use them as I suspect the majority of surgeons do. Obviously patients would prefer not to have them bit they serve a purpose, specifically to reduce the chance of getting fluid accumulate beneath the skin, also something docs and patients would prefer not to have. The use of drains doesn't have anything to do with the actual technique though, as if a "no drain" tummy tuck is better than a "drain" tummy tuck.

Drains and tummy tuck

I use drains for tummy tucks with or without a quilting technique. The risk of accumulating fluid is high in tummy tuck and dains are an excellent way to divert this fluid until the body has the capacity to absorb the remaining amount.

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 57 reviews

Tummy tuck without drains

There are surgeons who are able to perform an abdominoplasty without drains. I tried the technique a few years ago but found that I was not able to consistently prevent seromas so I did not think it worth the extra time. Also, we are performing more liposuction of the abdoman at the time of abdominoplasty and thus have a greater need for drains.

So the bottom line is that is if  your surgeon can get a good result without drains, fine. Just don't be the first patient he or she tries it out on!

Ann F. Reilley, MD (retired)
Baton Rouge Plastic Surgeon
5.0 out of 5 stars 7 reviews

No-drain tummy-tuck

There are advantages and disadvantages to both techniques, also remember that one operation does not fit every patient.  I use both a standard and no-drain abdominoplasties in my practice and feel that both give excellent results. The technique I use depends on the individual situation and desires of each patient.  Since surgeons have been using an internal quilting technique, the incidence of seromas has almost dropped to zero.  The amount of time drains have to be in place has also dropped by 1/4.  I wouild defer to your surgeons judgement as to whether drians should be used.  Better to have a few days with a drain that have to deal with a seroma.

Robert M. Jensen, MD
Medford Plastic Surgeon
4.5 out of 5 stars 23 reviews

Yes, it can be done

Yes, some surgeons will do a suture underneath the skin to close the dead space.  I always use drains because i feel more comfortable using them. The risk is that the sutures do not close the space and fluid will accumulate, which is a complication which can handled.

Miguel Delgado, MD
San Francisco Plastic Surgeon
4.5 out of 5 stars 39 reviews

Yes, no drain after tummy tuck

Some surgeons are reluctant to change. Not much of a controversy here though, as we have discontinued drains on tummy tuck for many years as have other practices. There are no additional risks, and the recovery is much easier without.

Best of luck,

peterejohnsonmd.com

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 33 reviews

Drains with Tummy Tuck?

Thank you for the question.

The use of drains will vary from one surgeon to another. As long as your surgeon is a well experienced board certified plastic surgeon who can achieve the results you're looking for,  the  Travel safeuse of drains ( or not)  should not be a primary concern.

I personally use drains for tummt tuck surgery and probably will continue to do so given the risks associated with not using drains.  I would certainly not fault surgeons who do not use drains and who can show low incidence of seromas  with their patients.

I hope this helps.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.