Opinions On No Drain Tummy Tuck?
- Asked by Erin Woodridge in Woodridge, Illinois
- 2 years ago
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?
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.
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.
Martin Jugenburg, MD
No drain tummy tuck
I have used both traditional drains and a technique that allows for avoiding drains, which can be irritating to patients and do not always prevent seromas anyway. Currently, I use a technique that involves progressive tension sutures that eliminate the space where fluid can accumulate. While it does take a little longer in the operating room, the end result is that patients do not need to care for drains and have them removed and patients have very few seromas (and there is no extra charge). The other benefit is that the tension on the abdominal flap is spread out over all the tissue, so that it is not just along the incision line. Both options are good, and I would let your surgeon decide what technique for wound closure and avoiding complications works best in his or her hands.
It really depends on the tummy...
The question of drains is one that has been debated continuously for the 15 years I've been in practice. While there is still no definitive answer, I subscribe to the idea that patients should plan to have a drain and be thrilled if they wake up without one. Drains obviously help limit the amount of fluid that can accumulate under the skin. In addition, they act as an early indicator of abnormal bleeding. So do drains always eliminate potential problems. NO !! Even more frustrating is that some patients develop postop seromas DESPITE having drains in place.
My take home for you is: While drains are inconvenient, they are a short term inconvenience and if your surgeon feels they are an important part of your recovery, don't look at it as a poor decision or something to negatively impact your longterm result. Good luck. Dr Frank
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.
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!
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.
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.
Web reference: http://www.sanfranciscocosmetic-surgery.com/
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.
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.