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Drains Vs Internal Sutures for Tummy Tuck?

asked 2 years ago by Sammi2010 in NJ
Latest answer by Michael A. Jazayeri, MD
Question viewed 1,352 times
Tags: stomach, drainage, side effects, sutures

I am planning a Tummy Tuck soon & the Dr I have chosen said he prefers to do internal sutures as opposed to drains. I have heard that might be more dangerous. What is the reality?

16 answers to Drains Vs Internal Sutures for Tummy Tuck?

Tummy Tuck drains vs internal sutures

Most plastic surgeons place drains in the abdomen during a tummy tuck procedure. These drains help remove excess fluid/blood from the surgery and also help the soft tissue and skin to adhere to the abdominal wall (muscle). Internal sutures, also called progressive tension sutures or quilting sutures, can be used to help attach the soft tissue to the abdominal wall, thus minimizing any space and potential for fluid accumulation. Often times a combination of internal sutures and drains... more

William Bruno, MD
Beverly Hills Plastic Surgeon

www.williambrunomd.com

Tummy tuck without drains

This is a rather new technique that is gaining more popularity. I have done it several times with good success. I wouldn't say that's it's more dangerous, it just might slightly increase the possibility of a seroma forming (fluid collection). The benefit of internal sutures is that no drains are necessary which is a great postoperative perk. The downside is that it may increase the formation of seroma, but again, this is only slight. If a seroma does form, it is easily drained in the... more

Elan B. Singer, MD
Manhattan Plastic Surgeon

Drains vs. internal sutures in tummy tuck

"An ounce of prevention is worth a pound of cure." The definition of tummy tuck varies widely, but in my O.R .it includes: muscle repair, aggressive suction, skin and fat resection,and umbilical reconstruction. I've used drains for 27 yrs. without problems. In these abdominal and flank reconstructions--which may or may not be what you will have I do not use "quilting sutures" but use drains as the "ounce of..."

Barry H. Dolich, MD
Bronx Plastic Surgeon

I stopped using internal (quilting) sutures for tummy tuck

A Tummy Tuck (Abdominoplasty) requires a lifting and separation of the skin / subcutaneous fat from the underlying muscles. After the muscles are brought back to the midline, the loose, excess lower tummy skin and fat are removed and the surgical incision is closed, we want the skin and fat to adhere back to the underlying muscles. Unfortunately, fluid collections (seromas) tend to form in that space. As long as drains remove the fluid as soon as it forms, the skin adherence/healing goes on... more

Peter A. Aldea, MD
Memphis Plastic Surgeon

Internal sutures (quilting) versus drains with tummy tuck (TT) abdominoplasty

SEE VIDEO FOR SAMPLE RESULTS: These internal sutures (also called quilting sutures) have been recommended to minimize the potential for fluid collection between the fat and muscle. Traditionally in the past, these fluid collections were treated with drains. The thought with the sutures is that if you close the space, the fluid will not accumulate. In reality, I have performed both techniques and still have fluid collections. Because the sutures take more time, I have abandoned this method... more

Otto Joseph Placik, MD
Chicago Plastic Surgeon

Use of drains and internal sutures for Tummy Tuck

This is a great question. Personally, I am a believer of "tried and proven" techniques. Drains after tummy tuck surgery have been used for decades and are safe and effective. Seroma develops after tummy tuck surgery due to movement of the abdominal skin against the abdominal wall. The theory behind internal sutures is to keep the skin from moving. However, there is NO way the entire internal abdominal skin can be sutured. There will be pockets of skin, therefore, with some... more

Michael A. Jazayeri, MD
Santa Ana Plastic Surgeon

Personally, I do both drains and internal sutures for Tummy Tuck

As one of the other doctors mentioned, I do a combination of both quilting sutures and drains.I have been doing this combination for about 5 years. Since I starting doing quilting sutures I would say my drains stay in shorter (usually about 1 week) and I have reduced the occurrence of fluid collections postop. I would ask your doctor how often he sees fluid collections without drains. If he has good success with his technique you should be OK to proceed.

Robert B. Pollack, MD
La Jolla Plastic Surgeon

Tummy tuck drains or internal sutures

Sammi, I personally do not use quilting sutures. The literature as it stands today seems to indicate that either drains or quilting sutures are adequate in minimizing fluid collections. The use of both is probably overkill and may add time to the operation that would increase risks that are based on longer anesthesia times. Good luck!

Kenneth R. Francis, MD
Manhattan Plastic Surgeon

Use both drains and internal sutures for tummy tuck.

Hi! 1) It's not an either or situation. The point is to avoid a seroma (collection of liquid under the skin) after a tummy tuck. 2) We use both internal quilting sutures and drains. They both help with no down side. Many surgeons do not use internal sutures, but I personally think drains must be used. 3) A minimal undermining (minimal skin lifting) tummy tuck technique also prevents seromas.

George J. Beraka, MD
Manhattan Plastic Surgeon

Tummy Tuck and Drains

Drains are the standard of care after abdominoplasty. After elevating such a large area and performing a large surgery, the body produces fluid which needs to be drained. Some have suggested that internal sutures help close the space and make the drains unnecessary. However, fluid can still accumulate which would need to be drained. Having drains for a few days to a week after surgery is a much better alternative than having to undergo a second procedure to remove fluid which... more

David Shafer, MD
New York Plastic Surgeon

www.ShaferPlasticSurgery.com

I use quilting sutures and drains

And I also keep an ultrasound in my office to check for fluid collections. Even with the quilting sutures, I still see fluid in about half of patients. I do believe the quilting sutures lessen the amount of time the drains stay in place, however, and can contain any bleeding if that should occur.

John LoMonaco, MD
Houston Plastic Surgeon

www.DrLoMonaco.com

I agree with the other doctors

I have never regretted placing a drain, but I have regretted not placing one. I have not personally been moved by arguments to avoid a drain. Drains today do not have to be painful on removal, though they are a hassle and uncomfortable at times. The benefit is that it minimized seromas and risks that lead to additional surgery. I use three drains, and they stay in usually longer than a week but my seroma rate is nearly zero for many years.

Scott E. Kasden, MD
Dallas Plastic Surgeon

Tummy tucks and Drains

Personally, I have been very happy with the use of drains after a tummy tuck. I think that it is rare for a surgeon to not use one-- there is very little if any risk with them, and most patients tolerate it very well. The downside of not using a drain is that you would be at a high risk for developing a seroma or fluid collection, which would need to be drained in the office at least once or twice-- not the end of the world, but this can usually be avoided with the use of a drain for a... more

Shahram Salemy, MD
Seattle Plastic Surgeon

www.drsalemy.com

Internal sutures vs drains

Both techniques are used successfully. If your plastic surgeon has used this technique successfully then trust his judgement. The internal "quilting sutures" are safe as is the use of drains.

John P. Stratis, MD
Harrisburg Plastic Surgeon

Your choice of surgeon

As usual, there is more than one way to skin a cat (or do a tummy tuck). In my experience, quilting sutures add time (and therefore cost) to the surgery and do not really add much. I use 1 small drain which is usually removed at the first post op visit. There is no guarantee that you wont get either a collection of blood or serum, no matter what technique is used.

William B. Rosenblatt, MD
New York Plastic Surgeon

Internal sutures vs drain in a tummy tuck

I personally use one small drain in a tummy tuck and it stays in until it gets to less than 25 cc's for a 24 hour period, usually a week. I rarely have any seromas with this and the drain is very easy to remove and is well-tolerated. I personally have no interest in doing internal sutures to eliminate the drain.