Hello. I am a healthy, 29 year old male at my ideal weight and about a week ago I underwent IV sedated, tumescent PAL & Laser liposuction of my abdominal area, flanks, and chest. My plastic surgeon sealed the incision sites. I have regularly read that incision sites are typically left open to drain to help recovery. Why would my "board certified" plastic surgeon, who trains other surgeons, choose to seal the incisions sites? I would rather have a few days of messy drainage and a more comfortable recovery than a comparatively cleaner but longer, uncomfortable recovery.
Drains Used for PAL & Laser Lipo Incision Sites?
Doctor Answers (6)
Liposuction Incision Sites
There is no rght answer for this question. Some surgeons prefer to close the incisions completely, while others allow excess fluid to drain out the incisions and heal on their own. Neither has been proven to be markedly better than the other,no matter what any surgeon says. I have gone both directions with patients and am hard pressed to say their is a difference in recovery time, final outcome, infections, etc. I hope this helps.
Insertion sites of liposuction may be left open
I know of many surgeons that leave their incisions open and others who close them. Some close the upper areas but leave the dependent ones open to allow fluids to ooze out. The closed wounds may or may not heal prettier than open insertion sites if the size is small. There are many variables and there is no proof that one way is better or more comfortable than the other.
Liposuction and Drainage
There is not board certified answer. Every plastic surgeon has their own way of performing surgery and doing their postop care. Plastic surgeons do what works for them, not what others do. Many plastic surgeons close the incisions and their patients do fine.
Again, plastic surgery is an art and most if not all the surgery that is performed takes time to heal and you get results at about 2 months time. That is the case with most of the surgeries performed.
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Surgeons have Different preference regarding Liposuction Ports
From your rather sarcastic tone ("Why would my "board certified" plastic surgeon, who trains other surgeons, choose to seal the incisions sites?"), I guess the "love is gone" between you and your surgeon.
As most Plastic surgeons would gladly confirm for you, Plastic surgeons are extremely nonconformist and individualistic in their thinking and practice. We approach treatments and procedures with skepticism and often vary in how we do things based on our understanding.
While some surgeons close all the liposuction ports completely setting the patients up for prolonged swelling but nicer access port scars, others leave them open, as you stated, allowing for a few messy days of drainage but no swelling. An in between group closes these ports loosely, allowing fluid to exit yet for the scars to heal nicer. Finally, in a minority, there are those who like to spare their patients the mess of constant drainage by using suction drains through the most dependent of access ports. These suck away the fluid into bulbs, protecting clothes and furniture, while allowing the other ports to be closed off nicely. There is No one right answer but many different choices that depend on your surgeon. If you know what you want - tell your surgeon.
Different strokes for Different folks: variations in practice among plastic surgeons.
Plastic surgery is an art an as such, different surgeons practice differing techniques and styles when performing surgery. Freqeuntly there are differences of opinions on how to treat a condition among leaders in the field and this reflects that excellent results can be achieved with different approaches.
Closing lipo cannula sites is a trade off
I think its reasonable to allow small cannula sites to remain 'open' for drainage purposes, assuming the cannula sites are small (<4 mm). This results in minimal scarring. Larger port sites should be closed with suture for optimal scar quality.
Closing lipo ports eliminates the wet messy drainage of tumescent solution. The scars are probably a little better, but not markedly so, for small cannula sites.
I don't think either maneuver alters a patients 'recovery' after liposuction. I place a single nylon suture in liposuction ports, and remove this suture at 5 days post-op.