What Are the Pros of "No Pain-no Drain" in an Abdominalplasty ?

asked 11 months ago by JVE in Atlanta, GA
Latest answer by Glynn Bolitho, PhD, MD, FACS
Question viewed 322 times
Tags: alternative, comparison, drains

A surgeon I am looking at uses a technique called no pain no drain tummy tuck which eliminates the use of drains after completion of the surgery, can I get more information about this type of procedure and what are the benefit/cons of this compared to an tummy tuck with drains after the procedure.

11 answers to What Are the Pros of "No Pain-no Drain" in an Abdominalplasty ?

Tummy tuck without drains

Using internal stitches to eliminate the drain is becoming more common in tummy tucks as we strive to make the procedure better for our patients. The "no pain" part is probably better described as " less pain" and involves using long acting local anesthetics to reduce pain. These can be very effective.

Hugh McLean, MD
Mississauga Plastic Surgeon

What Are the Pros of "No Pain-no Drain" in an Abdominalplasty ?

From reading ALL the previous expert posters you can see what good PR or marketing can do. 99% of all boarded PSs use some drainage in abdominalplasties. As for "NO Pain" issue, do you really believe this? Pain is subjective so how can you ever promise no pain?

Darryl J. Blinski, MD
Miami Plastic Surgeon

No pain no drain abdominoplasty

The no pain no drain tummy tuck is a sales pitch, the kind of which should raise a red flag when choosing a plastic surgeon. Though clever, the use of drains in tummy tuck can depend on individual circumstances. We happen to not use a drain for tummy tuck though would say that the idea is not a new a one. No pain suggests that the surgeon does not have a respect for the serious side of cosmetic surgery. You will need pain medication and expert after care and we would suggest you... more

Peter E. Johnson, MD
Chicago Plastic Surgeon

No drain abdominoplasty

Abdominoplasty can be achieved by the use of progressive tension sutures as an alternative to drains. The vast majority of BC plastic surgeons will use drains for this procedure however. Not using a drain does not impact on the postoperative pain relief in any significant way. Management of postoperative pain after abdominoplasty has progressed significantly, but not to the point that "no pain" can be claimed. I would need to know exactly what modality of... more

Glynn Bolitho, PhD, MD, FACS
San Diego Plastic Surgeon

Tummy Tuck

Failure to use a drain can result in prolonged healing time. Without knowing the details of the surgery, there is no way to know if this is a risky decision or not. Most Board Certified Plastic Surgeon I know, use drains when doing full TT’s. A mini tuck may not require the same things. Do not think though that lack of a drain will get you to heal faster. Marketing is also prevalent in the cosmetic world…..beware.

Vivek Bansal, MD
Danville Plastic Surgeon

No pain no drain tummy tuck - Marketing or Reality?

There are ways to decrease the risks of fluid collection in a tummy tuck, and this can sometimes lead to the elimination of drains. Improving postoperative pain is also in part related to technique. In a standard tummy tuck, the abdominal skin and fat is lifted off the abdominal wall, directly on the fascia, or covering of the abdominal wall. Being careful to spare the loose lymphatics system which runs along this fascia can lead to less fluid accumulation and less pain... more

David Bogue, MD
Boca Raton Plastic Surgeon

What great marketing name

The question should be why this specific surgeon does not teach rest of the plastic surgeons about his technique to help all the patients? The term NO PAIN is very misleading. How you remove tissue,fix the abdominal muscle and cause no pain? The logical answer is no muscle work and minimal tissue removal. Please send me your doctor's information so I can go and learn from him or her( I am serious ). The drain can be avoided by deep progressive suturing.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon

No pain no drain abdominoplasty

Though I am not familiar with the term, a need for a drain can be reduced by a number of techniques. However it will be dogmatic to say that one will not use a drain in abdominoplasties. Most abdominoplasties will benefit by having a drain for the first few days. Pain after surgery can be reduced by a number of means. I presume your surgeon refers to the practice of leaving a fine tube under the skin and attaching it to a slow pump of anaesthetic solution. I personally use a 'patient... more

Anindya Lahiri, MBBS
Birmingham Plastic Surgeon

Brand Name Surgery

There is no specific surgery called a no pain / no drain abdominoplasty. Many plastic surgeons or cosmetic surgeons try to brand name a surgery to make it seem like they have something special. The decision to place a drain is customized to the patient. If no drain is needed, then I do not place one. If a drain is needed, then I place one. There is way too much emphasis placed on whether a drain is used or not. We are talking about a 3 or 4 mm wide drain... more

David Shafer, MD
New York Plastic Surgeon

www.ShaferPlasticSurgery.com

Progressive tension suture tummy tuck reduces need for drains

The procedure you are describing is usually called the progressive tension suture method, which was reported by Dr. Harlan Pollock several years ago and which I have been using for more than 13 years. There is no question that the need for drains is minimized because there is less tendency for fluid to build up (seroma) but I still prefer to use drains for about 3 days. The "no pain" twist is something new and I am frankly skeptical about that; we use an On-Q pump that infuses... more

Richard Baxter, MD
Seattle Plastic Surgeon

Seromas after tummy tucks

Much discussion about drains in TT's has been done on RS, please look these threads up. I personally like to use one tiny drain and take it out at a point where the fluid output is minimal, usually a week postop. This is to minimize the risk of fluid collecting after surgery requiring needle aspirations until it is gone. This is called a seroma and I feel it is better to try to prevent it than to have to treat it. Others will tell you that by using quilting... more