Ask a doctor

What is the Progressive Tension Method? Drains or No Drains I'm Getting Confused, Which is Better?

I need to know what is the difference between the progressive tension method or drains?

Doctor Answers (4)

Benefits of progressive tension suture method for abdominoplasty

+2

I have been using the PTS method for tummy tucks for almost 15 years and have found several benefits. The sutures are under the skin flap to anchor it down with even distribution of pulling. One of the first things I noted when I started using this technique was a dramatic decrease in the amount of fluid output in the drains, so that they could be removed in a couple of days instead of the usual week or so. Some surgeons do it without any drains at all but I still prefer them. Another benefit is that the scar can be kept low where it is more easily concealed, but without excess tension that can lead to a thickened scar.


Seattle Plastic Surgeon
5.0 out of 5 stars 23 reviews

Drains and Tummy Tucks

+1
Thank you for your post. Whenever there is a potential space in your body, your body tends to fill that space with serous fluid (the yellow type of fluid that also comes out of a 'weeping wound'. This is similar to when you get a blister: the layers of skin separate and fluid is deposited in to the space. In a tummy tuck, the space is in between the skin/fat layer and the muscle layer. Most surgeons will place a drain to remove this fluid while your body is secreting it until the fat layer grows back together with the muscle layer. At that point, no more fluid is secreted into the area, because there is no more space for fluid. The length of time that this takes varies from patient to patient. Some patients heal much faster, thus the layers seal together much faster. Also, the more twisting motion you have in your belly area, the slower the two layers grow back together because they are moving in relation to each other. The fluid coming through the drain can be initially dark red, and eventually clears to pink then yellow. This is because it takes just a little bit of blood to make the fluid dark red. Also, initially, there can be a large amount of fluid (few hundred cc's in the first day is not out of the range of normal) and this should slow down substantially over next few days. Once the fluid slows down to the amount that your surgeon is comfortable with (usually 25-50 cc in 24 hours) then they will be pulled. There is minimal discomfort in pulling the drain in most patients.
More recently, 'drain free' surgery has become more popular. Fat layer is sutured down to the muscle layer starting at the ribs and progressively down to the lower incision. This makes the space for the fluid to collect much smaller, and in many patients can have surgery without drains. However, I have seen multiple patients come from other surgeons because they developed a seroma despite the suturing of the tissue. This is not the surgeon's fault, but some patients just do not heal fast enough or put out too much fluid for the body to absorb.
Best wishes,
Pablo Prichard, MD

Pablo Prichard, MD
Phoenix Plastic Surgeon
5.0 out of 5 stars 26 reviews

You need to check before and after

+1

There are many ways to perform abdominoplasty  or tummy tuck, the most important factor is the results your surgeon will get, not the way he will obtain them. There is no scientific evidence showing any advantage in this techniques (applying to every surgeon), just anecdotal data, some surgeons citate big numbers when talking about the incidence of fluid collection (seroma) in abdominoplasty, however I believe this is related to the surgical technique more than to the use or not of drains or stitches, some surgeons have a minimal number of seromas without using this kind of techniques, so there is no reason for this surgeons to change their procedure. The most important factor in obtaining a good result in your cosmetic abdominoplasty is the surgeon you choose, when you talk to your surgeon have him showing before and after pictures and ask the office for patients you can call to discuss their experience with the surgery. When you find the surgeon that is right for you, you will know.

Victor M. Perez, MD, FACS
Kansas City Plastic Surgeon
5.0 out of 5 stars 7 reviews

You might also like...

Autologus fat and plastma are "organic" and better than any comercial fillers

+1

drains are external  ducts  than succionate internal fluids  after any kind  of  surgery precisely to avoid  any  sepsis,progressive tension method  it serves for  to get a better scar in case  of an spetial kind of surgery

 

Ramon Navarro, MD
Mexico Plastic Surgeon

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.