Drainless tummy tucks: to drain or not to drain?
Dr. Jed Horowitz
Newport Beach, Ca
The most important decision is to choose a Surgeon who is a Board Certified Plastic Surgeon with experience. This will provide you with a high degree of safety and the ability to achieve the new body contours that you want and deserve.
What are drains used for? The purpose is to remove fluids such as local anesthetic, irrigation, liposuction fluid, blood and serum that may accumulate between the skin and muscle. Drains also create a vacuum to hold the skin to the muscle. They are usually removed in 3-10 days depending upon the amount of drainage, usually less than 30 cc, or one ounce in 24 hours.
I have used drains throughout my career of more than 25 years for many operations including tummy tucks, facelifts, and breast surgery. Early in my training we stopped using drains for breast surgery. Fifteen years ago I stopped using drains for facelifts. Two years ago I stopped using drains for almost all abdominoplasty (tummy-tuck) patients. If my results were better with drains for any of these procedures, I would have resumed placing them.
Many methods have evolved for decreasing the need for drains with tummy tucks. I have used most of these methods. Quilting, or internal sutures have been proposed to tack the skin to the muscles. This takes more time, can be uncomfortable and leave small dimples that usually go away but not always. I have found that a gentle compression garment will work well for most patients.
Seromas can occur with all of these methods including the use of drains. Approximately 15% of patients develop seromas after drain removal. This was the same statistic for my drainless patients.
However… recently I have started to use TissuGlu by Cohera Medical. In their clinical studies, patients treated with TissuGlu Surgical Adhesive generally had a quicker easier healing period with less swelling, and a quicker return to normal activities. I am very excited about this new product and the benefits for my patients. TissuGlu and Exparel for long term pain relief have allowed me to offer our Drainless , Pain-less Tummy Tuck for those patients wanting the best.
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