Is Drainless Tummy Tuck a Safe Procedure?

A no-drain tummy tuck is not more or less safe than a traditional tummy tuck in which drains are used.TBH, I am baffled that surgeons are still using drains for tummy tucks, and I surmise that they are resistant out of a fear of change. I have been performing my tummy tucks without drains for over 10 years now. Not only does this make the patient infinitely more comfortable post-op, it actually reduces complications and yields a superior result.
This technique adds just 5-10 minutes on to a traditional TT. Instead of just pulling the skin down and suturing at the incision line, the flap is sutured down to the muscle at several different points. This reduces the space in which fluid can collect to small pockets that the body can manage and absorb. This technique of tacking the skin down also allows me to give a better aesthetic result  with a funneled natural-looking indentation around the belly button. Additionally, I have seen FEWER seromas after a no-drain tummy tuck than I did when I was using drains. Tacking the flap down also evenly distributes the pressure over the entire abdomen vs just at the incision thus reducing complications of a wound opening while also allowing for the incision to heal in a very thin line.
I recommend that you continue your search for a Board Certified Plastic Surgeon who performs drainless tummy tucks. 

Hi there,
The drainless tummy tuck procedure is not more dangerous and it does not take more time in the OR. Every surgeon works at a slightly different pace in the operating room. Most tummy tucks take between 2 and 4 hours, and the progressive tension sutures take about 20 minutes to perform (we have timed it to answer this question :) ). Ultimately, the time you save and the convenience you have with not managing drains postoperatively makes the drainless technique worth it.
Phillip Dauwe, MD

A drainless tummy tuck procedure usually involves placement of multiple "progressive tension sutures" deep under the skin. By helping to quilt down the skin flap to the underlying abdominal wall, this eliminates "dead space" where fluid collections (or seromas) could form. These sutures also prevent shearing forces between the skin and abdominal wall, which reduces inflammation and fluid production under the skin. Both these factors help to make drains unnecessary. These sutures are resorbable and will dissolve over time. Although it takes some additional time to place these sutures, it only adds about 15-30 minutes at most to the procedure time. The additional OR costs for this are not very much - plus drains themselves cost money too. I believe the enhanced patient comfort without drains is well worth this small amount of additional operative time.
The other benefit of "progressive tension sutures" is that they help to take tension off the skin closure, and could help prevent scar widening as you heal.
There have now been multiple studies with hundreds of patients that had drainless tummy tucks. And these have shown that drainless tummy tucks are indeed very safe - in fact, this technique might result in even fewer seromas than when drains are used! I recommend drainless tummy tucks to tall my patients.
Emile N. Brown, MD 
Johns Hopkins & Harvard Trained Plastic Surgeon