Drain or no drain tummy tuck?
Recovery will be very similar, except that you will not need to deal with the difficulty of managing the drains (draining them daily and keeping a log, they can get caught on your clothing and pull on the stitch holding them in place and that hurts, the site that the drains come out tends to be tender and there is always a scar where they come out (even if they come out the ends of the transverse scar). In addition, in a study we are publishing, we noted that the rate of fluid collections (seroma), the very thing the drains are supposed to prevent, was dramatically decreased using the no drain tummy tuck procedure. So, for these reasons I no longer use drains and prefer the no drain tummy tuck. The results are similar, but my patients and nurses have noted that the recovery is easier without the annoying drains. I hope this helps and best wishes
Dear Ms. KCENC,
Thank you for your questions.
Your overall result, recovery, risk is not dependent on the use or not use of drains.
Drainless tummy tuck does add some additional time to perform and expense.
Excess fluid is absorbed by the body (to a a point). If it is excessive it will collect (seroma) and require drainage.
I recommend that you schedule several consultative appointments with Plastic Surgeons who are experienced and Certified by the American Board of Plastic Surgery. In addition ideally a members of the American Society for Aesthetic Plastic Surgery (denoting by membership as having met additional criteria and a focus on Cosmetic Plastic Surgery).
I wish you my best and success,
R. A. Hardesty, MD, FACS
Diplomate and Certified by the Am. Bd. of Plastic Surgery
4646 Brockton Ave
Riverside, Ca 92506
Thanks for your question.
There is no conclusive answer to which is best. You should choose the surgeon you like and follow with what he/she is most comfortable with and has had good results performing. The drainless procedure does have advantage of less post operative discomfort but disadvatage of more operative time.
Fluid accumulation results from surgery.
Many of my colleagues have provided excellent answers. Any time you create a surgical space by virtue of lifting the abdominal skin, tightening the muscles, and excising the excess skin and re-suturing for a prettier and tighter abdomen, the potential exists for the body to produce fluid (serum) and in the absence of drains, you are likely to experience a bit more short term swelling, and the risk of a post-operative seroma that will require drainage in the office with a needle. The "quilting" technique theoretically eliminates the need for drains in some surgeon's hands. In my 25 years of experience, I have almost always used drains, even if short term for a few days, and I have rarely regretted doing so. No patients ever relish the idea of drains, but they definitely reduce the likelihood of short term swelling, and the likelihood of post-operative seroma, and they should not be left any longer than absolutely necessary. I myself do not charge more for the quilting technique, but this is a personal decision for each plastic surgeon to determine their own surgical fees for any given procedure. Make sure you are confident that your plastic surgeon seems to be the right fit for you, and that her or she are board certified and experienced in body contouring surgery. Best of luck to you.
Thank you for your question.
Progressive tension suture has helped resolve one of the lingering problems associated with recovery: the use of surgical drains. After the traditional form of abdominoplasty is complete, patients are typically fitted with small, thin tubes that pass through the skin. For about one to two weeks following surgery, these tubes are used to drain any of the excess fluid that accumulates in the potential space between the skin / fat and the muscle left behind by the surgery and ensures a safe, speedy recovery. Without drains, the fluid that naturally collects in the wound can stop the underlying fat and muscle tissues from coming together and properly healing.
The use of drains can lead to certain problems, though. Patients often report irritation and discomfort with the drain itself, annoyance regarding limitations on movement, and the need to empty the drains two to three times per day. Drains also carry the risk of creating infections, making unnecessary scars, and can also technically malfunction.
While using PTS to create a drainless tummy tuck may take the surgeon slightly longer to perform, the benefits of the approach are well worth it. Not having drains in place makes the recovery process more comfortable, cost effective, and less painful. There is also a greatly lessened risk of infection, additional scarring, and healing complications. When PTS is used, the tummy tuck heals more quickly and recovery isn’t as difficult for the patient.
I'd recommend booking a
consultation with a Board Certified Plastic Surgeon to determine what your
options would be.
When are drain used with and abdominoplasty.
The use of drains with any procedure is at the discretion of the surgeon. I personally don't use drains with the type of abdominal procedure that I do. However, it's more important to choose the surgeon who will give you the best result not whether or not drains are used.
Some excellent plastic surgeons use drains, some use internal
quilting sutures, and some use both. Whether a surgeon uses drains or not
should be one of the least important factors in choosing the surgeon. The
choice of drains or no drains should depend on the extent of the procedure and
the surgeon’s opinion based on his or her experience. Good results have been
obtained both with and without drains. The length of the recovery and the
extent of swelling are not diminished in procedures where no drains are used.
What is far more important is the choice of the
surgeon. I would suggest you find a plastic surgeon certified by the American
Board of Plastic Surgery and ideally a member of the American Society for
Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with. You
should discuss your concerns with that surgeon in person. While a second or
third opinion may be worthwhile, continuing to pursue consultations until you
get the answers that you think that you want to hear may not necessarily be in
your best interest. If you are ambivalent, don’t do the procedure.
Robert Singer, MD FACS
La Jolla, California
I have not found that the drains were a major complaint for my tummy tuck patients. They serve a great purpose and the progressive tension sutures used to do the "drainless tummy tucks" caused puckering (albeit temporary) and increased OR time. I do not really see a benefit besides marketing that you do a "drainless tummy tuck". The most important thing to consider is results- what do your surgeon's tummy tucks look like in the long run? Scar placement, contour improvement, how the belly button looks- all of those things are way more critical than whether drains are used. That's what you will live with the longest, not the drains. Hope this helps.
I give my patients the option to have drains or not. We charge more for the drain-less because it takes more time and requires many more sutures. Of the thousands of patients that I have performed tummy tucks on, virtually all of them complained about the drains. When we started doing the drain-less tummy tucks, patients complained less and had more mobility. The end result was the same, but the recovery seems easier without drains. Also, we have had a zero percent post-op seroma rate with the drain-less tucks.
Tummy Tuck - Drain or No Drain?
Thank you for your question. I always place a drain with tummy tuck surgery. The drain typically comes out within 3 - 5 days and does not cause the patient significant discomfort. I believe it is better to have the drain close down the space between the skin and abdominal wall than have the potential for a seroma to develop which would require multiple aspirations. Hope this helps and good luck with your surgery.