Are drainless tummy tucks safe? What are the pros and cons between drains and drainless? (Photo)

Doctor Answers 25

Pros and Cons between drains and Drain-less Tummy Tucks

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Plastic surgeon performing tummy tucks for more than half a century years have used drains. Recently a technique has been slowly becoming more popular using Progressive Tension Sutures (quilting stitches) to attach the superficial skin/fat to the deep muscle layer below to prevent fluid accumulation that a drain would otherwise remove. It is not fool proof (nothing is), takes a bit more time under anesthesia to place these stitches and a girdle is generally worn immediately but a drain-less Tummy Tuck seems to work well. Patients tend to like this as there is no drain care and they can shower earlier. There may be slightly more swelling, more of a chance for seroma in some but in the long run (after 1-2 months) no difference in the swelling of those with and those without drains. On the other hand use of drains in my experience is a quicker operative time, early on prevents seroma and minimizes bruising, easy and painless to remove postoperatively, no need to wear the elastic garment/girdle until the drains come out in my practice.

For those patients who choose another surgeon, the question to drain or not to drain is at the surgeon's discretion. There is no consensus at this point though most surgeons still favor drains until the output is generally about 30cc/24 hours. I individualize and if little or no liposuction at the time of a tummy tuck, a minimal or mini-tummy tuck I often do not use drains, whereas for significant liposuction with a tummy tuck and other procedures (#MommyMakeover) I most often use drains but individualize as needed.

Are drainless tummy tucks safe?

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It depends on how your procedure is performed.  To be "safe" it may be a good idea to have drains applied but it does not guarantee that you will not develop fluid below your skin surface.  Best to discuss this with your doctor. 

Michael Kulick, MD, DDS
San Francisco Plastic Surgeon
4.3 out of 5 stars 12 reviews

Drained vs Drainless Tummy Tuck

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The issue of whether to use a drain in a tummy tuck is not one of safety but whether you will develop a fluid collection (seroma) later. While there is good appeal to not having a drain after a tummy tuck, it cost a little more to do because of the extra time and sutures to quilt the dead space closed. But even so doing does not guarantee that a seroma will not develop later. Using a drain adds some inconvenience to the patient but poses no risks in doing so and is the most assured way to lessen the risk of a fluid collection later. Each patient needs to be considered individually and the size of the tummy tuck plays a major role in the merits of using a drain. 

Drainless Tummy Tuck

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The drainless tummy tuck is becoming more and more commonly performed and involves the use of progressive tension sutures that close the open space that is created during the procedure.  There has been some compelling evidence that it works very well.  There are also practitioners that use both the progressive tension sutures and drains.  More clinical research is needed to determine if there is a superior method.  Both seem to be safe.  Good Luck, 

Gaurav Bharti

Gaurav Bharti, MD, FACS
Charlotte Plastic Surgeon
5.0 out of 5 stars 124 reviews

Tummy tuck with no drains

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An abdominoplasty can be safely performed without drains, in the proper settinig.  On the other hand drains, while a short term nuisance, have very little risk.

Michael B. Tantillo, MD
Boston Plastic Surgeon

Are drainless tummy tucks safe? What are the pros and cons between drains and drainless?

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There is an ongoing debate in Plastic Surgery on this exact issue. For safety ALWAYS use a drain even if it comes out after a few days. Better safe... 

Drain Free Tummy Tuck with TissueGlu

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Drains are inconvenient, painful, and can leave a tell tale scar.  The drainless technique is more comfortable, easier, and offers a quicker recovery.

John L. Burns Jr., MD
Dallas Plastic Surgeon
4.7 out of 5 stars 56 reviews

About a Drainless Tummy Tuck

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In some cases a tummy tuck or #abdominoplasty can be completed without #drains. The #drainage tubes are used by trained Plastic Surgeons for many different operations.  The purpose is to release extra fluid that may otherwise accumulate under the skin, fat or muscle following an operation.  Patients generally find this annoying and uncomfortable and they can impede mobility and therefore slow aspects of #healing. Over the years, surgeons have improved procedures and found ways to eliminate the need for these #drains in a variety of operations; including #tummy #tuck or #abdominoplasty.

I have found that most of my patients do very well with the exception of those have large areas of liposuction or lipo-abdominoplasty.  I may use drains on a case by case basis for these patients.

A newer option now can include the use of tissue #glue to adhere the abdominal #skin to the #muscle; eliminating any space that previously required a drain.

If you go to a plastic #surgeon who uses drains, or if your situation requires drains, they usually stay in 3-5 days but may be required to remain in longer. Your board-certified plastic surgeon will recommend the type best suited for you. The most important decision to be made before performing any surgical procedure is determining whether you are an ideal #candidate.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

New Study Shows Superiority of Drainless Tummy Tuck

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I have performed drainless tummy tucks for many years and have found it to be a safe and reliable procedure when performed in appropriate surgical candidates.  I have not had any problems with seromas.  The length of surgery is increased somewhat, but I have been able to shorten my operative times by using a suturing technique which is somewhat different that is typically described by other surgeons.  I use a continuous stitch which is woven back and forth to secure the overlying fat to the underlying muscle fascia (fibrous covering of a muscle).  An average of 10 to 15 minutes is added to the length procedure, however, the closely woven continuous stitch that I use allows me to completely close the “dead space”, which is the reason I have not had problems with seromas.

In my experience, the extra time is very well justified, because all of the potential problems associated with drains have been eliminated.  Because the tissues are securely attached to one another, healing between the fat and underlying tissues begins immediately.  This allows patients to be more active during the early postoperative period, which in turn helps prevent potentially fatal clots from forming in the legs

I believe that conflicting views between surgeons are often the result of varying levels of experience with a particular procedure.  Therefore, I would advise you to find a board certified plastic surgeon that has significant experience and success with drainless tummy tucks.

 I hope that you find this answer helpful.  Good luck!

Tummy Tuck : Drains or no drains

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To drain, or not to drain; that is the burning question. The decision is dictated by the extent of the procedure. Non formation of seromas, can neither be assured by using drains, nor by the drainless technique. Therefore, while I might not use drains for mini tucks, I would prefer to use them in a lipoabdominoplasty just for "safety" with no extra downtime added to the patients recovery.

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.