About No Drain Tummy Tucks
Thank you for your question.
During a tummy tuck surgery, there is space between the abdominal wall and the overlying fat and skin (the abdominal flap). The body will do what it usually does during the healing process, produce fluid, if nothing is done to close this space. Because there is nothing to confine the fluid from accumulating, a seroma can develop in this space. In other words, the tissue produces fluid more quickly than it can reabsorb.
Negative suction drains are placed in spaces like this to get rid of the fluid and create suction between the tissue planes. There is a way, however, to eliminate this space without using uncomfortable drainage tubes. Dr. Patel utilizes progressive tension sutures inside the tissues to close off the space and relieve tension on the last surgical closure. This results into less pain, less discomfort and less tension. Also, there will be better scarring with potentially minimizes infection risk.
We have successfully used progressive tension sutures during abdominoplasty instead of surgical drains, with a lower seroma rate than is generally thought to occur with tummy tucks and drains. With this method, the seroma rate is close to zero and you cannot beat that approach. Best of luck!
Dhaval M. Patel
Double board certified
Are drains necessary or an option with having a tummy tuck?
No, if done properly with an internal suture technique, drains can be eliminated. However, only few plastic surgeons do this so find an experienced one. I have not used drains in over 10 years. See link below for examples.
Most surgeons use drains after tummy tuck surgery. There are some that don't use drains. A good compromise would be to use quilting sutures and drains but remove them fairly early depending on the drainage to prevent having seromas which can be very difficult to treat. I would recommend having a consultation with an experienced, board certified plastic surgeon to determine what is best in your case.
There is no hard and fast rule regarding drains after full abdominoplasty. In those patients with only a small amount of excess skin and very little fat, drainless tummy tuck is quite possible. This is achieved through the usage of multiple quilting sutures on the inside to close the space that would normally be drained. However as a patient's residual fat increases, the probability for needing drains also increases. I certainly limit drain usage whenever possible but it depends upon the patient. If the drain is never used for any patient, then it simply increases the likelihood of postoperative complications such as seroma in certain patients. I hope this helps and good luck.
To drain or not to drain a tummy tuck?
I have always drained tummy tucks with tiny 7mm drains that do not leave scars or hurt when removed. These drains typically drain 300-400 cc of fluid (almost a pound) in the first 2-3 drains after surgery. I have always used quilting sutures which help prevent fluid collections called seromas, but I believe most patients would prefer not to carry around that extra fluid, which increases the swelling, in the first couple days following surgery. Since drains I use do not hurt when they are removed, my patients do object to them. Good luck
Drains necessary in tummy tuck?
excellent question... The answer is it depends entirely on surgeon preference. The intention behind leaving drains is that they remove fluid that may accumulate in the open space in the immediate postoperative period. Alternatives include no drains and/or "quilting sutures" which are meant to hold the tissues against one another and limit the space where fluid can accumulate. If drains are placed they are typically removed by one week. At the end of the day I would not advise choosing your surgeon based on this particular aspect of the case (as it represents a small aspect of your overall recovery) but rather based on your comfort with the surgeon and the results you think you can achieve with him/her. Hope this helps and good luck!
Are drains necessary or an option with having a tummy tuck?
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
Robert Singer, MD
La Jolla, California
Drains are up to the surgeons discretion. Some surgeons use them and some do not. The idea behind drains is to prevent seromas, which unfortunately, still happen. The literature is not clear the best approach to prevent seromas and both techniques are reasonable. Talk to your surgeon about their plan for drains.
Drain v. Drainless Tummy Tuck
I do not use drains any more with this procedure and have switched from pain pumps to Exparel which is a long acting injectable pain medicine like Lidocaine or Marcaine but lasts for three days. This is injected all along the muscle and skin to provide pain relief. This is termed the Pain-less, Drainless Tummy Tuck.
If you go to a doctor who uses #drains, they usually stay in 3-5 days but may be required to remain in longer.
With drain-less tummy tuck as an option for this procedure, take a look at the video attached here for some more information on this procedure and what to ask your surgeon in consultation.
The use of drains with a tummy tuck varies depending on the extent of the procedure and the preference of the surgeon based on their experience. This is something that would be discussed during your consultation.