I Was Told Two Different Things at Two Consultations?

I have been to 2 consultants and both told me diff things 1 said I should try and lose more weight, witch I can do, the other said he doesent think it would do much cause of my muscles and one uses drains the other uses no drains and no pain pump witch is better with the shortest recovery?

Doctor Answers 10


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Different surgeons have different ways of performing the same procedure. I find the results with pain pumps to be very individual and vary considerably

New York Plastic Surgeon

Different opinions

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Sure - different surgeons may use slightly different techniques.

As for the weight loss, you'll get a better result if you are close to your ideal weight.  Once the fat from the abdomen is gone, the surgeon can really take care of the loose skin better.

As for pain pumps, I haven't found them to be especially impressive for the TT patients - a bit of a disappointment really.

As for drains - I use them, some surgeons use quillting sutures internally.  This one is a surgeon preference type of thing.

Hope that helps!

Tummy tuck consultation

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It's fairly common to hear different recommendations when you visit with different plastic surgeons. You should be close to your ideal body weight or be at a stable weight before having surgery. Most surgeons use drains to minimize the risk of seromas (fluid collections) after surgery. A pain pump can be useful at minimizing the amount of oral pain medication required during recovery. Regardless of technique, most patients will take off about a week to ten days to recover before returning to work.

I would recommend meeting with at least one more plastic surgeon before making your decision. Be sure that the surgeon is board certified by the American Board of Plastic Surgery and that the surgeon has many before and after photos for you to review.

Best wishes,


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There is more than one way to skin cat so to speak.

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Different surgeons can have good results doing slightly different things.  Drains are most commonly used after abdominoplasty by most surgeons, but some do not use them.  Some use pain pumps, but studies have shown no real decrease in pain medication usage, so their use is debateable.   Neither one of these things will greatly affect the end result of the surgey.   Look more at before and after pictures and experience to make your decision.   Most surgeons that that if you are going to lose less than 20 lbs, you should do the surgery, and if you are going to lose more than that it is better to wait.   This is a general rule of thumb, and not a hard and fast rule.  Chose the surgeon you feel most comfortable with. 

Best regards,


Dr. Lane Smith

Best Tummy Tuck Results

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If you are within 10-20 lbs of your weight goal, losing more weight will not make much difference. The way we suture the flap makes the use of drains much less, but I think it is risky to not use them at all. I always use a pain pump. It markedly reduces the pain and makes tummy tuck an outpatient procedure with a quick recovery.

Weight Loss Before Having A Tummy Tuck

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If you are within 10 to 15 lbs of your ideal weight goal, then there is no need to lose more weight before tummy tuck surgery. It is quite different if you are 35lbs or 50lbs from your goal, then more weight loss is needed. Whether you have a tummy tuck with a drain or a drainless tummy tuck, the recovery between the two is no different. The drain may be an inconvenience but it does not affect the tummy tuck recovery process.

Different Opinions

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Whenever a patient has two widely different opinions from two different surgeons, I usually recommend a third opinion to help you settle it.  I cannot say if a tummy tuck is the right answer for you without pictures and without knowing your overall state of health.  I usually recommend the use of drains with a tummy tuck to prevent fluid pockets from developing that can cause infections and other problems down the line.  Drains do not slow your recovery.  I prefer to inject the local anesthesia myself to using pain pumps, but I do not think one will significantly speed your recovery over the other.  Good luck.

Tummy tuck questions

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Impossible to give you specific info without photos. I realize it is easy to tell you to lose weight, but it's not so easy. If you are around twenty pounds from your ideal weight, I would probably go ahead with the tummy tuck. The important thing would be not to gain weight after a tummy tuck, which is also easier said than done. As far as drains, I do use a drain in all tummy tucks. The drain sounds gross but it really is not that big a deal. I would not choose one surgeon over the other based solely on that issue. As far as the pain pump is concerned, I don't think they work and would not waste the extra money.

Tummy tuck confusion

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I also advise patients to try to lose more weight and stabilize their weight prior to surgery.  Frankly, I am sure that I could "sell" more surgery if I didn't tell patients to do this but it would be in my financial interest rather than in their best interests.  Sure, you could always have more surgery later but unless you are rolling in money, I think that is just unrealistic.  I do not use the pain pump; my patients do very well with a few days work of oral pain medication and the presence of a modicum of pain guards against overexertion.  I prefer drains as they reduce the risk of seroma or hematoma.  These two issues are a matter of surgical judgment.  Find a plastic surgeon with whom you are comfortable and who you trust.  Best wishes.

I Was Told Two Different Things at Two Consultations?

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Some photos would help, or at least some info such as height and weight. If you are talking about 10 pounds of weight loss, not much difference. If you are talking 50 pounds, maybe a big difference in terms of safety and results. I don't quite understand what your muscles would have to do with it. 

The use or non-use of drains will not affect discomfort or speed of recovery. I have been using pain pumps on all my tummy tucks for the past year or so, and I am stopping that practice because I am quite unimpressed that it has made much difference. 

If you are significantly overweight, I would go with the surgeon who wants you to lose weight whenever you decide to do your surgery. 

Thanks for  your question, all the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

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.