Would it be a mistake to ask a surgeon to perform a DRAINLESS tummy tuck using PTS if this is not their usual method?

I need to combine a hysterectomy with the tummy tuck and my gynecologist works at Presby Plano. I have found a GREAT surgeon, but she does not use this method. Is it easy for a doctor to switch to this technique? How do I find a doctor that uses PTS instead of drains in Plano?

Doctor Answers 7

You should not tell your doctor what to do

There is much intrigue about drainless surgeries.  However going drain less does not mean that you will be immune from seromas. Drains are used to prevent that complication. 
PTS and using drains is one method. However just because drains are not used does not mean you have a superior surgery. You can develop seromas after PTS and no drains. In that case you will regret not using drains. 
It is best to leave choice of your technique to your surgeon instead of asking him to use a technique you encountered on posts.


Dallas Plastic Surgeon
5.0 out of 5 stars 22 reviews

Drainless tummy tuck questions

Go with the surgeon you like especially since you will be combining procedures. I have been using the Progressive Tension Suture method for almost 20 years and still prefer to use a drain!

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 46 reviews

Would it be a mistake to ask a surgeon to perform a DRAINLESS tummy tuck using PTS if this is not their usual method?

Thank you for your question.  If I were a patient, I would go to a surgeon who has done the procedure often, regardless of the procedure.  Even thought PTS is just taking extra time to place stitches between the skin flap and abdominal wall and is technically not difficult, it's worth considering a surgeon who has experience in perfecting it aesthetically.  Keep in mind that most plastic surgeons use drains and they work very well.  Every method has pros and cons.  For PTS, it may be associated with a longer operative time and more postoperative pain.  Be sure to consult with an experienced plastic surgeon certified by the American Board of Plastic Surgery.  Good luck!

Zachary Farris, MD, FACS
Dallas Plastic Surgeon
5.0 out of 5 stars 16 reviews

Drains after tummy tuck surgery

Drains are used after tummy tuck surgery in order to reduce the chances of a seroma (blood and fluid build up) which would have to be drained manually if one develops. If you are not comfortable with the idea of having drains, I would discuss this with the plastic surgeon with whom you are the most comfortable. My patients are initially not very excited about having drains to take care of, but after surgery and healing, they understand why they were placed. Good luck with your decision.

Surgeon and surgery

Thanks for your inquiry.  I will answer your question simply:  pick surgeon A and surgeon A's plan, not surgeon A and surgeon B's plan.  We all get our best results through our precision and form.  I wish you the best of luck.  

Drain-free tummy tuck

Hello - interesting question-
When the skin is separated from the abdominal wall during the tummy tuck, it leaves a raw surface that can ooze blood and fluid until it sticks back down to the muscle. That blood and fluid could accumulate and cause what's called a seroma (a collection of fluid under the skin). For that reason, many surgeons use drains so that the fluid drains out, rather than accumulating under the skin.

However, there are newer techniques that can allow us to avoid drains in many tummy tucks. Some surgeons use "quilting sutures" or "progressive tension sutures" to stick the skin back down to the abdominal wall. This works very well to prevent fluid buildup, take tension off the incision, and reduce swelling. Some surgeons will use quilting sutures, but also place a drain for a short time. All of the above options are acceptable, drains or no drains, and will depend upon your surgeon's experience and preferences. Similarly, some surgeons use pain pumps but there is a newer trend toward long acting numbing medications (Exparel) and nerve blocks.

If you've found a surgeon you trust, I would discuss your preferences with her, but I would not push too hard to ask her to change her technique. There can be a bit of a learning curve with new techniques, and many surgeons get lovely results with tummy tucks that use drains. Both techniques are very acceptable in my opinion.
I hope that helps-

Drainless Tummy Tuck

In plastic surgery there are many ways to do the same surgery. Sometimes a new method comes along and it is worth perusing the "cutting edge" surgeon. There is nothing new about PTS and drainless tummy tuck. It was first described by a Dallas plastic surgeon nearly 30 years ago (see link) I can't speak for everyone, but I would guess that many of us have tried it or use it for certain patient situations. Of the 130+ PS in Dallas the vast majority of us use drains. It's a conscious decision not because we are late adopters of a new concept. I would encourage you to discuss with your PS how she made the decision to use drains. I am sure she answers that question commonly and won't be offended. 

Best of luck! 

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.