Full Abdominoplasty - I've read recently that Full Tummy Tucks are being done without drains.

Is there a medical advantage to this? Is the tummy tuck done differently and does this affect the outcome of the TT? I am thinking of having one and have consulted with 1 doctor so far. She uses drains. I am in the process of consulting with a PS who advertises that he does not use drains. Is this a new technique that will eventually become mainstream? Thank you

Doctor Answers 5

Drainless tummy tuck

This technique has been used for several decades by a few plastic surgeons with exceelent results. Over the last 5 years it has been gining accpertance and is becoming more man stream. The main advantage of drainless surery is just that no drains. Drains can be uncomfortable and are definitely cumbersome to manage. Drainage tubes are typically in place for a week but can be in longer depending on how much fluid is being produced by you r body. The pupose of draiins is to prevent a complication known as as serum. A seroma occurs when fluid accumulates in the space created between the skin and fatty tissue and your abdominal muscles. With "drainless" surgery sutures ( known as progressive tension sutures ) are used to suture the tissues back together minimizing the space so there is very little room for fluid to accumulate; therfore, drains are not needed. Studies have shown this technique to be very effective at preventing seroma formation. Some feel that it also speeds recovery and results in thinner scars due to the distribution of tension throughout the lower abdomen and not just at the incision site. With either technique you should get a great result. I would choose the surgeon 9 and the office staff )  you feel most comfortable with to do your surgery.

Mckinney Plastic Surgeon
5.0 out of 5 stars 4 reviews

Drainless tummy tuck

The medical advantage is that the surgery can be completely safely and with the same or better outcomes without the need for drains. The surgery technique is exactly the same as it has been in the past with the addition of one step. Before the final closure, sutures are used to "quilt" the skin back down to the abdominal wall. This step closes off the space between the skin and the abdominal wall and prevents inflammatory fluid from collecting and forming a seroma. Surgeons that still use drains can obtain great results. And surgeons that don't use drains can have less than optimal results. But in general, patients that have drainless tummy tucks have better satisfaction outcome ratings, especially in the post operative phase of healing.

I attended a body contouring symposium in New Mexico in 2009 and again in 2013. The audience was polled both years asking who was completing drainless tummy tucks. In 2009, there were only a handful of surgeons who raised their hands. In 2013, about 15% of the audience said they were using progressive tension sutures. My guess is that the number of surgeons completing drainless procedures is closer to 40-50% now and will be considered the standard of care in the next 10 years.

Wm. Todd Stoeckel, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 76 reviews

Full Abdominoplasty - I've read recently that Full Tummy Tucks are being done without drains.

When performing a tummy tuck, a lot of empty space is created when lifting and redraping the abdominal skin/fat layer - this space tends to accumulate fluid, hence the use of drains traditionally.  Another way to address this issue is to close the superficial and deep layers of this empty space with multiple stitches, essentially closing this empty space and negating the need for drains.  Although this may appear clever, the multiple stitches that are tacked down to the fascia tend to contribute to increased postoperative pain and also lengthen the procedure.  Furthermore, modern day technologically advanced drains hardly contribute to any pain and are painless coming out.  As a plastic surgeon, If I were getting a tummy tuck, I would have it with the drains (my preference).  Be sure to consult with an experienced board certified plastic surgeon.  Good luck!

Zachary Farris, MD, FACS
Dallas Plastic Surgeon
5.0 out of 5 stars 14 reviews

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Tummy tucks without drains

Patients are looking for options that minimize post operative discomfort. One of these is to look for a surgeon who has a technique which optimizes the bodies own internal lymphatic system and thus obviates the need for drains.
In doing so, the fluid which is withdrawn using drains is alternatively reabsorbed by the bodies own drainage system. The layer which is responsible for this is called Scarpa's Fascia. In addition concomitant liposuction can aid in recontouring the abdominal waistline.
The Brazilians pioneered these procedures and these techniques are taught to other plastic surgeons at the national meetings. 

Drainless tummy tuck

The decision to use drains is a personal one and depends on your surgeon's preference.  There are steps which can be undertaken during a tummy tuck procedure to reduce the chance of bleeding post operatively and help the abdominal flap stick down to the underlying tissues.  If your surgeon uses these steps then the need for drains post operatively is reduced.  My practice is to avoid the use of drains in tummy tuck surgery unless absolutely necessary.

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.