Why do some doctors use drains after a tummy tuck. And some don't?

Thanks for this great question. Historically, in performing a tummy tuck we would lift up the skin, remove the excess and then just lay it back down, using a binder to help the skin stick down and promote healing. Some have found that instead of just laying the skin down, sewing it back down from the inside or "quilting" may help patients to heal more quickly and have a lower chance of fluid collections. Because of this some doctors choose not to leave a drain in a quilted patient. I believe in quilting and have been doing it for many years. I have found a far lower incidence of fluid collections. Even so, I consider a drain a safety precaution. If fluid got stuck inside you and could not come out it could become infected. I consider a drain an emergency exit-- just in case.
Hope this explanation helps.

This is an excellent question.  Using drains is often the surgeon's preference.  I use sutures underneath the skin (quilting sutures) to help prevent seromas (fluid build up).  I will use one drain as a safety measure.  If the patient is very thin, I will not place any drains.  Your board certified plastic surgeon will discuss their preference with you. 

Thanks for your questions. In my personal experience I like to use drains after tummy tuck procedure because I like to make liposuction in the waistline and the drains help to remove the seroma and liquid for the tumescent infiltration. Please make sure to contact a Board Certified Plastic Surgeon. Best of luck:)

Hi Junta7101 and thank you for your question.  You ask a very important question and I think that it is important to note that the choice to use drains or not with a tummy tuck is highly patient and surgeon specific.  When performing a tummy tuck the skin of the abdomen is lifted off of the abdominal wall, the excess skin is trimmed or removed, the abdominal wall muscles are plicated, and the skin is then placed back down on the abdominal wall.  In the past it was almost routine for plastic surgeons to leave one or two drains between the skin and abdominal wall to help reduce the risk of fluid collections but today more and more surgeons are opting for a drainless tummy tuck.  A drainless tummy tuck requires quilting or sewing of the skin to the abdominal wall.  In my practice I have made the shift in recent years to a drainless tummy tuck procedure, as I have found that in most cases patients have a much easier recovery with a lower risk for fluid collection.  In some cases, I will still use drains depending upon the patient and their medical health profile.  I hope this helps an I wish you all of the best.

I would base the decision on the results and not necessarily on the methods used to achieve the results. I find it unnecessary to use drains if the compression garment is worn as instructed.  Select your PS based upon experience, education, American Board of Plastic Surgery certification, number of surgeries performed, and patient feedback.  Trust your PS to make the right decision to achieve an uneventful and successful recovery.Kenneth Hughes, MD, Board Certified Plastic SurgeonLos Angeles, CA

Thank you for your question. Drain use is a standard practice with tummy tuck, however, recently more surgeons are performing a specialized type of closure that allows for no drains. Not every patient is a candidate for drain-less tummy tuck, and not every surgeon is comfortable with the idea. Recent studies showed similar results and similar rates of complications whether drains are used or not. Presence of drains requires patients to empty drains and do measurements and sometimes there is a small added discomfort, otherwise there is no difference. Hope this answers your question.
Sincerely,
Olga Bachilo, MD

junta7101.  Opinions differ among plastic surgeons regarding the need for drains after Tummytuck. Many surgeons view drains as a necessary inconvenience to allow revovery without seroma formation.  While drains do not guarantee “seroma free” recovery, “drain-free Tummytuckdo not either.  Be sure to consult with a board certified plastic surgeon and discuss the option best for you. Good luck!

A tummy tuck  operation involves the removing of the extra skin and fat from the abdomen. The difference between a drainless or traditional tummy tuck procedure where a drain is used has much more to do with the surgical technique than the simple avoidance of drains. The technique of quilting or progressive tension sutures has been demonstrated to be helpful in minimizing the accumulation of fluid in the operative space after the dissection is completed. 
 A more comprehensive and anatomically supportive approach to a drainless tummy tuck operation is preserving the bodies own lymphatic system. This involves preserving a thin layer of fascia on the abdominal wall which has upwards of 10 to 20% of the abdominal wall‘s lymphatics. By preserving this in the lower aspect of the abdominal dissection the patient’s own in lymphatic process drains out any fluid which may accumulate in the space created from the operation. This is a technique which was pioneered by the Brazilians over 10 years ago and has been demonstrated to deliver significant advances in surgical technique.
 My own journey with avoidance of drains began when a patient of mine caught their a drain on a door knob. This was painful for the patient and prolonged her recovery. 
 I have been using the Scarpa sparing technique for seven years and have found it to be superior aesthetically and result in a pain-free postoperative period which allows for immediate showering and faster return to recovery. Additionally this allows for fewer seroma issues and superior aesthetic results. 
Watch my animated video which demonstrates this technique.

Hello and thank you for your question. I prefer to use drains in my patients in order to decrease seroma rate and avoid the potential problems with drainless tummy tucks using quilting sutures, such as skin indentations.  Far more important than the usage of drains, is the overall quality of the work your surgeon can demonstrate.  If you are an appropriate candidate for a tummy tuck, this can be done through a low and short
incision, all completely below the bikini line. 
The belly button can be designed to look natural and have no scars on
the exterior.   Your muscles can also be
plicated resulting in a flat abdomen. 
Make sure you specifically look at before and after pictures of
real patients who have had this surgery performed by your surgeon and evaluate
their results.  The most important aspect is to find a surgeon you are
comfortable with. I recommend that you seek consultation with a qualified
board-certified plastic surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D. FACS
Harvard-trained plastic surgeon

There is a space created during the abdominoplasty between the muscles repair and skin. The body fills that space with fluid. The drains help that area to “seal”.   Some plastic surgeons put multiple sutures to reclose the area and others choose to use a skin glue type material but most use drains to eventually have this space close and not develop a Seroma.  Good luck  

To drain or not to drain that is the question. Quilting sutures are great for heavy set patients, thin belly patients may show indentations on the belly from quilting sutures. There are tissue glues I have tried with limited success in patients I see. When doing liposuction for the lateral fat deposits or love handles it is best t o drain. The drains come out in 3 to 10 days. Aspiration may be indicated if there are fluid collections after drain removal. Chronic serums can form which may have to be removed by surgery. Conservative management dictates drain use in tummy tucks. Good luck...