Are Drainless Tummy Tucks good to remove my loose skin? (photos)

Question

My stats: 6'1, BMI 27, recently lost 60 lbs. I workout 5 days/week. I want a TT to remove my loose skin. Had a consult and the Dr suggested the drain-less approach since I'm not getting lipo. Thoughts? Would I need to get a lymphatic massage even with no drains?

Robert M. Tornambe, MD · Answer

Congratulations on your weight loss Toni! 
There are pros and cons for each Tummytuck technique and the bottom line is consulting with a board-certified plastic surgeon that you are comfortable with and who’s reputation and experience deserves your attention. While I prefer using drains after tummy tuck surgery, especially massive weight loss patient such as yourself, the dreamless technique that you describe is also an option. Seroma issues can arise with either technique, and massive weight loss patients have a higher incidence of seroma and for that reason drains are a better option in my opinion. 
I am not a fan of lymphatic massage after liposuction as it is very painful and not proven to be effective. It is not indicated after tummy tuck surgery and should be avoided at all costs! Be certain you have consulted with a board-certified plastic surgeon in our area, best of luck

Dhaval M. Patel, MD · Answer

Thank you for your questions and photos. From your photos, you are a good candidate for a tummy tuck with liposuction. A tummy tuck will address excess skin & repair of the abdominal muscle. The abdominal wall can be weakened after pregnancy and (or) significant weight gain & loss. By repairing the muscle, not only does the appearance of your abdominal area improve, but your core strength as well. The repair of the muscle will cinch your waist like an inner corset, which will accentuate your curves. Liposuction will remove excess fat from unwanted areas with some skin retraction. I would never sacrifice your end result by not using drains. Your expectations and health will dictate the best procedure(s) for you. I suggest a consultation with a board certified plastic surgeon to go over the options that best address your goals. Best of luck!

Dhaval Patel MD
Double Board Certified Plastic Surgeon
Chicago
South Barrington
Oakbrook
Orland Park

Dhaval Patel MD 
Double Board Certified Plastic Surgeon 
Chicago 
South Barrington 
Oakbrook 
Orland Park

Casey Anderson, MD, FACS · Answer

There is some amount of swelling after tummy tuck even if no liposuction is done. I don't know that you will find a huge benefit from the lymphatic massage.

Jules Feledy, Jr., MD · Answer

Hello. From your photos and your interest in body contouring, it seems likely that you will need an abdominoplasty (Tummy Tuck-TT) and also liposuction. For the TT, a great number of plastic surgeons use progressive tension sutures (PTS) and these are extremely helpful to close the space between the abdominal wall and the overlying skin and tissue. That reduces how much fluid (seroma) is able to collect postoperatively, but many of us realize that a drain is still very helpful to expedite the healing process. Drains help remove excess fluid, and can be removed when the output is low. I have often found it somewhat more of a 'marketing tool' to recommend 'drainless surgery.' Best of luck! Jules A Feledy, Jr, MD American Board of Plastic Surgery, American Society of Plastic Surgery

Michelle Zweifler, MD · Answer

Tummy tuck removes excess skin, tightens the muscle and repositions the belly button.  In order to achieve the maximum results, the abdominal tissue is undermined from the pubic region to the ribs/ costal margins.  
With abdominoplasty, there is a risk of seroma.  Drains help remove the fluid and minimize the risk of seroma.  Internal sutures may be used to decrease the risk of seroma with a "drain-less" approach and this is discussed at consultation.  Liposuction is frequently used for additional contouring with a tummy tuck.

Carmina Cardenas, MD · Answer

It is wonderful what you have achieved after weight loss. 
Based on your photos I consider you are more candidate for a Lower Body lift because your outer thighs, front thighs and buttocks are saggy and  not only saggy skin on your abdomen. 
You will need muscle repair and also liposuction to waist and lovehandles in orde to achieve the best and more curvaceous result. 
I do quilting stitches and leave drains because of safety. And I have never regretted of using drains but I have, of not using them. 
Be encouraged. 
Dr. Cárdenas

Richard Baxter, MD · Answer

A drainless tummy tuck is the same as a regular tummy tuck with progressive tension sutures (PTS) which I have been doing for more than 20 years. What I have seen is that with drains, the fluid coming out is much less with PTS but it is not zero, so I still use them most of the time and remove them early. From your pictures, you would benefit from lipo to the waist as part of the tummy tuck for the best result anyway.

Daniel Barrett, MD · Answer

Dear Toni J.,
based on your photos, you look like a good candidate for a TT. Full tummy tuck should tighten your abdominal muscles and remove the excess skin. Flanks liposuction would give you a better shape. I would suggest you to consult a board-certified plastic surgeon because only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Nelson Castillo, MD · Answer

Thank you for sharing your question and photographs.  I agree with the tummy tuck decision to get you the best results but I would also do flank liposuction to further refine your results.  The use of drains is dependent on the procedure and the patient and is a discussion that needs to be had with your surgeon based on the techniques they will employ to minimize the risks of seroma formation. I prefer to still use a single drain in your case which is typically removed within 4-7 days.  Hope this helps.

Camille Cash, MD · Answer

Congratulations on your impressive weight loss! From your photos it appears you are a good candidate for a tummy tuck with liposuction for contouring.  In may practice I often use drains with my tummy tucks to avoid seroma formation and consequently rarely have a patient develop one.