What are the pros and cons of a drainless tummy tuck?

No Drian Tummy Tuck-Pros:1. Decreased seroma rate. Which is why we used to use drains... To prevent seromas but found that seroma rates were actually decreased (9% with drains, down to 2% without drains) using the no drian technique utilizing progressive tension sutures2. no drain site pain 3. no drian to empty and keep a log of drain output amount.4. no drian to be careful to make sure you don't pull out by accident 5. no drain to pull out later6. no drain exit site scar (even if brought out at sides there is a worse scar where ever the drains come out)7. No drian for bacteria to track up and become a potential source for infection8. More skin can be removed because the skin is stretched downwards with each suture and thus less chance of needing a vertical scar.Cons: 1.15-20 minutes extra in the operating room. (Makes it a little more expensive, but not more risk of anesthesia because it's a short time.2. Very temporary dimpling to skin at progressive tension sites in some, but goes away in all by 1-2 weeksThis being said, the final results are very similar with or without drains in most cases. However, we have found that the recovery is much nicer for the patients now that we no longer use drains.  In my opinion, the extra 15-20 minutes in the operating room is worth not dealing with those drains for 1-2 weeks.  I hope this helps and best wishes. 

Our meta-analysis research (link below) showed that "drainless tummy tuck (abdominoplasty) with progressive tension sutures" were more effective than tummy tuck with drains in reducing seroma (fluid buildup) and reoperation rates, with no difference for hematomas or infections.
Many plastic surgeons continue to use drains during tummy tucks because it has been the standard practice for many years. Drains are traditionally used to prevent fluid accumulation under the skin, a common occurrence after the procedure. The accumulation of fluid, known as a seroma, can slow healing and lead to complications. Using drains helps remove this fluid, ensuring proper healing and minimizing the risk of complications. However, drains can be uncomfortable, require additional care, and increase the risk of infection at the insertion points. They can also leave scars, even after they are removed.
The advent of the "drainless" tummy tuck, typically achieved through the use of progressive tension sutures, offers an alternative to this approach. These sutures help to close any dead space in the skin flap, significantly reducing the likelihood of fluid buildup and seromas. This technique not only eliminates the need for drains but can also result in faster recovery times and less post-operative discomfort for patients. While it has been shown to be highly effective, it is not without its challenges, such as a slightly longer surgical time and the need for a highly skilled surgeon to perform the procedure. Some surgeons may still prefer to use drains out of familiarity or due to concerns about fluid accumulation, especially in patients with certain body types or those undergoing significant liposuction. However, as more evidence supporting the benefits of drainless tummy tucks accumulates, this method is becoming increasingly popular for its enhanced patient comfort and streamlined recovery process.
While not every patient is a suitable candidate for a drainless approach, the procedure has proven to be a highly effective option. Your plastic surgeon needs experience in this technique, because incorrect placement of the sutures can cause major problems including contour deformities and possible need for re-operation. Be sure to consult with an experienced plastic surgeon to determine if a drainless tummy tuck is right for you!
Krishna Vyas, MD, PhD, MHSHarvard, Hopkins, & Mayo Clinic Trained Aesthetic Plastic SurgeonNew York, New York

Over the years, surgeons have improved procedures and found ways to eliminate the need for #drains commonly used in a #tummy #tuck or #abdominoplasty, and a variety of other operations. I have found that most of my patients do very well with the exception of those have large areas of liposuction or lipo-abdominoplasty. Any extra fluid may be reabsorbed back into the body without the use of drains.  I may use drains on a case by case basis for these patients. If you go to a plastic #surgeon who uses drains, or if your situation requires drains, they usually stay in 3-5 days but may be required to remain in longer. The use of tissue #glue is to adhere the abdominal #skin to the #muscle. It is a new option and alternative to sutures in a tummy tuck. If you go to a plastic #surgeon who uses drains, or if your situation requires drains, they usually stay in 3-5 days but may be required to remain in longer. Your board-certified plastic surgeon will recommend the type best suited for you. The most important decision to be made before performing any surgical procedure is determining whether you are an ideal #candidate.