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. 

There are multiple ways you should be using to decide which surgeon should do your operation.  Drains are a very useful tool which are temporary.  Since they are not a permanent feature of your outcome, they should not be the reason you choose to find someone that does not use drains.  Look at the surgeon's outcomes, training, experience, and whether you trust them.  I personally find drains to be essential in tummy tuck.  

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.

Plastic surgeon performing tummy tucks for more than half a century years have used drains. Recently a technique has been slowly becoming more popular using Progressive Tension Sutures (quilting stitches) to attach the superficial skin/fat to the deep muscle layer below to prevent fluid accumulation that a drain would otherwise remove. It is not fool proof (nothing is), takes a bit more time under anesthesia to place these stitches and a girdle is generally worn immediately but a drain-less Tummy Tuck seems to work well. Patients tend to like this as there is no drain care and they can shower earlier. There may be slightly more swelling, more of a chance for seroma in some but in the long run (after 1-2 months) no difference in the swelling of those with and those without drains. On the other hand use of drains in my experience is a quicker operative time, early on prevents seroma and minimizes bruising, easy and painless to remove postoperatively, no need to wear the elastic garment/girdle until the drains come out in my practice.#tummytuck#drainornodrain#tt

   I use drains in very few procedures.  If you have a fluid collection that needs to be drained after a tummy tuck, this can compromise the incision and healing.Kenneth Hughes, MDLos Angeles, CA

The pros for a drainless tummy tuck are:No pesky drains and collection bulbs to manage for a week or longer post-opNo painful drain-holding sutures in your pubic area for as long as your drains are inNo additional wound care of the drain sites after they are removedNo additional scars from the drain siteThe ability to remove more abdominal wall skin when progressive tension sutures are used.The cons for a drainless tummy tuck are:A theoretical increase in the risk of a fluid collection forming (most studies show this is not the case when the procedure is done properly.)As you can see, the pros greatly outweigh the cons and that is why I personally do not use drains and many surgeons who do are switching to a drainless technique.

I no longer use drains was abdominoplasty. Drains are worst a nuisance until they were removed. The length of time a surgeon leaves them in can be highly variable.

Dear NewImprovedMe, the drain in a tummy tuck is placed to take out liquid produced in the surgical area from the surgical trauma.The only PRO from not leaving a drain is comfort for the patient. CONS are many more; In order to prevent this fluid to get produced there are techniques which implies more surgical time,  which also implies more cost; if the technique don't work and you develop liquid (seroma) you will need to take it out with a syringe to aspirate this fluid. I would recommend you to talk to your plastic surgeon about this topic. Good luck.

Thank you for your question.  The advantage of not having a drain is the inconvenience and discomfort of it.  The con is that you could still develop a seroma which could require several aspirations done in the office.  Not everyone may be an ideal candidate for this approach.  Discuss this option with your plastic surgeon to see if they routinely perform it and if you are a good candidate.  One of the most important aspects is your overall results in the end which is not drain dependent.  I suggest you consult with a board certified, ASAPS plastic surgeon when making important decisions such as these.  Best wishes!