What is the difference between drain or no drains for a Tummy Tuck?

Drain or no drain procedure. If no drain where do all that fluid go. I like hearing about this procedure.. I hate the drains so many of Real self family complain about them how they come out, infection, scare tissue. They make my flesh crawl and want to throw up. But for the TT I'll take it.

Doctor Answers 10

No drain tummy tuck is a great operation

Most of us were trained to place one or more drains during a tummy tuck to prevent a pocket of fluid from building up in the space between the skin and the muscle, called a seroma.  I started using the progressive tension mattress suture technique more than eight years ago and I have been very happy with the results.  I have noticed a much lower rate of fluid build up, fewer complications and happier patients.  Many surgeons are uncomfortable with the idea of not using a drain, as I was before I started doing this procedure.  To date, I have never regretted changing my technique and I encourage everyone to consider it.

No drain tummy tuck

Thank you for your question. I rarely use drains in my tummy tuck procedures. Surgical drains are a source of discomfort and anxiety for many patients following a tummy tuck. In a traditional tummy tuck procedure, drains are used to prevent fluid accumulation in the "open space" created between the abdominal flap (skin and fat) and the muscle. Through the use of progressive tension sutures this space can be eliminated, and the flap is securely advanced with tension distributed over a broader area. Patients can not feel these sutures so they are not even aware of their presence. After a few months, they dissolve leaving no foreign material whatsoever in the body. This technique prevents seroma formation (fluid build up) as there is no longer any space in which fluid can accumulate.

There are many advantages to having a tummy tuck without drains. The recovery is much easier: there is no cumbersome management of tubes hanging from the body, no pain from drain sutures pulling on the skin, and no fear and possible discomfort associated with their removal. Additionally, because the tension is spread out rather than concentrated at the wound closure site, there is a decreased risk of other complications such as a wide or hypertrophic (raised) scarring. Furthermore I believe that the absence of drainage tubes going through the skin after a tummy tuck reduces the risk of infection and the need for antibiotics.

The Fluid Is Absorbed By Your Tissues

The secret to the Drainless tummy tuck is that it prevents the fat layer and the muscle layer of the abdomen from being separated from each other by a layer of fluid which would interfere with the healing process and lead to more build-up of seroma fluid.  When these tissues are secured together with sutures, healing begins immediately and under these circumstances, the fluid is prevented from building up, and is absorbed by the tissues and returned to the bloodstream through the lymphatic channels. 

I hope that answered your question.  Good luck!

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No Drain Tummy Tuck

Most surgeons still use drains because they were trained that way and they have been getting nice results with their technique. We used to get very nice results using drains as well.

However, we transitioned from using drains to the no drain tummy tuck procedure 4 years ago and the addition of this technique of the best things I have done for my patients. We used to use drains in order to supposedly prevent fluid collections after surgery (called seroma). It only takes an extra 15-20 minutes to place the progressive tension sutures in the operating room. The sutures prevent movement of the surgical site and close off the space so that fluid isn't made as much and it can not build up.

In a study we conducted in over 450 tummy tucks over 7 years we found the the seroma rate was 9% when drains were used and it dropped to 2% when the no drain tummy tuck procedure was introduced to our practice.

The drains are not only annoying to care for, they are painful at the exit site, are a possible source of infection and always leave some additional scar (even if they come out the ends of the incision). I hope this helps and best wishes. 

Drains vs No Drain Tummy Tuck Differences

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.
For those patients who choose another surgeon, the question to drain or not to drain is at the surgeon's discretion. There is no consensus at this point though most surgeons still favor drains until the output is generally about 30cc/24 hours. I individualize and if little or no liposuction at the time of a tummy tuck, a minimal or mini-tummy tuck I often do not use drains, whereas for significant liposuction with a tummy tuck and other procedures (#MommyMakeover) I most often use drains but individualize as needed.


What is the difference between drain or no drains for a Tummy Tuck?

The no drain tummy tuck has continued to increase in popularity over the past several years as surgeon have gained experience in the procedure. I personally rarely ever use drains in my tummy tucks and I have been extremely happy with the results. The purpose of the drains is to prevent a seroma (collection of fluid in the abdomen), the no drain tummy tuck prevents this fluid collection by using a technique called progressive tension sutures.

Progressive tension sutures hold the abdominal skin in place and avoid any space for fluid to collect. By placing these sutures the body can absorb the fluid that is made in the abdomen naturally as it did before your tummy tuck. Without the sutures there is a large space where the fluid can collect and that is why the drains are needed to remove that fluid and prevent a seroma.

The biggest reason that I have been doing the no drain tummy tuck is that it makes recovery from a tummy tuck much easier. Without the drains patients are able to walk after surgery without the worry of the drains being pulled on. It also avoids the pain and discomfort associated with the drains as they can irritate the skin where they exit the abdomen.

Please discuss your tummy tuck options with you plastic surgeon.

Drains or not in tummy tuck

Drains are used to remove excess fluid after surgery and to get skin to attach to the muscle below.
Various techniques to reattach the skin surgically, including progressive tension sutures, reduce the need for drains. For patients who have liposuction, I place 1 drain and remove it at the first visit. To not have pain with drain removal, your surgeon needs to inject the skin around the drain with local anesthetic.

Progressive Tension Suturing

Dear Jewelie, The progressive suture technique was developed to try to avoid using drainage tubes after tummy tuck, which is the traditional way surgeons are taught. However, it should be noted that even the authors of this technique point out that many unrecognized seromas (fluid collections) do occur. For that reason, I do use the progressive tension technique for the last several years, but I also put in short-term drainage tubes and have found those to absorb almost universally out in under a week time with no seroma formation afterwards. By ensuring that there is no seroma, we get the flattest result possible, and there is less of a chance of an infection developing. You could kind of view this as belt and suspenders, but I think it is important to get the best quality final result. Robert D. Wilcox, MD

Robert D. Wilcox, MD
Dallas Plastic Surgeon
4.1 out of 5 stars 13 reviews

Drains and abdominoplasty

While I respect the opinion of people who don't use drains, I have had a lot more issues with seromas on patient's attempting this versus the traditional method of drainage for a few days. I personally have not found the no-drain approach to be particularly effective in eliminating that complication

Robert Oliver Jr., MD
Birmingham Plastic Surgeon

No Drains or Minimal Drains best

I prefer drains for TWO days only and have NEVER had reason to regret that on my many tummy tucks.   I think it is just fine to use NO DRAINS and I may start that.  I see absolutely NO REASON for prolonged drains and feel they just cause trouble.  The fluid is simply returned to the body .  A very normal process.  I feel long drainage programs are absolutely unnecessary.   My Best,  Dr C

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.