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 14

What is difference between no drain and drain tummy tuck/abdominoplasty?

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 I have had really good success with using tissue glue for closure of the tummy tuck/abdominoplasty without the use of drains which are quite a hassle for patients. Finally, one has become available that is synthetic and not from human products so there is no need to worry about problems like before. I am very pleased with my results with this new product as are my patients, especially the ones that come to see me from different parts of the country and overseas! I have even started using it in my post-bariatric plastic surgery patients. 

Dr. Edward Jonas Domanskis is Certified by the American Board of Plastic Surgery Newport Beach, San Francisco,Miami, Italy, Anguilla 949.640-6324/1.888.234-5080(Ca) FAX- 949.640-7347 Assistant Clinical Professor of SurgeryWOS-Plastic,University of California (Irvine) Orange County’s Physician of Excellence/America’s Top Physicians/Top Doctors Plastic Surgery- 2005-2017 President,American Society of Bariatric Plastic Surgeons

Newport Beach Plastic Surgeon
4.5 out of 5 stars 28 reviews

The Fluid Is Absorbed By Your Tissues

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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!

No Drain Tummy Tuck

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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. 

No drain tummy tuck

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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.

Drain Free Tummy Tuck with TissueGlu

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Tissue glu will cause immediate adherance of your abdominal flap to your muscle well.  Once adhered there is no place for fluid to collect.

John L. Burns Jr., MD
Dallas Plastic Surgeon
4.7 out of 5 stars 59 reviews

Drains vs. no drains

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When performing abdominoplasty, some surgeons choose to use drains to evacuate the space created with dissection of the flap.  However, over the last five years, I have been performing this procedure without the need for drains.  By using a method called progressive tension sutures, the flap is advanced towards the incision by way of quilting sutures.  This eliminates all dead space as well as takes tension off the final line of closure producing a much thinner and better quality scar.  Because there is no longer a space for fluid to collect, seromas are a thing of the past.  Patients love not having drains.  I also allow tummy tuck patients to shower the day after surgery.

Drains vs No Drains

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It is possible to have a tummy tuck or #abdominoplasty without #drains. The #drainage tubes applied during traditional tummy tucks are also used by trained Plastic Surgeons for various operations. The purpose is to drain extra fluid that may otherwise accumulate under the skin, fat or muscle following an operation.  Patients generally find this annoying and uncomfortable and they can impede mobility and therefore slow aspects of #healing. Over the years, surgeons have improved procedures and found ways to eliminate the need for these #drains in a variety of operations; including #tummy #tuck or #abdominoplasty.

I have found that most of my patients do very well with the exception of those have large areas of liposuction or lipo-abdominoplasty.  I may use drains on a case by case basis for these patients. Also, a newer option now can include the use of tissue #glue to adhere the a#bdominal #skin to the #muscle; eliminating any space that previously required a drain.

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 most important decision to be made before performing any surgical procedure is determining whether you are an ideal #candidate. Your board-certified plastic surgeon will recommend the type best suited for you during a one-on-one in-person consultation. Also, another element to a satisfying result of your procedures are realistic #expectations.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Drains vs No Drain Tummy Tuck Differences

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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?

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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

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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.

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.