Traditional Tummy tuck vs drainless tummy tuck? (photos)

I'm currently on round two of consults for my mommy makeover. I'm learning so much and with each consult realizing I know nothing. On my last consult the doctor states he doesn't use drains with his tummy tucks. My other two consults did. I must say I'm temped by the thought of not having drains. What are the pros and cons

Doctor Answers 12

Drains are necessary

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There are multiple techniques for tummy tuck.  Traditionally this operation is performed with drains.  The skin is elevated off of the abdominal wall, the excess is excised, and the skin is draped over the abdomen.  This leaves a large area that needs to heal by sticking back down to the abdominal wall.  Drains provide a way for the fluid and blood to be evacuated and speed the process of the abdominal skin sticking back to the abdominal wall.  If drains are not used, the fluid that is generated by the elevation of the skin is still generated.  Those of us that use drains do not believe that simply by quilting the skin to the abdominal wall will prevent the accumulation of fluid.  In fact, the quilting would make the fluid accumulate in isolated pockets.  Drains are a very useful tool in an abdominoplasty.   They are temporary.  If they affect the outcome in a negative way, were difficult to manage after surgery, or were permanent, then it would be a topic worth debating.  There are surgeons that have good outcomes with drains, and surgeons that have good outcomes without drains.  Pick your surgeon based on their outcomes, professionalism, experience, training, ability, not on whether they use drains.

Traditional Tummy Tuck vs Drainless Tummy Tuck

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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.

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

About No Drain Tummy Tucks

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Thank you for your question.

During a tummy tuck surgery, there is space between the abdominal wall and the overlying fat and skin (the abdominal flap). The body will do what it usually does during the healing process, produce fluid, if nothing is done to close this space. Because there is nothing to confine the fluid from accumulating, a seroma can develop in this space. In other words, the tissue produces fluid more quickly than it can reabsorb.

Negative suction drains are placed in spaces like this to get rid of the fluid and create suction between the tissue planes. There is a way, however, to eliminate this space without using uncomfortable drainage tubes. Dr. Patel utilizes progressive tension sutures inside the tissues to close off the space and relieve tension on the last surgical closure. This results into less pain, less discomfort and less tension. Also, there will be better scarring with potentially minimizes infection risk.

We have successfully used progressive tension sutures during abdominoplasty instead of surgical drains, with a lower seroma rate than is generally thought to occur with tummy tucks and drains. With this method, the seroma rate is close to zero and you cannot beat that approach. Best of luck!

Dhaval M. Patel

Double board certified

Plastic surgeon

Hoffman Estates




Dhaval M. Patel, MD
Hoffman Estates Plastic Surgeon
4.8 out of 5 stars 100 reviews

Traditional Tummy tuck vs drainless tummy tuck?

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Judging from your photo, it appears that you only need a liposuction. However, if you are assessed to have too much skin to for a lipo alone, a mini-tummy tuck may be indicated. A plastic surgeon could evaluate this for you with a personal examination. Another excellent alternative would be a liposuction with a ThermiTight, which would tighten the skin as well as diminish the excess fat.

Regarding drainless tummy tucks vs. the traditional TT using drains, the "no-drain TT" is always my recommendation instead of a traditional TT. The complication rate is lower, and both the recovery time and discomfort are significantly reduced. Plus, you are not encumbered with drains for 5-7 days. Seromas, which are collections of fluid, with traditional TT's is from 15 to 50%. according to the PS. The seroma rate with the drainless TT is nearly zero in my series and that of the inventors of the procedure with over 1000 procedures.

One cannot simply elect to eliminate the drains, however. It takes a special suturing technique called Progressive Tension sutures to eliminate the drains. Go for the drainless TT. 

Best of luck to you., and thank you for your question and photo.

What surgery are you getting?

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Your stomach looks awesome- who is saying you need a traditional tummy tuck?  Granted, I haven't been able to do an examination, but from your pictures, you certainly don't need a tummy tuck- or at least a full one.  The drainless tummy tuck is fine but un-necessary.  Drains are not a big deal with tummy tucks and really do a lot to control swelling and fluid accumulation.  I rarely have a patient complain about them.  With the "drainless" technique, your surgeon has to sew your abdominal flap down to your muscles in dozens of places which can create temporary puckering and potential places for tears and increased bleeding.  I just haven't found it to be practice-changing.  I think it is more of a marketing ploy.  Hope this helps.-JGH

Limitations of drainless tummy tuck

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The drainless tummy tuck is based on the use of a technique called progressive tension sutures, which I have been doing for 20 years. The fluid output through the drains is much diminished using PTS compared to traditional techniques, and the drains can be removed within a few days. However, the fluid output is not zero, and I believe that overall healing and recovery is faster using both drains and the PTS technique.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 59 reviews

To drain or not to drain.....that is the question.

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While most plastic surgeons still use drains with tummy tucks, there are several techniques which permit the deletion of drains. My preference has been to use drains: they are removed at 4 days after surgery, on average. They provide a lower risk of fluid collection in my experience. Be certain that you address your concerns with a Board Certified plastic surgeon who had plenty of experience with tummy tuck surgery.

Tad Grenga, MD, FACS
Suffolk Plastic Surgeon
5.0 out of 5 stars 18 reviews

Drainless tummy tuck

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The drainless tummy tuck is a small modification of the traditional tummy tuck. It preserves some lymphatics and utilises quilting sutures and or tissue glue to reduce the dead space. Surgeons can offer excellent results with both techniques. It's the surgeons choice and expertise to choose the technique he/ she feels can give you the best result.  For your procedure you should plastic surgeon you were most comfortable with. All the best for your makeover.

Tubeless tuck

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This is surgeon dependent(more older surgeon will be using drains than younger more "aggressive" surgeons). Ultimately, most younger progressive surgeons use both, meaning they will opt for a tubeless tuck if during the surgery things appear appropriate for no drains, but if during the surgery things are a little more "wet" than they like, then a drain will likely be left in place. You need to choose your surgeon based upon the rapport you developed with him/her and not based upon if they use drains or not. Good luck with your upcoming surgery.

Traditional Tummy tuck vs drainless tummy tuck?

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Some excellent plastic surgeons use drains, some use internal quilting sutures, and some use both. Whether a surgeon uses drains or not should be one of the least important factors in choosing the surgeon. The
choice of drains or no drains should depend on the extent of the procedure and the surgeon’s opinion based on his or her experience. Good results have been obtained both with and without drains. The length of the recovery and the extent of swelling are not diminished in procedures where no drains are used.
 What is far moreimportant, is the choice of the surgeon. I would suggest you find a plastic surgeon certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person. While a second or third opinion may be worthwhile, continuing to pursue consultations until you get the answers that you think that you want to hear may not necessarily be in your best interest. If you are ambivalent, don’t do the procedure.
 Robert Singer, MD FACS
 La Jolla, California

Robert Singer, MD
La Jolla Plastic Surgeon
4.6 out of 5 stars 22 reviews

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.