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 10

Traditional Tummy tuck vs drainless tummy tuck?

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?

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

Drains are necessary

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.

Limitations of drainless tummy tuck

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 45 reviews

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

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
Norfolk Plastic Surgeon
5.0 out of 5 stars 11 reviews

Drainless tummy tuck

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

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?

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 19 reviews

Traditional Tummy Tuck versus Drainless Tummy Tuck

Thank you for your excellent question and for sharing your photograph.  You will find many opinions from physicians on this topic as techniques to minimize the formation of a fluid collection called a seroma have gained popularity.  This includes quilting sutures, progressive tension sutures, or tissue glues.  In most cases plastic surgeons still use drains to assess how your internal healing is going and to minimize the risk of possible aspirations of seromas in the office.  Though a consideration for any tummy tuck candidate the use of drains should be lower on your list of importance as they often are removed within two weeks. Hope this helps.

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 38 reviews

Traditional Tummy tuck vs drainless tummy tuck? = it depends on the technique used #tummytuck #tt

Tummy tuck can be performed with both drains and not drains.Traditionally and the majority of the plastic surgeons use drains.The Drainless technique retries using "quilting" sutures or "tissue glue" that may have also side effects ( dimples in the skin, serum formation, etc).When using drains, some patients may complain of discomfort when taking the drains out. However, there is  type of drains ( blake drains) that do not cause pain when removed compared with the common (cheap) ones ( JP drains).In my practice i routinely use blake drains for my tummy tucks. It avoids the risks of the "drainless" technique and patents tolerate them well since the removal is virtually painless. 

John Mesa, MD
New York Plastic Surgeon
5.0 out of 5 stars 95 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.