Hi there-
As you can read, you will find many differing opinions on this matter- it reminds me of something my chairman of surgery used to say during my training- "When data is poor, emotions will run high"...
He meant that when proof of one opinion or another being absolutely correct is lacking, proponents of differing opinions will argue passionately for their point of view.
I know from experience that it is safe and effective to perform tummy tuck (abdominoplasty) surgery with or without compression garments. There is no doubt that if you are dealing with a compliant, intelligent patient who will be good about following all postoperative instructions, that the binder may not be absolutely necessary.
On the other hand, let's apply some common sense here... The critical intervention performed in a tummy tuck is the repair of the diastasis recti (the separation of the abdominal muscles that results from the stretching force of the growing uterus in pregnancy). By applying gentle compression using a garment, these important sutures are taken off of tension to some degree, supporting their healing, reducing pain, and reminding the patient of the importance of not straining these muscles. Without this gentle compression, it is hard to imagine that these sutures would not undergo at least a little stretching and pulling after surgery- resulting in a more pain and a diminished result.
While the arguments against their use can also sound compelling (pressure from the garment reducing blood flow to the skin and making it more difficult for blood to return to the heart from the legs, increasing the risk of blood clots), I think the reality is that if the blood supply to the abdominal skin is so tenuous as to be compromised by a garment that surgeon's technique is probably too aggressive.
Similarly, while blood clots are a serious risk that we should all take very seriously, there are many, more important risk factors for blood clot formation, and many, more effective precautions that can be employed to prevent them than the avoidance of a garment. In other words, if a patient gets a blood clot after a tummy tuck, the likelihood is that the greatest factors in its causation were unrelated to use of a binder (length of surgery, lack of attention to appropriate precautions before, during, and after surgery).
I think that as long as appropriate attention is paid to the precautions that I know are important in the prevention of blood clots, and as long as I use safe surgical technique in the performance of my tummy tucks, that the benefit to my patients of using a compression garment are undeniable. Indeed, most of my patients ask to be allowed to continue to use their garment even after I tell them they are free to go without it!
Having said all of that, it is really important in general that you follow the recommendations and precautions that your chosen surgeon has found to maximize the success of his patients in the past. It would not be fair to him to engage him to do your surgery, only to alter his postoperative plan for you based on what we say on this site. If you are concerned about the recommendations you are getting from him, discuss it further, in an open and honest fashion. Be comfortable with the choices you make.