Is lymphatic drainage necessary after a tummy tuck with lipo on the sides?

Hello and thank you for your question. Lymphatic massage is highly variable among different surgeons, so I would ask your surgeon what their protocol is.  For my patients, I don't often find this necessary.  If you are an appropriate candidate for a tummy tuck, this can be done through a low and short
incision, all completely below the bikini line. 
The belly button can be designed to look natural and have no scars on
the exterior.   Your muscles can also be
plicated resulting in a flat abdomen. 
Make sure you specifically look at before and after pictures of
real patients who have had this surgery performed by your surgeon and evaluate
their results.  
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

The tummy tuck procedure involves removing the extra abdominal skin and fat from the abdomen. There's a very specific anatomic feature which performs lymphatic drainage for the body on the abdominal wall down into the groin. This is called Scarpa's fascia. Traditionally this is removed during the tell me tuck procedure. However with the Scarpa sparing abdominoplasty  The internal lymphatic drainage is left intact and this obviates the need for drains. In terms of an lymphatic massage or post procedure to minimize swelling, compression garments are always indicated and discussions with your surgeon about best postoperative practices will be helpful.