Which is better - Drains or Drainless tummy tuck? Do I have to stop breastfeeding before the surgery?
Doctor Answers 9
Drain vs No Drain TT Decision
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.
Thank you for your question. The results with tummy tuck are excellent with either technique. I would suggest weaning your baby at least one month prior to surgery since your breasts will be uncomfortable for several days/weeks after you stop nursing. You will need help with your 8 month old a few days after your surgery.
Good Luck, Beverly Friedlander, MD
To drain or not to drian
Thank you for this question. The use of drains after surgery is generally up to surgeon preference and comfort level. The use of drains in abdominoplasty surgery is extremely common, and I use drains routinely in my practice. Some studies have shown acceptable outcomes and seroma rates without the use of drains; however, it is far from standard of care. Unfortunately, fluid collections and other issues will occur regardless of any precautions that are taken in a small subset of patients. The most important thing is that you have this discussion with your surgeon and understand why they use a certain technique and what works best in their hands. There are many ways to arrive at a safe outcome that makes you happy. I will restrict my patients from lifting and straining, including some aspects of child care for 4-6 weeks after surgery to protect the muscle repair.
In general, you should avoid breast feeding following anesthesia and until you are no longer taking narcotic pain medication. Most patients are able to stop this within the first week after surgery. You should also speak to your surgeon about long acting local anesthetics which may decrease your need for narcotics post-op. Good luck.
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Drainless tummy tuck
Here are the answers to you questions:
1. In my practice, I do not use drains for tummy tucks but rather quilting sutures that attach the skin flap to the muscle and prevent seromas. The sutures dissolve after 2 months and allow for the wound to heal well. Drains are a potential source for infection and they give more discomfort to patients. They are removed usually after one week at which time the wound is not healed strongly yet and it can disrupt unintentionally , allowing for the formation of seromas.
2. After tummy tuck, in my practice, patients are not allowed to have strenuous activity for six weeks in order to protect the muscles repair. This includes lifting up the baby.. So you will have to get some help.
3. Avoiding breast feeding is needed only for the period of time following anesthesia and pain medications that can affect the baby, usually for 3-5 days after surgery. You can harvest the milk in bottles for that period of time.
Always, consult with experienced board certified plastic surgeons who perform surgery in accredited surgery center for your safety. Most importantly, check the before and after pictures in the photo gallery, to make sure that they are numerous, consistent and attractive with flat stomach, low scar and nice belly button. Also, check the reviews on 'RealSelf' for ratings and positive experience reports.
Best of luck,
Tummy Tuck Drains or no Drains
I use drains to make sure no fluid collects under the flap of skin/fat that is elevated. Some doctors do not use drains. We all place sutures to tuck the skin down, but I believe that drains remove the extra fluid and therefore make a quicker healing. As for the breast feeding, it is not as important as if you were doing breast surgery as well, but I still feel you should stop breast feeding before any surgery.
The best way to manage this depends on the regular routine of the surgeon. I generally use drains on a full tummytuck. The alternative is to stitch the skin down to the muscle all over the abdomen. This can increase discomfort. Furthermore it can also result in fluid accumulation between the sutures that require needle aspiration over multiple areas. Though these are really a temporary issue, I feel that it's more annoying than just having a drain. Tummy tucks after 9 months post pregnancy is fine as long as your not planning on having more children. You should not breast feed while you are on antibiotics and pain meds.
Best regards, prashant Soni md
When the patient has multiple questions like this, it is better to sit down with your surgeon to go over your concerns and questions in person.
That said, the quick answers are as follows.
Some surgeons prefer drains, some do not. Each we will give pros and cons to why or why they will not use to drains. I would say not to let this be a factor in choosing your surgeon, but rather, choose your surgeon based on reputation, skill, and rapport with him or her. Drains generally do cause some irritation and annoyance, but may cut down on the rate of fluid collections needing drainage.
I think planning to care for an eight month old a few days after surgery is unrealistic. I would make sure you have someone to offer significant help for about three weeks.
The decision on when to stop breast-feeding should only be made by your operating surgeon.
I hope this helps,
Best of luck!
Board-Certified Plastic Surgeon
Newtown Square/Philadelphia, PA
You should complete breast feeding before undergoing any type of surgery. I prefer to use drains. Some docs don't.
Hello and thank you for your question. It depends on your individual anatomy as to if drains are the best method. An in-person examination could help determine this most accurately. If you are an appropriate candidate, a tummy tuck can be done through a low and short incision, all completely below the
bikini line. Your muscles can also be
plicated resulting in a flat abdomen. I usually recommend most patients allow for a 10 day recovery before returning to work or caring for their children without help. 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. The
most important aspect is to find a surgeon you are comfortable with. I
recommend that you seek consultation with a qualified board-certified plastic
surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon