Drains or No Drain Tummy Tuck- Which Has Better Overall Results, Recovery and Safety?

I am scheduled for three more consultations this week. Two for Thursday and one for Friday, then I shall make my decision. I am very nervous/scared for the surgery itself, more for the anesthesia. But my question is f any body can give their opinions on a tummy tuck with drains and with no drains. The no drains sounds so tempting since I hear a lot about the drains being a big hassle.

Doctor Answers 20

Drains vs. No drains

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Great question.  There is a tummy tuck technique that uses sutures to close down the empty space left from a tummy tuck.  Advocates for this technique highlight the advantage as no need for drains after a tummy tuck.  However, published studies on this technique show up to a 10-20% seroma rate (fluid collections).    The use of drains in a tummy tuck carry less than a 5% seroma rate.  

I understand your apprehension about drains.  Most patients don't like their drains. They are not painful but a nuisance; these drains can tug at you.  But consider drains as a safe and necessary nuisance to help prevent fluid collections.   As my colleagues have mentioned here, drains are generally removed 3-7 days after tummy tuck surgery.

Everyone including physicians and nurses are nervous about having surgery - that's normal.  I'm glad you are thinking about your safety.  First, make sure you are only visiting with board certified plastic surgeons who are members of the American Society of Plastic Surgeons.  Make sure your surgery will be done in a fully accredited surgery center or hospital only with a board certified MD anesthesiologist.  Definitely review your surgeon's before/after photos as they are a testament to the quality of outcomes.  Lastly, go with your gut feeling - pick the surgeon and his/her team with whom you feel most comfortable.

In the end, if you've done your homework, I'm sure you will love your results!. Best wishes.

Dr. Basu

Houston, TX

Drains with Abdominoplasty

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An excellent tummy tuck result can be achieved with or without the use of drains.  You are right in that drains are annoying and typically remain in place for about a week.  Drains can be avoided but require the placement of many more sutures internally to close off the space in which the fluid would accumulate.  This should be one of many factors that you use to determine your choice of surgeon and probably not one of the more important ones.

Richard Kofkoff, MD, FACS
Saint Louis Plastic Surgeon
5.0 out of 5 stars 82 reviews

TT Drains Pros and Cons

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Drains vs No Drain Tummy Tuck
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.


Drains or No Drain Tummy Tuck- Which Has Better Overall Results, Recovery and Safety?

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This is a great question as it can be difficult to decide which procedure is right for you with so many options available for your tummy tuck. There are several ways to do a tummy tuck, I personally rarely ever use drains in my tummy tucks and I have been extremely happy with the success of it. It varies from plastic surgeon to plastic surgeon on how they perform the procedure. However this does not make a traditional tummy tuck with drains a bad procedure. Both procedure can result in great results and are equally safe when done correctly.

The biggest reason that I have been doing the no drain tummy tuck is that it makes recovery from a tummy tuck much easier. Without the drains patients are able to walk after surgery without the worry of the drains being pulled on. It also avoids the pain and discomfort associated with the drains as they can irritate the skin where they exit the abdomen.

The reason patients can avoid drains is that I place what is called progressive tension sutures. The sutures hold the abdominal skin in place and avoid any space for fluid to collect. By placing these sutures the body can absorb the fluid that is made in the abdomen naturally as it did before your tummy tuck. The vast majority of patients do extremely well with this new method of tummy tuck and tend to recover much faster because it is easier for them to move after surgery.

Please discuss your tummy tuck options with you plastic surgeon.

No drain tummy tuck

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a no-drain tummy tuck is as safe as any other tummy tuck procedure. This is typically done using the progressive tension suture technique, which I published a modification. The fact that no drains are used also reduces the chance of postop infection.
I have experienced far fewer postop fluid collections since I began using the no drain technique than when I used drains many years ago.
Because there are no drains, getting up and walking is easier, and showering can be started the day after surgery. 
As far as results, the scar has definitely improved since I began using the progressive tension suture technique and I have also noticed an improvement in the contour of the anterior waist/lateral abdomen.

This information is for educational purposes only and is not a substitute for a consultation with a plastic surgeon certified by the American Board of Plastic Surgery.

Drains or No Drain Tummy Tuck?

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Thank you for your question. The no-drain option is a bad option.  If a tummy tuck is done right, you will need a drain.  No drain and fluid will accumulate and delay healing.  Get past the drain idea, and get the right procedure done. I hope this helps.

Vivek Bansal, MD
Danville Plastic Surgeon
4.9 out of 5 stars 26 reviews

Don't sweat the small stuff

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Ultimately the question "to drain or not to drain" is a minor issue when compared with the overall complexity of the surgery and your subsequent post-operative recovery. My advice to you is choose a surgeon that you trust and trust your surgeon to make the right decision about whether or not to use drains.

Best of luck

James Southwell-Keely, MD, FRACS
Sydney Plastic Surgeon

Tummy tuck technique matters more then drains

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and those that leave the loose lymphatic tissue behind will always have less fluid collections then those that cut down to the fascia of your muscles.  I use only one drain when done with preservation of the loose lymphatic tissues and have removed them in 7-10 days.  And you can shower with your drain in.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

I Prefer Drains

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Drains can be a hassle  but I believe drains are effective and very appropriate for body contouring. Drains prevent seromas. Seromas if they develop can be persistent. It is better to deal with the hassle of drains for about 10 days that to deal with a seroma for months.

Dr. ES

Drain or No Drain for Tummy Tuck

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For many patients, drains are uncomfortable and a hassle. However, that should not be your deciding factor for choosing your plastic surgeon. 

I have not used drains for tummy tucks for over 8 years and after over 200 cases, have less seromas than when I used drains. The success of not using drains depends on the surgeon's technique. 

For more details, go the website below.

Karol A. Gutowski, MD, FACS
Chicago Plastic Surgeon
4.9 out of 5 stars 76 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.