Drains or no drains for tummy tuck?

Question

I’m having a Mommy Makeover in a few months. Breast lift/reduction and full tummy tuck. My doctor will use drains. I had 2 other consults and those docs did as well. Having second thoughts, as I have school aged kids that will be in school and I can’t afford to be down for 2 weeks. What are the pros and cons? I recently read drains are the “lazy” way for a surgeon. Help!

Matthew Schulman, MD · Answer

Drains serve an important purpose - they help removed fluid that normally builds up.  There is a bog push for "drainless procedures" but this is mostly because patients prefer not to have drains, not because it is better. As a very experienced surgeon, I use drains, and I can assure you that I am not "lazy".  I would make the argument that doctors who don't use drains for the sole purpose of appeasing patients, are the lazy ones ;).   It sounds like you are having an extensive procedure and I think you need to expect to be down for at least 2 weeks, with or without the drains. If you really need a more rapid recovery, you should speak to your surgeon and consider doing less surgery.

J. Timothy Katzen, MD, FACS · Answer

Dear SuperMomof2,

I understand your concerns and the desire for a swift recovery, especially with school-aged children to take care of. However, it's important to note that the use of drains is not a reflection of the surgeon being "lazy", but rather, it's a well-established method to prevent postoperative complications.

When performing a tummy tuck, fluid can accumulate in the surgical area, creating a seroma (a pocket of serous fluid) or a hematoma (a pocket of blood). Drains are used to remove this fluid and reduce the risk of these complications, which can lead to discomfort, prolonged recovery, and the need for additional treatment. Without drains, these fluids can accumulate, and the body's natural process to absorb them can be quite slow, potentially leading to issues down the line.

Several surgeons may opt for a "drainless" tummy tuck using progressive tension sutures, but this doesn't entirely eliminate the risk of seroma or hematoma formation. In some cases, a "drainless" procedure might result in the need for office visits for needle drainage if a seroma does occur.

It's crucial to trust your surgeon's judgement and expertise as they choose the method they believe will offer you the safest outcome and the best results. If your surgeon recommends drains, it's likely because they believe this method will provide you the most optimal and safe result.

Remember, every surgical technique has pros and cons, and it's essential to discuss these with your surgeon to feel comfortable and confident going into surgery.

Sincerely, Dr. Katzen

Caner Kacmaz, MD · Answer

Drains are extremely necessary components of a successful tummy tuck recovery because they help with less postoperative complications. For best results, safe recovery, and a happier post-recovery patient, it's much needed.

Emmanuel De La Cruz, MD · Answer

The use of drains after a tummy tuck (abdominoplasty) can vary based on the surgeon's preference, the surgical technique used, and the patient's individual circumstances. Drains are small tubes placed under the skin during surgery to help remove excess fluid that might accumulate at the surgical site. They are used to minimize the risk of fluid buildup, which could otherwise lead to complications like seroma (a collection of fluid under the skin).

Some surgeons opt for the use of drains following a tummy tuck to aid in the drainage of excess fluid, while others might use techniques that minimize the need for drains by utilizing internal sutures or other methods to control fluid accumulation.

Advantages of using drains may include:

Reducing the risk of fluid accumulation.
Potentially lowering the risk of complications such as seroma.
Assisting in the healing process by preventing excessive swelling.
Disadvantages of drains can include discomfort, inconvenience, and an increased risk of infection if not cared for properly. Their presence might also extend the recovery period for some patients.

Whether drains are used or not often depends on the surgeon's experience, the surgical approach, and the individual patient's condition. Your surgeon will discuss the use of drains and the specifics of your recovery plan during your pre-surgery consultations. They will provide guidance on drain care, their expected duration of use, and what to expect during the post-operative period.

It's essential to follow your surgeon's post-operative instructions diligently, whether drains are utilized or not, to ensure proper healing and minimize the risk of complications after a tummy tuck.

Albert Ko, MD · Answer

Thank you for your question! Drains are necessary to drain excess fluid that can accumulate and cause poor wound healing and or pain. Drains are usually left in for 1-2 weeks depending upon how much fluid you are draining. This is a surgeon choice and can vary with their preference and comfort level. Best of luck!

Zoran Potparic, MD · Answer

Large wounds like after abdominoplasty, create lots of bleeding/secretion for a long time before the wound heals and cavity seals. For that reason, an experienced surgeon will place the drain whenever there is a chance for postoperative bleeding and prolonged secretion (face/neck lift, breast reduction, TT, any mayour wounds). Recently, some surgeons started using special glue which may be working  as a wound sealant a drain replacement, but we still do not have much information about safety and efficasy of this remedy? It is best to leave to your surgeon to decide how many drains and for how long; during that time consider drain(s) your best friend and take good care of it. Good luck.

Daniel Barrett, MD · Answer

Dear SuperMomof2,
drains or no drains is a dilemma. With drain there is a smaller chance of seroma formation but you will have to deal with it for days. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Christopher Pannucci, MD, MS · Answer

Hi SuperMomof2,
Many surgeons used drains after tummy tuck, for 2 reasons. Reason one is to encourage the upper abdominal flap to stick back down to the abdominal wall, and reason two is to remove the fluid which drains from the injured deep tissue. Drains are not lazy, they are preventative. Yes, there are surgeons who use quilting sutures to avoid the use of drains. This is not necessarily better, just different. Drains can be an encumbrance, meaning that they stick out from the sides and have to be managed. However, in my own experience, use of drains decreases the likelihood of fluid collections which might require return visits for aspiration to the office.
To be clear, when you say "I can't afford to be down for 2 weeks" these restrictions are inherent to the procedure you are choosing, and not necessarily the drains. With or without drains, you would have postoperative restrictions and I would suggest that you clarify these with your surgeon.
Hope this helps.
Best,Christopher Pannucci MDBoard Certified Plastic SurgeonPlastic Surgery NorthwestSpokane, Washington

Connie Hiers, MD, FACS · Answer

Drains are not the "lazy" way but help decrease the risk of excessive fluid to accumulate and stretch out the hard work your surgeon has done.  There are more pros and cons to use drains for tummy tucks and I use them.  I do not consider myself to be a lazy surgeon but a surgeon who tries to give my patients the safest procedures.

Scott C. Lindsay, DO · Answer

Thanks for your question! Drains are most certainly not the "lazy" way. Drains do make it easier for your body to drain necessary fluid. Drainless tummy tucks have a higher incidence of seroma and therefore can actually delay your recovery time. Personally, I would go with the surgeon that made me the most comfortable and ignore the drain issue completely. Good luck!

Drains or no drains for tummy tuck?

Answers (15)

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