What Are the Pros of "No Pain-no Drain" in an Abdominalplasty ?

A surgeon I am looking at uses a technique called no pain no drain tummy tuck which eliminates the use of drains after completion of the surgery, can I get more information about this type of procedure and what are the benefit/cons of this compared to an tummy tuck with drains after the procedure.

Doctor Answers 13

What Are the Pros of "No Pain-no Drain" in an Abdominalplasty ?

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From reading ALL the previous expert posters you can see what good PR or marketing can do. 99% of all boarded PSs use some drainage in abdominalplasties. As for "NO Pain" issue, do you really believe this? Pain is subjective so how can you ever promise no pain? 

Tummy tuck without drains

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Using internal stitches to eliminate the drain is becoming more common in tummy tucks as we strive to make the procedure better for our patients. The "no pain" part is probably better described as " less pain" and involves using long acting local anesthetics to reduce pain. These can be very effective.

Hugh McLean, MD
Mississauga Plastic Surgeon

No pain no drain abdominoplasty

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The no pain, no  drain, tummy tuck is a sales pitch, the kind of which should raise a red flag when choosing a plastic surgeon. Though clever, the use of drains in tummy tuck can depend on individual circumstances. We happen to not use a drain for tummy tuck though would say that the idea is not a new a one. No pain suggests that the surgeon does not have a respect for the serious side of cosmetic surgery. You will need pain medication and expert after care and we would suggest you look for a surgeon who expects to provide it.

Best of luck,


Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

What Are the Pros of "No Pain-no Drain" in an Abdominalplasty ?

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Thank you for the question. It is extremely common to receive different opinions from different plastic surgeons about the best way to treat a specific “problem”. Each plastic surgeon may have his/her opinion that is based on their specific/unique education, experience, and personal preferences. Their opinions may also be shaped by unfavorable results they have encountered in their practices.
Although these different opinions can be confusing and a source of anxiety for patients, it is good for patients to understand the different options available. Ultimately, it will be up to each patient to do their due diligence and select their plastic surgeon carefully. Part of this selection process will involve the patients becoming comfortable with the plastic surgeon's experience level and abilities to achieve their goals as safely and complication free as possible. In my practice, I currently use drains for all tummy tuck patients; I also use progressive tension sutures for most patients.
I hope this, and the attached link (dedicated to tummy tuck surgery concerns), helps.

Do not listen to marketing slogans for tummy tuck, find the best surgeon

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Thank you for your question No pain no drain is a ridiculous marketing slogan designed to capture you as a patient.

Please focus on finding the best plastic surgeon who is certified by the American Board of Plastic Surgery, very experienced in tummy tuck,and who has an excellent reputation in your community. Be sure to ask for references of patients that the surgeon has operated on and photos of their own before and after results.I suspect that this surgeonwill call your procedure and abdominoplasty or tummy tuck.

No drain abdominoplasty

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Abdominoplasty can be achieved by the use of progressive tension sutures as an alternative to drains.  The vast majority of BC plastic surgeons will use drains for this procedure however.   Not using a drain does not impact on the postoperative pain relief in any significant way.  Management of postoperative pain after abdominoplasty has progressed significantly, but not to the point that "no pain" can be claimed.  I would need to know exactly what modality of postoperative pain relief is being employed.  I would go discuss this with one of the plastic surgeons at Emory for an opinion.

Glynn Bolitho, PhD, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 15 reviews

Tummy Tuck

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Failure to use a drain can result in prolonged healing time.  Without knowing the details of the surgery, there is no way to know if this is a risky decision or not.  Most Board Certified Plastic Surgeon I know, use drains when doing full TT’s.  A mini tuck may not require the same things.  Do not think though that lack of a drain will get you to heal faster.  Marketing is also prevalent in the cosmetic world…..beware.

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

No pain no drain tummy tuck - Marketing or Reality?

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There are ways to decrease the risks of fluid collection in a tummy tuck, and this can sometimes lead to the elimination of drains. Improving postoperative pain is also in part related to technique. In a standard tummy tuck, the abdominal skin and fat is lifted off the abdominal wall, directly on the fascia, or covering of the abdominal wall. Being careful to spare the loose lymphatics system which runs along this fascia can lead to less fluid accumulation and less pain from the nerves in this locale. Also, using liposuction to free up the abdominal skin as opposed to only releasing the skin with a knife or cautery, will preserve more of the lymphatics and blood vessels which improves both healing and limit drainage. "Quilting" sutures eliminate dead space under the skin and when combined with a compression garment, will significantly decrease drainage. Pain control can be improved with the use of pain pumps which deliver anesthetic medication directly to the surgery site (On-Q Painbuster Pump is an example). These techniques are commonly used by Board Certified Plastic Surgeons to reduce the recovery and discomfort associated with an abdominoplasty. Although a "No Drain, No Pain" surgery sounds wonderful, it is more marketing than reality. There is always a tradeoff and you should discuss the issues related to how the surgeon would manage a fluid build up or persistent swelling.

David Bogue, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 26 reviews

What great marketing name

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The question should be why this specific surgeon does not teach rest of the plastic surgeons about his technique to help all the patients? The term NO PAIN is very misleading. How you remove tissue,fix the abdominal muscle and cause no pain? The logical answer is no muscle work and minimal tissue removal. Please send me your doctor's information so I can go and learn from him or her( I am serious ). The drain can be avoided by deep progressive suturing.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.7 out of 5 stars 152 reviews

No pain no drain abdominoplasty

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Though I am not familiar with the term, a need for a drain can be reduced by a number of techniques. However it will be dogmatic to say that one will not use a drain in abdominoplasties. Most abdominoplasties will benefit by having a drain for the first few days.

Pain after surgery can be reduced by a number of means. I presume your surgeon refers to the practice of leaving a fine tube under the skin and attaching it to a slow pump of anaesthetic solution. I personally use a 'patient controlled analgesia' in appropriate patient where the patient can control a drip of a painkiller solution being injected into a vein.

Overall 'no pain no drain' sounds a bit gimmicky and there are pros and cons to be considered for both use of a drain and the method of delivery of pain relief.

Anindya Lahiri, FRCS (Plast)
Birmingham Plastic Surgeon

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.