Is it possible to have a drainless circumferential body lift?

In my hands a Lower Body Lift means several procedures in order to achieve the best results: Circumferential Tummy Tuck, Muscle Repair, Pubic Lift, Front and outer thigh lift, real buttocks lift, gluteal flap (using your own tissues to create volume to top of buttocks) and if it is the case (almost a 100% of my AWL patients) liposuction to lovehandles and use that fat to transfer to bottom of buttocks and hips if needed. So because of the liposuction and buttocks flap I must use drains to prevent seroma. Drains are used for safety reasons. So if your surgeon determines is the best for you, there is nothing wrong about it, it means safety and we are obligated to do what is best for our patients  Be encouraged. Dr. Cárdenas 

Hello,Thank you for your question regarding whether it’s possible to have a drainless circumferential lower bodylift. This is an excellent question. While it is possible to have a drainless tummy tuck, I do not suggest a drainless 360 circumferential lower body lift, belt lipectomy, or circumferential lower body lift (LBL).  You must consider your waistline. For easy math, consider your waistline is 30 inches. Therefore, during an average tummy tuck, the incision would be 10 to 12 inches. If however, you were to undergo a 360 circumferential lower body left, the incision would be 36 inches. This is three times longer than the tummy tuck. Also, consider the amount of surface area that is undermined. There is 2 to 3 times more surface area that is undermined during a body lift compared to a tummy tuck. The more surface area and a longer incision means that is more serous fluid naturally created by your body in an effort to heal and seal the wound. I have performed hundreds of body lifts and all of my patients have required drains. There is simply too much fluid that is produced by your body during a 360 body lift to undergo a body lift without drains. Therefore, I do not advise a 360 circumferential lower body lift without drains. Since the 360 circumferential lower body lift or belt lipectomy  is considered to be a complex procedure, please seek an experienced, board-certified plastic surgeon. Please seek a plastic surgeon who is performed hundreds of body lifts  in their career. Travel out of state if you must. Good luck!If you have any, more questions regarding the 360 circumferential lower body lift, please call my office. Sincerely,Dr.Katzen(Certified by the American Board of Plastic Surgery and member of the American Society Plastic Surgeons, International Society of Aesthetic Plastic Surgery, American Academy of Cosmetic Surgery,and Fellow of American College of Surgeons and American Board for Metabolic and Bariatric Surgery)

Thank you for your question. You could have a body lift without drains, however I always use drains after surgeries such as liposuction, Tummy Tuck and body lifts. I've found it's the most efficient way to remove fluids from the patient and should not be avoided. 

Thank you for your questions. Often I have patients who are scared and afraid of drains and then once they have them, they realize that they are not that bad. Any procedure can be done without a drain, but the question remains, is that the best method? Drains are useful to remove fluid from the surgical site and to prevent complications. I find it better to put the drains in and then remove them when they are no longer needed. The alternative is to try not to use them and then try to figure out how to deal with problems when they arise. Studies have shown that over 50% of patients who have "drainless" procedures end up undergoing needle aspiration drainage of fluid collections in the office during the post-op period and I think this is worse than having a drain.Hope this helps!Dallas R. Buchanan, MD, FACSOwner & Board-Certified Plastic SurgeonVIVIFY plastic surgery

You can perform any procedure without a drain.  The concern would be whether no drains would provide you with the smallest risk for complications.Kenneth Hughes, MD, ABPS Board Certified Plastic SurgeonLos Angeles, CA

Great question!  For body lifts, absolutely you need to have drains.  Personally, I use drains for tummy tucks as well.  The reason is with both of these procedures, you are creating a lot of "empty space" that tends to fill with fluid.  I have several colleagues who use the drainless tummy tuck technique but their seroma rates are very high and some have to even re-operate to remove the seroma.  I personally don't feel the risk is worth the benefits - the drains are only in for 1 week for the vast majority of patients.  If you end up getting a seroma, you would need to have it drained a few times a week by sticking a big needle into the fluid collection.Best of luck and hope this information helps!
- Dr. Roger Tsai  @DrRogerTsai
Board Certified Plastic Surgeon

You need to understand that drain(s) is a safety measure to decreases chances of postoperative fluid collection (seroma) which is one of more frequent complications of TT/body lift. Using inside sutures to decrease space and friction  between skin and abdominal wall and vacuum drainage, significantly decreases incidence of seromas. Recently, tissue glue is used for the same purpose but there is no sufficient experience with that technique to omit the drains. In someone with low BMI as yours drains can be removed within 3-4 days; in the meantime you can shower and have almost full activity which drains do not limit significantly. Patient safety should have a priority over patient desires. Discussing this issue with your surgeon is the best next step. Good luck.

My personal opinion is that the "drainless" procedures are touted as a marketing tool, and not always in the best interests of patients.  I have used the PTS sutures, but still get fluid or small collections of blood that I am glad my drains removed I perform ultrasound exams in the office at each visit, and am well aware how often fluid can build up.  I never leave them in past 10 days either, as most patients have "healed and sealed" by then.I was impressed that even when doing limited tummy tucks, no liposuction, in patents at ideal BMI and using the new TissuGlu, 20% of patients still got fluid that required another procedure.  

Tummy tucks and lower body lifts can potentially be done without drains especially if no liposuction is being done. However, I would recommend you chose your surgeon  on who gives the best final result not on whether a drain winds up being needed or not. Sometimes a surgeon does not know till intraop whether they will need to use a drain. Go on your surgeon's websites and look for the post op look you want and depend on your surgeon to chose the best and safest way to get there. Good luck.

Dear Mamame34,
drains are used to reduce the chance of developing seroma. Most plastic surgeons use drains when they perform tummy tuck surgery. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery