Is a drainless tummy tuck as safe as a TT with a drain in?

Thank you for  your question.  Yes, a drainless tummy tuck is as safe as a tummy tuck with drains.  There are not higher risks of complications in tummy tucks without drains.  Patients can have excellent results without having the need for the drains.  Good luck.

Our meta-analysis research (link below) showed that "drainless tummy tuck (abdominoplasty) with progressive tension sutures" were more effective than "tummy tuck with drains" in reducing seroma (fluid buildup) and reoperation rates, with no difference for hematomas or infections.
Many plastic surgeons continue to use drains during tummy tucks because it has been the standard practice for many years. Drains are traditionally used to prevent fluid accumulation under the skin, a common occurrence after the procedure. The accumulation of fluid, known as a seroma, can slow healing and lead to complications. Using drains helps remove this fluid, ensuring proper healing and minimizing the risk of complications. However, drains can be uncomfortable, require additional care, and increase the risk of infection at the insertion points. They can also leave scars, even after they are removed.
The advent of the "drainless" tummy tuck, typically achieved through the use of progressive tension sutures, offers an alternative to this approach. These sutures help to close any dead space in the skin flap, significantly reducing the likelihood of fluid buildup and seromas. This technique not only eliminates the need for drains but can also result in faster recovery times and less post-operative discomfort for patients. While it has been shown to be highly effective, it is not without its challenges, such as a slightly longer surgical time and the need for a highly skilled surgeon to perform the procedure. Some surgeons may still prefer to use drains out of familiarity or due to concerns about fluid accumulation, especially in patients with certain body types or those undergoing significant liposuction. However, as more evidence supporting the benefits of drainless tummy tucks accumulates, this method is becoming increasingly popular for its enhanced patient comfort and streamlined recovery process.
While not every patient is a suitable candidate for a drainless approach, the procedure has proven to be a highly effective option. Your plastic surgeon needs experience in this technique, because incorrect placement of the sutures can cause major problems including contour deformities or dimpling and possible need for re-operation. Be sure to consult with an experienced plastic surgeon to determine if a drainless tummy tuck is right for you!
Krishna Vyas, MD, PhD, MHSHarvard, Hopkins, & Mayo Clinic Trained Aesthetic Plastic SurgeonNew York, New York

Yes, if performed correctly, drainless tummy tucks have advantages for the patient and the surgeon over using drains. In order to dispense with drains, some "preventive measure" must be used, e.g., progressive tension sutures, tissue glue. However, tissue glue does not decrease the incidence of seromas per the manufacturer, it just allows dispensing with drains.  Seromas or fluid collections are what we really want to avoid in order to avoid the need for multiple needle aspirations and the possible formation of a bursa.  A bursa requires further treatment, such as instillation of antibiotic solutions to sclerose or surgery to remove it.
Using a drainless technique with progressive tension sutures avoids seromas entirely. For the patient the recovery is much more comfortable.  When the flap is re-attached to the abdominal wall there is no space for fluid to accumulate, or minimally so.  The flap then sticks down and heals rapidly to the abdominal wall, eliminating any shearing forces that could open a space and allow fluid collection after a patient with drains has had them removed.
I have used the drainless technique for five years or so and have had only two that needed any aspiration and then quickly resolved with no further treatment. Progressive tension sutures have further safety benefits by taking tension off the flap, so it there is no concentration of tension at the incision line. This may contribute to better scar quality