In my experience, closure of liposuction Incisions will not be associated with increased postoperative adverse effects.
I have always closed the incisions on my liposuction patients.
There are different "camps" regarding closure vs. non-closure of the liposuction incisions, perhaps based on training and surgeon preference/experience/technique.
The tumescent solution is evenly distributed throughout the subcutaneous adipose (fatty) layer, and suction is used, so there are no pools of fluid remaining and the body lymphatic system and circulatory system will resorb the tumescent fluid that remains even if the incision is closed.
The truth is, the incisions close even if left open---the incisions are small and they close on their own in 24 to 48 hours. The best way to "drain" the area, if drainage were surgically required, is with the actual placement of small siliconized drains through the liposuction entry/access incisions. Very few surgeons, if any, use drains after liposuction, and if they do, I am certain each surgeon has his/her reasons to do so. I never use drains after a pure liposuction procedure, but I will use them if the liposuction (I use Smartlipo-laser-assisted liposuction) procedure is combined with a skin flap and skin excision procedure, such as abdominoplasty and rhytidectomy (face/neck lift).
I perform Cellulaze, laser minimally-invasive, single procedure for the anatomical treatment of cellulite, and in these cases, I do leave the access incisions open to drain, as in this procedure the tumescent fluid is put under the skin in the space between the skin (dermis) and fat. I do not want the tumescent fluid to "pool" under the skin, so the incisions are left open in the lower parts of the treatment areas, so that drainage is encouraged by gravity. Another fact is that ---suction is not any part of the Cellulaze procedure, so the fluid is not aspirated at the end of the procedure. The fluid is massaged out of the access incisions at the end of the Cellulaze procedure and the incisions are left open and the areas are padded to "accept" the drainage, which may continue for 1 to 2 days.
It is important to understand why certain aspects of an operation are done, so these explanations will be useful to help patients know why in some cases, the incisions are left open and in other surgical situations, the incisions are closed, or even drains are utilized.
It is rationale, clinical and scientific reasoning ----and knowledge is power---so patients can feel confident that with understanding --comes confidence in the surgical procedure.
Chrsitine Petti, M.D., F.A.C.S.