Hello,I don't know about the 'extensive training', but the concept of progressive tension sutures not only improving the aesthetic outcome of a tummy tuck (by getting more tightening where you need it, above the belly button) and eliminating the need for drains has been around for a decade. In the last year there have been multiple studies showing the superiority of progressive tension sutures/no drain tummy tucks over conventional tummy tucks with regard to seroma formation and infections. The 'fluid' is a product of movement between skin flap and underlying muscle; this is eliminated with progressive tension sutures, allowing immediate post operative 'sealing' of the space. No drains required.I was an early adopter, and have been using progressive tension sutures for over 5 years. My seroma rate went from 20% prior to 0.5% (just one person so far!). Why isn't every surgeon doing it? Its time consuming and it's difficult to do well. There is a learning curve, and most of surgeons don't want to spend the time (and money) in the operating room making a long operation longer. For me and some of my colleagues, it's been worth every penny, paying itself back handsomely with happy patients that go back to work in about the same time as liposuction patients with the best result possible!Best of luck!
When performing a tummy tuck, you create a space between the abdominal skin/fat and the abdominal muscles. Doing so allows you to repair the separation between the muscles and take out the excess skin/fat. This space is temporary and will eventually heal. When the space is not closed throughout (closed only at the bottom incision), drains are required to avoid collection of unwanted fluid (seroma). When the space is closed in a quilting fashion, with sequential tension sutures, then fluid does not collect and drains are not required. Aside from a more comfortable recovery for the patient, the drainless technique produces better aesthetic results, simply by eliminating tension on the abdominoplasty scar at the bottom of the belly. The scar stays where it is placed, in a low position, and not be pulled up by tension on the abdominal flap in a window shade fashion. The lack of tension also makes for a nicer healing scar.
In my own practice, all tummy tucks and lower bodylifts are all done without drains. The lower complication rate, increased patient comfort, and improved aesthetics of the results are clear. The technique will eventually be more widely available and adopted by other surgeons. Dr. B
Plastic Surgeon Preference
Hello 'ByeByeBelly33', thanks for your question. All physicians, including plastic surgeons, practice in a way that reflect their different training, experience, and backgrounds. This is also reflected in their preferred methods and techniques to address the same problem, which is part of what makes my specialty so interesting to practice. There are drain and no drain methods to perform tummy tuck and other procedures, but there have been no definitive studies that show one method is superior to another. Ultimately, it is important to go with the board-certified plastic surgeon who you feel most comfortable with. Good luck!
The procedure of a abdominoplasty or tummy tuck is relatively extensive, and I must admit that most surgeons use drains to "evacuate" fluid. There is no scientific evidence that drains are beneficial, and I have not used drains for over 30 years. The compression garment, however, is mandatory with this surgery.
are possible but with discontinuous undermining and lipoabdominplasty procedures available, I use drains and they come out in a weeks time. You can shower with the drains as well so its not an impediment to activities of daily living. But if not having drains is the most important thing to you, then find a surgeon who does that and has a reasonable revision policy in case things don't work out as you anticipated. Drainless procedures add more time to the operating room and for anesthesia so it costs more in my practice.
My experience of doing several thousand of these Tummy Tucks is that I prefer to use drains for a few days which eliminates the fluid build up that some of these women get after this procedure. My suggestion is you find an experienced Plastic surgeon and don't worry whether drains are used or not.
A tummy tuck can be performed with or without drains. With drains it can be easier to control the excess fluid. Without drains there is less of course to take care of post operatively. I don't know that it should be a major factor in making your decision. Choose the plastic surgeon you are most comfortable with and who is the most qualified/experienced.
Drainless TT/UH repair sounds like a dream -- does it REALLY make a difference when choosing a PS
You should go with the surgeon you feel comfortable with and have confidence in. As to extensive training for a drain-less tummy tuck, I think he is really exaggerating things. Not using drains in tummy tucks has been around for years and is nothing new. What is new is that surgeons are promoting it more. As to a drain-less tummy tuck. In many cases it works great. In some cases it does not. If there is a fluid accumulation in a drain-less tummy tuck the fluid can take time to be absorbed, slowing the recovery process or requiring needles to be placed, possibly repeatedly in order to remove the fluid.
Drainless TT/UH repair sounds like a dream -- does it REALLY make a difference when choosing a PS? (photos)
Thank you for your question. An experienced plastic surgeon will tell you that, yes there is a recently re-popularized technique of tummy tuck that eliminates the need for drains, but that it depends on the situation at hand and how dry the surgical field is. I personally tell my patients that I will try to use the "drainless" (which is I think what you meant by "stainless") technique, if the field is dry enough. And I do not commit myself by saying "I use the drainless technique", or "I always leave drains" for a tummy tuck. Hope that helps.
What to know about drainless tummy tucks
The "drainless tummy tuck" is based on the use of a technique called progressive tension sutures (PTS), which I have been doing for almost 20 years. The purpose of drains with tummy tucks is to prevent fluid accumulation, and I found that the amount of fluid with PTS is much less, it is not zero. For that reason, I still prefer to use drains most of the time but they can be removed earlier.