Tummy Tuck Without Drainage Vs. with Drains?

Thank you for your question.  Drains are placed during tummy tuck surgery to prevent seroma, or fluid collection, in the area in which the operation has occurred.  While the operation can be successfully performed without the use of drains, the risk of persistent seroma remains significantly higher in these cases.  It is my personal feeling as a surgeon that this risk outweighs any potential (relatively brief) inconvenience that drains may create.

Thank you for your question. A No Drain Tummy Tuck is usually an option. Surgical drains are awkward, irritating and very uncomfortable. They are always a worrisome part of abdominoplasty surgery for patients and produces lots of anxiety in patients. One reason that surgical drains are such a nuisance is that they make normal, everyday activities extremely difficult to perform such as: One reason that surgical drains are such a nuisance is that they make normal, everyday activities extremely difficult to perform such as: getting dressed, walking and showering. This can result into a longer recovery process. Another thing that patients worry about is the pain associated with pulling the drainage tubes out; drains are generally used in surgery to stop fluid from accumulating between tissue planes.

During a tummy tuck surgery, there is space between the abdominal wall and the overlying fat and skin (the abdominal flap). The body will do what it usually does during the healing process, produce fluid, if nothing is done to close this space. Because there is nothing to confine the fluid from accumulating, a seroma can develop in this space. In other words, the tissue produces fluid more quickly than it can reabsorb.

Negative suction drains are placed in spaces like this to get rid of the fluid and create suction between the tissue planes. There is a way, however, to eliminate this space without using uncomfortable drainage tubes. Utilizing progressive tension sutures inside the tissues to close off the space and relieve tension on the last surgical closure. This results into less pain, less discomfort and less tension. Also, there will be better scarring with potentially minimizes infection risk.

We have successfully used progressive tension sutures during abdominoplasty instead of surgical drains, with a lower seroma rate than is generally thought to occur with tummy tucks and drains. With this method, the seroma rate is close to zero and you cannot beat that approach.Dhaval M. Patel Double board certified Plastic surgeon Hoffman Estates Barrington Oakbrook Chicago 

I use a "no drain" technique in every Tummy Tuck and Body Lift procedure I perform, although if I also perform a significant amount of liposuction, I will commonly use a drain. "No drain" technique includes using what are called "quilting sutures" or "progressive tension sutures" that help close off spaces where fluid may collect and take tension off of the closure line of the skin.Your question about whether there is less swelling when a drain is places is a good one. I believe that drains can reduce the amount of swelling seen, but this is hard to accurately anticipate for a given patient. Surgeons that do not place drains undoubtably will see some fluid collections (called "seromas"), and in such cases, perhaps the use of a drain would have prevented this. My approach is to use quilting sutures in every case and to selectively use drains when I have performed a significant amount of liposuction -- a bit of a "belt and suspenders" approach that has made the occurrence of seromas drop to nearly zero in my practice.Hope this helps,Nick Slenkovich, MD