Tummy Tuck and Drains
Drains are the standard of care after abdominoplasty. After elevating such a large area and performing a large surgery, the body produces fluid which needs to be drained.
Some have suggested that internal sutures help close the space and make the drains unnecessary. However, fluid can still accumulate which would need to be drained.
Having drains for a few days to a week after surgery is a much better alternative than having to undergo a second procedure to remove fluid which collected in the absence of drains. (David Shafer, MD, New York Plastic Surgeon)
I use quilting sutures and drains
And I also keep an ultrasound in my office to check for fluid collections. Even with the quilting sutures, I still see fluid in about half of patients.
I do believe the quilting sutures lessen the amount of time the drains stay in place, however, and can contain any bleeding if that should occur. (John LoMonaco, MD, FACS, Houston Plastic Surgeon)
I have never regretted placing a drain, but I have regretted not placing one. I have not personally been moved by arguments to avoid a drain.
Drains today do not have to be painful on removal, though they are a hassle and uncomfortable at times. The benefit is that it minimized seromas and risks that lead to additional surgery.
I use three drains, and they stay in usually longer than a week but my seroma rate is nearly zero for many years. (Scott E. Kasden, MD, Dallas Plastic Surgeon)
Tummy tucks and Drains
Personally, I have been very happy with the use of drains after a tummy tuck. I think that it is rare for a surgeon to not use one – there is very little if any risk with them, and most patients tolerate it very well.
The downside of not using a drain is that you would be at a high risk for developing a seroma or fluid collection, which would need to be drained in the office at least once or twice – not the end of the world, but this can usually be avoided with the use of a drain for a few days. (Shahram Salemy, MD, FACS, Seattle Plastic Surgeon)
Internal sutures vs drains tummy tuck
Both techniques are used successfully. If your plastic surgeon has used this technique successfully then trust his judgement. The internal “quilting sutures” are safe as is the use of drains tummy tuck. (John P. Stratis, MD, Harrisburg Plastic Surgeon)
As usual, there is more than one way to skin a cat (or do a tummy tuck). In my experience, quilting sutures add time (and therefore cost) to the surgery and do not really add much. I use 1 small drain which is usually removed at the first post op visit. There is no guarantee that you wont get either a collection of blood or serum, no matter what technique is used. (William B. Rosenblatt, MD, New York Plastic Surgeon)
Internal sutures vs drain in a tummy tuck
I personally use one small drain in a tummy tuck and it stays in until it gets to less than 25 cc’s for a 24 hour period, usually a week. I rarely have any seromas with this and the drain is very easy to remove and is well-tolerated. I personally have no interest in doing internal sutures to eliminate the drain. (Richard P. Rand, MD, FACS, Seattle Plastic Surgeon)