I would not take the risk in drainless Tummy Tuck
The risk of a collection of fluid that could relax an otherwise tight tummy is too high for me to recommend tummy tuck surgery without drains.
While I would love to offer this to my clients, I would not want to have to explain why my results were less tight than they are right now using drains. (John P. Di Saia, MD, Orange Plastic Surgeon)
Drainless Tummy Tuck
I personally would not do a tummy tuck without drain tubes. I think that the risk of developing a seroma is very high without drains.
At my facility, the use of drains adds no cost and little, if any, time. Some surgeons place quilting sutures to try to prevent seromas, but I feel a drain is still indicated. (John Whitt, MD, Louisville Plastic Surgeon)
Drain tubes a plus and a must for Tummy Tuck
I wouldn’t judge a procedure on having a few drains. Drain tubesprevent the complication of seroma (fluid) in your abdomen or blood (hematoma). If you are looking for a complication then go for it. We use pain pumps which helps post op pain relief and this fluid can also accumulate.
I have seen surgeons in Mexico do a tummy tuck with no drains and i see them in the Emergency Room at Cedars Sinai crying and infected with huge collections of fluid in their abdomen. Here in Amercian we adhere to a higher standard. Drains are a key to the best results. (Andrew T. Cohen, MD, Beverly Hills Plastic Surgeon)
Is tummy tuck without drain tubes a safe procedure?
Is a tummy tuck without drains a safe procedure? You bet it is, providing your plastic surgeon adheres to the principles that allow for using no drain tubes. The “dead space” must be closed. What is a dead space?
Let me give you an example: When a surgeon does a breast biopsy, it leaves a space where the mass was. This space is called a dead space, and it must be sutured closed or fluid or blood will accumulate, and this is postoperative complication.
When a tummy tuck (abdominoplasty) is done the skin/subcutaneous fatty layer is elevated from the underlying muscles starting at the incision in the inguinal region all the way up to the ribs. (The tummy button is, of course, left attached to the muscles.) The muscle are sutures together, and the excess skin is removed. The skin/SQ flap is then sutured back to the skin in the inguinal region.
That is this the only suture line, and the rest of the abdomen under the skin/SQ flap is a “dead space.” When a patient following surgery bends or roles to one side or the other the flap slides on the underling muscles and doesn’t stick well. This flap thus accumulates fluid or blood as a similar flap would anywhere else in the body. The answer, developed by Drs. Pollock, is to place numerous mattress sutures between the skin/SQ flap and the underlying muscle layer closing off this dead space.
This is done starting at the ribs and going down to the inguinal incision below. This eliminates the need for drains. The incidence of fluid accumulation, a seroma, in the technique that requires drains typically varies from 10% to 20%. Thus far the drainless technique in my practice for the last two years has resulted in a zero seroma formation. I do believe Pollock’s seroma incidence the last time I inquired is or approaches zero as well. Yes, it does take a few minutes more to include the mattress sutures, but the patients benefit enormously in my opinion.
Other benefits to the drainless tummy tuck are: less swelling, faster recovery, less discomfort, no painful drain tubesto deal with for 5-10 days, and finally, no drain tubes that have to be removed, which is not comfortable at all. Tummy tuck without drain tubes is one of the best techniques I have adopted for my patients in my several decades of surgery. Thank you for your interesting question. (E. Ronald Finger, MD, Savannah Plastic Surgeon)
Drains After a Tummy Tuck
Most surgeons use drains after a tummy tuck to minimize post-operative swelling. Placing drains takes a minimal amount of time while placing quilting sutures to collapse the tissues onto the muscle takes much longer. The quilting sutures are what is used to decrease the need for a drain. After a tummy tuck, whether drains were placed and then removed, or no drains used at all, fluid collections can occur that have to be drained with a needle. At times, that procedure needs to be repeated as fluid re-accumulates. This can happen to the best of surgeons.I will say that performing a tummy tuck and not using either a drain or quilting sutures does have a much higher risk of fluid accumulating and you needing the needle aspiration. (Julio Garcia, MD, Las Vegas Plastic Surgeon)
Drainless tummy tuck (abdominoplasty)
I have performed this procedure that involves using a series of “quilting” sutures to collapse and eliminate the space where drains are placed and potentially eliminate fluid collection. In my experience, it does not always prevent fluid accumulation. (Otto Joseph Placik, MD, Chicago Plastic Surgeon)