Tummy tuck (abdominoplasty) is one of the leading procedures annually with more than 129,000 completed every year. There have been great advances in the tummy tuck procedure over the last 10 years, one of which is the elimination of drains.
Ask anyone who has had a tummy tuck and often what you hear is “the worst part of the was the drains”. This is why it is so shocking for me to discover that most plastic surgeons still use drains when completing a tummy tuck.
For approximately five years at my practice here in the St. Louis area, I have not used drains during tummy tucks. This comes as a surprise to many of our patients who often ask the question “why does it seem like everybody else tells me I need drains?”
My reply is usually “I don’t know”. It’s a tough question for me to answer because, like my patients, I’m not sure why they do either. I can only speculate and respond with “remember when people are reluctant to give up their land line and switch to cell phones?” I must assume physicians “have done it this way my entire career” and have not progressed with new techniques and the latest advancements.
Traditionally, the purpose of drains has been to prevent seromas. Seromas are basically a fluid collection that can occur whenever their space space to fill. For example, imagine there is a hole in your backyard and it rains. That space will fill up with water. Our body is mostly comprised of water and as such after surgery anytime there is a space this can fill with fluid as well.
So how do we do this without drains? By using a technique known as progressive tension abdominoplasty or tummy tuck. What we do is start from the top the open space and work our way to the bottom closing all of this space with sutures as we go. It’s the equivalent of filling the hole in your backyard so the water can’t collect.
What’s remarkable is that the literature is very clear, seroma rates without drains are approximately 1/3 the rate of these fluid collections when we do use drains. That’s right, the purpose of the drain is to prevent these fluid collections, and by using the drain the fluid collection rate is three times higher!
I also believe by not using drains and suturing this space closed, starting from top to bottom, and putting tension all the way down the abdomen as we close; we can get your stomach tighter than ever before, have better control of the scar location, take tension off the scar and minimize its appearance. Further, if there are healing problems they are often easier to manage because there is less tension at the scar.
So what’s the downside? Perhaps the only downsides I can see without drains are that it takes a few more minutes to close the space and my patients take a little bit longer to stand up straight after the procedure. Why? It’s because I’ve been able to get their abdomen tighter than ever by distributing the tension across the entire abdomen rather than just at the scar. This is a negative that patients ultimately thank us for!
Thanks to the advances in tummy tuck we no longer using drains, this is one of my favorite procedures. Whether you are having a tummy tuck after significant weight loss, pregnancy, or for any other concern of excess skin of the abdomen; the results can be astounding. Nothing makes me happier than to hear a patient walking in saying “well it’s not like I’ll ever wear a bikini again” and then in follow-up they say “well, it happened. I went to the beach in a bikini and loved it”. Nothing gives me greater satisfaction than to see the impact this procedure can have on patients lives.
For more information call our Glen Carbon, IL location today at 618-288-7855 or find us online at midamericaplasticsurgery.com. See more before and after photos here.
Learn more about Board- Certified Plastic Surgeon, Dr. Ryan Diederich of MidAmerica Plastic Surgery.
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