A tummy tuck is a procedure to improve the appearance of the abdomen. It involves a combination of the removal of extra skin, tightening of the abdominal muscles (or diastasis repair), and liposuction of extra fat. Doing this procedure creates a space between the outer skin layer and the inner muscle layer. To prevent a seroma, or fluid building up in this space, plastic surgeons traditionally place one or two drains. These drains are plastic tubes that exit out the skin and suck out fluid into a ball that the patient has to empty and measure several times a day. After one to two weeks, depending on the fluid levels, the drains are removed in the office.
While using drains is a fine way to manage fluid, what are the downsides to drains? First of all, they are pretty gross. Most people don’t like having to deal with looking at and emptying the bloody fluid out of their drains. Number two, the exit site of the drain makes an additional scar. Even if the drain exits through the primary surgical incision, I have found that the scar always looks worse where the drain exit site is. Number three, the drain site hurts. There is an open area where the drain comes out, and it gets pretty uncomfortable where the drain is rubbing against the exit site. And finally, surgical drains are just annoying. It’s like having a plastic tail that you have to hide inside your clothes and hang on to while taking a shower.
What is the solution to these problems? A drainless tummy tuck. No drains! A while back, some smart person came up with the idea to place internal stitches to get rid of the space where the fluid can build up. Then they did a study where they compared tummy tuck patients with drains to tummy tuck patients with the internal stitches, and they found out that the number of seromas (fluid pockets) was the same.
After learning about this, I decided to give it a try. First, I did the internal stitches, but I still placed one drain. After I saw that the fluid levels were low, I made the switch to completely drainless tummy tucks. I have now been doing drainless tummy tucks for over 5 years and I haven’t had any problems! My patients are so much happier and have a much easier, faster, and more comfortable recovery without any drains.