Drains vs. Drainless Tummy Tucks

Dr. Larry Nichter
Dr. Larry Nichter

Your board certified plastic surgeon is the best person to ask for a specific recommendation if a drain is needed or recommended after your tummy tuck procedure.

I determine whether or not to use drains on a patient-by-patient basis. Often my decision is to use drains if liposuction is done at the same time as a tummy tuck or if an extensive tummy tuck is required, for example, following massive weight loss. In those situations I have found an increased chance of having a fluid collection called a seroma, or prolonged swelling, delaying the final result by weeks. Use of a temporary drain seems to prevent this from happening.

Those plastic surgeons that do not use drains for these more involved surgeries often rely on extra “quilting stitches” internally which lengthens the procedure and requires external elastic garments that may be uncomfortable. These garments, if too snug, can also apply too much pressure on the lower skin flaps, decreasing blood flow with delayed healing or other problems.

The purpose of drains is to remove excess fluid such as tumescent liposuction fluid, irrigation fluid, local anesthesia, blood/serum, etc., so that the superficial skin flap can touch the underlying deep tissue (muscle) to begin the healing process. With drains, I do not find it helpful to use compression garments or binders while drains are in place and sometimes not at all especially for “mini tummy tucks.” This is more comfortable for my patients.

Typically, drains are removed within 10 days but if you had significant liposuction done at the same time, it may be a bit longer. In general when each drain has less than 30 cc’s of drainage over 24 hours they are removed. Have trust in your surgeon’s recommendations but feel free to ask the rationale of their decision.

The Most Popular Plastic Surgery Procedures 2011

Dr. Larry Nichter would like to make blog readers aware of new statistical information about plastic surgery and cosmetic procedures in the United States.

The number of cosmetic surgical procedures in America increased by 1% in 2011, the statistical survey by the American Society of Aesthetic Plastic Surgery has shown. Over 1.6 million such procedures were done in the United States last year.

In the fifteen years since the survey began (1997), the overall number of cosmetic procedures done in the United States has increased 197%.

Liposuction was shown to be the most popular procedure. Two breast surgeries—augmentation and lift—were among the top five most popular cosmetic surgeries:

  • Liposuction — 325,332 procedures
  • Breast augmentation — 316,848 procedures
  • Abdominoplasty — 149,410 procedures
  • Eyelid surgery — 147,540 procedures
  • Breast Lift — 127,054 procedures

The survey also showed a 2% decrease in the number of nonsurgical procedures, although 7.5 million such procedures were performed (constituting 82% of all cosmetic procedures).

  • Botulinum Toxin Type A — 2,619,739 procedures
  • Hyaluronic acid — 1,206,186 procedures
  • Laser Hair Removal — 919,802 procedures
  • Microdermabrasion — 499,427 procedures
  • IPL Laser Treatment — 439,161 procedures

An analysis on the society’s website attributed this growth to the aging of the Baby Boomer generation as well as their children.

Some other interesting findings from the survey include:

  • 91% of all cosmetic procedures were done on women (8.4 million procedures). This is a 208% increase over the last 15 years.
  • Of the 800,000 men who had cosmetic surgery in 2011, the most popular procedures were liposuction, rhinoplasty, blepharoplasty, breast reduction (for gynecomastia), and facelift.
  • About $10 billion was spent on cosmetic procedures in the United States, and of that $6.2 billion was spent on surgical procedures, the rest was spent on nonsurgical procedures such as injectables, skin rejuvenation, and laser hair removal.

Source: Babbitt, Adeena. “Celebrating 15 Years of Trustworthy Plastic Surgery Statistics.” ASAPS.