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.
Diastasis Recti simply means a separation of the paired midline abdominal muscles also called the Rectus Abdominis muscles. Although not dangerous this condition makes your tummy stick out even if you have good core strength. Paradoxically with greater separation of these muscles, when you try to tense your muscles to tighten your tummy the center part bulges between the separated muscles. Here are some simple ways to determine if you have a significant Diastasis Recti: If you have a midline muscle gap of more than a few finger breadths when you contract your muscles and if you have bulging or protrusion in your midline between your muscles, especially if made worse when you contract your muscles. In my experience the vast majority of women after pregnancy have a Diastasis Recti, the same goes for massive weight gain/loss regardless of sex.
Repair of Diastasis Recti is typically done as part of a Tummy Tuck or Mommy Makeover procedure (regardless of technique) and consists of bringing the Rectus Abdominis muscles together by suturing (sewing) the inside edges of the muscle fascia together. I have found that it makes no difference if the suture material is absorbable or permanent, and typically I perform a two layer repair to insure that the correction is secure. Single layer closures may have a higher tendency of dehiscence (separation) that would require reoperation for repair. Although Diastasis Recti Repair can be done endoscopically for minor separations, this is no longer as popular of a procedure as there is a tendency for midline redundant skin unless there is wide undermining. Recovery is similar to most plastic surgical/muscle repair procedures: no heavy lifting or vigorous exercises for 4-6 weeks depending on your plastic surgeons wishes. With core exercises as part of your daily routine following this procedure you are well on your way to develop a “six pack Abs of Steel”.
Any woman or man who has a lot of redundant skin, stretch marks, loss of abdominal tone due to pregnancy or significant weight gain/loss. A tummy tuck frees the redundant skin and removes it, tightens the underlying muscles, and liposuction contours add additional contouring to the abdomen and waistline.
Dr. Nichter’s practice, Pacific Center for Plastic Surgery, offers patients the option of using Exparel to reduce discomfort following an abdominoplasty. Exparel significantly reduces discomfort the first few days of recovery, which is when pain is at it’s highest.
The Mommy Makeover is a combination of procedures, which improve the breasts,abdomen and hips after pregnancy or significant weight loss. Dr. Nichter explains who makes an ideal candidate and how the Mommy Makeover is performed. He also mentions many women comment on how they look better after surgery than pre-pregnancy.
One of the most common complaints from women seeking liposuction or a tummy tuck is the storage of excess fat in the abdomen. In some cases even through diet and exercise there may still be some unwanted fat pockets. Dr. Nichter provides an explanation as to why fat stores in the abdomen and how a tummy tuck or liposuction can offer a solution to this common problem.
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.