One of the most common procedures done by plastic surgeons is an abdominoplasty or “tummy tuck.” Commonly, after weight loss from childbirth or diet, the abdominal wall, including the muscle and skin will be stretched and unable to contract back to its prior state. There may also be some extra fat that is accumulated around the belly button. In a modern tummy tuck, liposuction of the front of the belly, as well as the hips and flanks is one of the components. The extra skin is removed and the muscles underneath tightened.
Classically, when abdominal skin and fat is lifted off the muscle to allow sutures to be placed, a drain, a plastic tube hooked to a reservoir that withdraws the extra fluid that accumulates in that space, is placed at the time of the operation and removed within two weeks. These drains can be cumbersome to deal with and provide some degree of anxiety both in their day-to-day presence, as well as the uncomfortable feeling when they are removed.
One of the newer advances in body cosmetic plastic surgery, is to do a “drainless tummy tuck.” Instead of placing a drain to remove the potential accumulating fluid, multiple sutures are placed to reattach the overlying skin and fat to the muscle over the entire area in which they were separated. Some progressive tension can be placed in a downward fashion such that there is less pulling on the final closure at the bottom. We have done this “drainless” method for many months now and have had the opportunity of looking at all of the patients with our in-house ultrasound after their first week. We have not found any significant accumulations of fluid that needed to be removed with an additional procedure. Our patients have been quite pleased to avoid the use of drains and have raved about the more tolerable recuperation period.