Tummy Tuck

Introducing: The Drain-Free Tummy Tuck!

Tummy tucks are one of the most commonly performed plastic surgery procedures to date. In fact, the tummy tuck procedure has risen 104% from 2000 to 2016, according the ASPS. After childbearing or weight loss, the abdomen can have some remaining fat around the belly button with a little bit of extra skin and some laxity to the underlying abdominal muscles, creating an unsightly bulge. During a tummy tuck procedure, the extra fat is removed with liposuction, the redundant skin is removed, and the abdominal muscles are tightened and placed back into the midline creating a sleek, tight and thin abdomen.

The Drain-Free Tummy Tuck

In many patients’ minds, they fear the tummy tuck operation because they have heard that it hurts and that you must have a drainage tube. Well, no more! Dr. Salzman is amongst the first plastic surgeons in the United States to do what he calls a “drainless, painless tummy tuck.” Instead of a drain, TissueGlu™ is sprayed between the skin that has been lifted and the muscles that have been repaired underneath. We have also begun treating our patients with a long-acting numbing medicine that is placed under ultrasonic guidance by our anesthesiologists after the patient is asleep. This has reduced the tightness and pain for the first three days following the procedure.

Dr. Salzman is extremely skilled in this new tummy tuck technique. He has recently taught other plastic surgeons from around the world this new technique in a teaching course at the national plastic surgery meeting in Orlando this past October.

If you’re considering a tummy tuck, you might want to have a consult with Salzman Cosmetic Surgery and Spa to hear about the latest new tummy tuck methods. We would be happy to answer any questions that you may have!

The Modern Tummy Tuck

A “tummy tuck”, or abdominoplasty, is one of the more frequent procedures done in plastic surgery for women who have lost weight or have had developed laxity of the abdominal wall from childbirth. Over the last year or so, newer techniques have developed that make this procedure better tolerated, less painful, and overall have a speedier recovery. We have been doing drain-less tummy tucks for the last nine months and have found that, whether we place sutures or glue between the skin that’s been lifted and the underlying repaired muscles, we do not need to place a drain tube into the patient. This has allowed for earlier mobility as well as less worry of having to deal with the drain. There’s also no extra hole made for the drain to pass out of the body. Pain reduction with tummy tuck is paramount to a quick recovery. Recently, we have been doing a nerve block, called TAP block, which places the long-lasting numbing medicine called Exparel™ directly into the nerves that supply feeling to the front part of the abdomen under ultrasound guidance. This has had a profound reduction in the pain experienced by our patients during the first few days after surgery. I like to think of this new method as the drain-less, painless tummy tuck. We have also been using ultrasound in our office for over five years now and feel quite competent in being able to assess the amount of fluid that can build up when these drain-less procedures are done. Should there be the necessity of removing this fluid, rather than sending our patients to a radiologist at a hospital, we can simply place a small cannula under the guidance of ultrasound directly into the area of fluid collection and remove it. This has vastly improved our patient’s recovery time compared to drains or to other practices that don’t have the expertise to provide adequate detection and removal of the small fluid collections.

What is a Drainless Tummy Tuck?

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.

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