The Great Drain Debate

Having a tummy tuck is exciting and you’ve probably spent hours researching what to expect and the d-word has surely crossed your mind. Let’s just say it, drains sound scary! So drain-less surgery must be the answer, right? Drain-less tummy tuck surgery is not always the answer and we’ll discuss why below. Plastic surgeons use surgical drains during many different types of cosmetic surgeries to remove fluid buildup after surgery and prevent seromas (aka, inflammatory fluid collections). However, drains can be uncomfortable and they don’t always guarantee that a seroma won’t develop.  Therefore, some surgeons are now performing drain-less tummy tucks.  With the use of quilting sutures, they attempt to close the open space under your skin during surgery. This has shown promise and some plastic surgeons are using this terminology to market to potential patients.  Let’s discuss the pros and cons of this approach.

Potential Benefits of Drain-less Surgery

  • Increased comfort: Drains can be uncomfortable and awkward to manage at home. Avoiding them means a little less discomfort and hassle.
  • Slight decrease in infection risk: Drains require an incision for insertion/removal, which creates a small risk of infection. Going drain-less reduces this risk in the immediate post-operative time frame.
  • More manageable recovery time: No drains can translate to an easier road to healing for some, at least in the first few weeks after surgery
  • Less scarring – Drain scars are tiny and rarely visible once healed but no drain scars is a positive.

Potential Drawbacks of Drain-less Surgery

  • Higher seroma risk:  Drains help remove fluid buildup after surgery. Omitting them can increase the chances of seromas forming especially if aggressive liposuction of your waist is included in this procedure. Which is a very common add-on.
  • Increased swelling: Drains reduce swelling by removing excess fluid in the surgical site. Swelling may linger longer without drains. This can have downstream effects on your healing.
  • Compromised circulation: Drains help relieve pressure. Too much swelling without drains can potentially compromise blood flow and lead to a prolonged recovery. 
  • Need for follow-up procedures: If a seroma develops because the quilting sutures are unable to stop and inflammatory fluid collection underneath the skin, additional treatments or procedures will be required. 
  • Drain tolerance: Most patients tolerate drains well, they are usually only needed for 1-2 weeks after surgery.   

Is drain-less best?

Drainless tummy tuck surgery reduces some discomfort immediately after surgery. However, plastic surgeons rely on drains to control swelling and optimize your surgical results.  In our office, we offer both procedures but find that our combination procedures, ones that include a tummy tuck with liposuction, benefit from having drains placed. You should have an in-depth discussion with your surgeon about pros, cons, and personal factors to determine what is best for you. But remember, what matters most is the outcome. If drains are required, it’s only a short period of time. Don’t make drains the deciding factor in your surgical decision-making. Good luck!