Tummy Tuck: To Drain or Not to Drain … That is the QuestionPosted On: July 3, 2017
One of the big questions (and marketing messages) you see with plastic surgeons these days concerning tummy tuck is if a drain should be used or not. Let’s face it: Patients hate drains. Drains are placed to get rid of blood and fluid created by the body following surgery, and we all know you don’t want old fluid sitting around, whether it’s your kitchen sink, your kids’ bath, or your own shower. Think of what it looks like in there if a pipe clogs and the old water and assorted other stuff builds up. It just gets grosser and grosser. Yuck! The same is true when it comes to surgery. After your surgeon completes a procedure, all sorts of natural processes kick into gear in the incision area, causing fluid—made of blood, dead cells, healing proteins, and more—to collect and pool in the surgical space under your skin. This can lead to the most common complication now following surgery: seroma or fluid collection. This fluid can continue to build and needs to then be removed, or it can lead to infection, which is why your doctor may put in a drain after surgery. This gives that unwanted liquid a way out. Dr. Brad Bengtson has significant experience in this area. He has a number of new medical device patents and is working on a number of drain substitutes. He uses drains as a routine part of tummy tuck surgery in Grand Rapids, but also performs drainless tummy tucks in his busy Michigan practice. He has certainly seen a rise in drainless tummy tucks, but who should actually have one and how does Dr Bengtson decide?
A drainless tummy tuck is used for all mini and modified abdominoplasty surgeries where the belly button is not moved. It may also be used in thin patients for a full tummy tuck when no liposuction is performed and additional sutures, also known as progressive tension sutures, are utilized to sew the skin to the abdominal fascia. Known as the “quilting” technique, this involves the surgeon making a series of internal sutures to try to close down the space. With these sutures placed on the inside, they serve to pull together tissues internally, so a larger “open space” is avoided. With no place for liquid to pool in large amounts, a drain is not as crucial.
If, however, liposuction is performed and adds a lot of additional fluid and trauma to the area, or pain pumps are used, or patients are a little more chunky, buildup of extra fluid causing a seroma is more likely. To avoid having to stick needles in and drain this fluid off over the two to three weeks following surgery, or placing another drain, the drain is best placed in these patients from the beginning.
Some doctors have moved to the drainless method in every patient. It is not all beauty and no drama, though. Plication sutures can create visual dimpling and indentations in the skin and can also create delayed bleeding. As Dr. Bengtson says, if there is a lot of blood or fluid in there, it has to get out, and these sutures will sometimes just compartmentalize the problem, leading patients to develop seroma even after plication sutures.
As a nationally recognized plastic surgeon due to his experience, skill, and contributions in the industry, Dr. Bengtson is qualified and prepared to discuss whether he believes you should have a drain during your tummy tuck or not. He will give you the pros and cons based on his experience of performing more than 1,000 major abdominal procedures. As with any development in the medical field, doctors will continue to progress their knowledge and understanding of the available techniques, working with each patient as an individual to determine the ideal procedure for him or her.
That said, the drainless tummy tuck is increasing in popularity, with more patients asking about the possibility of leaving the drains for the bathtub. Anyone considering this route should make sure the decision is based on data and science—not just on marketing.
So, tummy tucks: to drain or not to drain? Dr. Bengtson has the answer …