In regular abdominoplasty, one or more additional small holes are made in the skin, usually below the initial incision. A tube is inserted through the hole so that part of it is under the skin and the rest is outside the body.
This tube is called a drain and is intended to clear any fluid that may accumulate between the skin and the underlying muscles.
As the name suggests, drainless abdominoplasty does not include any tubes. This is done by placing multiple sutures between the Scarpa’s fascia (the tissue surrounding the fat layer under the skin) and the deep muscular fascia.
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Before Drainless Tummy Tuck
Not everyone is a good candidate for a drainless abdominoplasty. People who have undergone massive weight loss, either through surgery or physical means, are generally not considered ideal candidates for the procedure.
It also may not be a good option for patients with a higher Body-Mass Index (BMI) who also tend to have more drainage naturally after the procedure.
An ideal candidate is someone:
. Who is on the leaner side; within 15 lbs. of their ideal body weight
. Whose weight is relatively stable
. Who is in good general health
With that said, there’s increasing evidence and sentiment among doctors that even patients who are traditionally considered high-risk may still safely benefit from the procedure. Your surgeon should be able to weigh the pros and cons with you, based on your physical condition, to reach a decision on whether to perform a no-drain tummy tuck or the conventional procedure.
While abdominoplasty is considered relatively safe, there are some risks associated with it like any other surgical procedure. Complications may include:
. Postoperative bleeding
. Skin discoloration
. Seroma formation
. Poor wound healing
. Allergy to tissue glue (rare)
. Blood clots
The safety profile of a no-drain tummy tuck is essentially similar to that of the traditional operation, with the exception of a possible slightly higher risk of seroma formation.
Obese people have a higher risk of developing complications.
Drains need to be meticulously taken care of, the bags emptied regularly, and the amount of fluid in the bag kept track of. The main advantage here is that you won’t have to deal with this additional hassle while recovering from your surgery.
While drains are an important tool in a surgeon’s arsenal, they can be very inconvenient for the patient. Patients often find drains cumbersome, painful, and limiting to their activities of daily living for the first week or two after the operation.
Drains can also leave extra scars at exit points and are sometimes placed in the pubic area, which can be very uncomfortable at best and painful at worst.
Furthermore, drains have to be removed after seven to fourteen days following the surgery, which can subject you to additional discomfort or pain.
A no-drain tummy tuck can also decrease the risk of other complications like infections. With drains, bacteria from the outside can travel underneath the abdominal flap and cause an infection. For that reason, patients are advised not to shower.
Since there is no way for fluids to drain outside the body, the drainless tummy tuck is theoretically associated with an increased risk of developing a seroma, which is a collection of fluid under the skin that may need to be cleared with a needle.
Some people have a higher baseline risk of developing a seroma. These patients may have better outcomes with a traditional tummy tuck.
However, with good patient selection and proper surgical technique by an experienced surgeon, the risk of seroma occurring is essentially no higher than that of an abdominoplasty with drains.
Another possible concern is that progressive tension sutures are time-intensive, which means you will spend a bit more time under anesthesia. On the other hand, surgeons who opt for the tissue glue only approach can perform the operation quicker than an old-fashioned tummy tuck.
During Drainless Tummy Tuck
The tummy tuck part of the procedure is the same in both cases. The difference is in the way that patients are stitched up.
After being administered anesthesia, your surgeon will form an incision above your pubic area. They will then tighten any lax muscles and remove excess skin. Next, they will reposition your belly button if necessary, stitching it into place.
Your surgeon would then close your incisions using sutures that will be drainless. After completing your tummy tuck, you will be guided to the recovery area and should be able to return home the same day.
Liposuction may be combined with the surgery to further remove stubborn pockets of fat, particularly in the flanks.
After Drainless Tummy Tuck
Recovery is very similar to that of a traditional abdominoplasty with the exception of not having to maintain and then remove a drain.
. Depending on your condition, you should be able to go home the day of the operation or the next day.
. Over the next week, you will experience mild to moderate pain, swelling, tightness, and bruising. Your doctor will prescribe oral analgesics to help with the pain, and you will be advised to avoid physical activity, smoking, and alcohol.
. In the second postoperative week, the discomfort should begin to subside. You may be able to resume work and light physical activity after 10-14 days.
. After about a month you may be able to begin some light exercise.
. Throughout your recovery and for up to a month, you will be advised to wear a compression garment over your abdomen to speed up your recovery and encourage optimal results
Over the next several weeks, you should begin to notice gradual improvements to your body contours, with your final results being visible in about 6 to 8 weeks. Provided you stick to your healthy diet and exercising habits once you've fully recovered from your drainless tummy tuck, you should be able to enjoy the same great results for years to come.