Why do patients hate drains commonly used in Tummy Tucks (abdominoplasties)?

• Drains are uncomfortable and even painful.
• Drains are not removed for 7 to 10 days, sometimes weeks.
• They slow recovery time. (Faster recovery is always better).
• The incidence of seromas is much higher with drains.
• They are cumbersome and need removal of fluid collected every few hours.

The general concept for surgeons for all procedures is to close all dead spaces, i.e., close open spaces from bottom up as in a breast biopsy, where we use sutures from the base of the open space to the skin. Any open areas behind closed skin usually collect fluid resulting in seroma formation.

With Tummy Tucks, the tendency is to close the skin and adjacent subcutaneous (SQ) tissue but leaving the entire abdominal area between the skin flap and the muscles open. This allows the skin and underlying SQ tissue to slide round on the underlying fascia, which covers the muscle, requiring drains. Recovery is greatly prolonged and seroma formation is reported to be from 10% to 60%. This requires drawing the fluid off with a needle and syringe, and occasionally more surgery.

Thanks to Dr.’s Pollock and Pollock in Dallas, the No-Drain Abdominoplasty was developed. The seroma incidence was zero in their 597 cases reported. This is outstanding! They use of “Progressive Tension Sutures” closing the dead space has allowed the elimination of drains.

I have used the Progressive Tension Sutures for about two years, and my incidence of seroma is thus far zero too. At the recent ASAPS (American Society of Aesthetic Plastic Surgery) annual meeting, I took a course given by Dr.’s Pollock and Pollock for any updates to the technique and was happy to hear that my technique is still what they recommend.

My patients and I are grateful to the Pollock’s for this leading edge technology allowing a much less painful and shorter recovery.