Most commonly called Tummy Tucks, abdominoplasties have become one of the most common procedures that I perform. Yes, they are usually accompanied with liposuction of the sides, hip roles, back and even inner and out thighs, and even breast augmentation – and when done together they are commonly called Mommy Makeover.
However, this discussion is solely about the Tummy Tuck, because of its prolonged recovery time, drains left in for usually five days, and the high complication rate.
I don’t leave drains in the majority of my abdominoplasty patients. This is not a matter of simply deciding to leave them out. Steps must be taken during the surgery to allow you to eliminate the drain step this safely.
The patient must be off any anti-coagulants for generally three weeks prior to the surgery: this means aspirin. Omega-3, flax seed supplements, Advil, Motrin, Advil, Vitamin E, and anything that contains vitamin E, such as diet or nutritional drinks.
The special technique used in surgery is also critical to eliminate the drains. When the flap of skin and subcutaneous tissue is elevated from the abdominal muscles, a “dead space” has been created. Generally this space is left open allowing the skin and underlying ft to move around on the underlying muscles. The technique to eliminate the drains is to suture the underlying fat to the muscles, so it cannot slide around, and this also closes the “DEAD SPACE.”
The incidence of seromas (an accumulation of fluid) varies from 10% to 20% with other techniques.
My incidence of seromas for the last two years has been zero, which doesn’t mean one won’t occur, but it still is a very good indication. In addition, the recovery time appears much shorter with less swelling. Plus, patients hate the drains and it is frequently a reason patients are afraid to have the procedure done.