Tummy tuck or abdominoplasty surgery still remains as one of the most dramatic and satisfying of the many body plastic surgery procedures that are available. Removing loose skin and fat, tightening the rectus muscles, and narrowing the side of the waistline with liposuction always makes for a significant change in one's waistline. Even when done in a more limited version (mini-tummy tuck), the flattening effect is always appreciated. Despite these improvements, the one aspect of tummy tuck surgery that patients, and I, did not like was the need for postoperative wound drainage. In the past, tummy tuck surgery (abdominoplasty) always required the use of drains after surgery. Staying in place for up to two weeks after the procedure, they were necessary to remove fluids that accumulated from the open space or layer left behind. (between the underside of the skin and the muscle)They could not be removed until enough internal healing had occurred as evidenced by a decrease in the amount of drainage that came out of the tubes. By the time this happened, many patients had a fair amount of soreness from the skin areas where the drains exited. In some cases, even though drains were used and removed when their output was low, patients still developed fluid collections weeks later that required multiple in-office drainage procedures. As an improvement to the tummy tuck procedure and to eliminate their inconvenience and discomfort, I have adopted an innovation that makes the use of drains unnecessary in many abdominal contouring procedures. This is a technique known as 'quilting' or partially closing off the space in which fluids can accumulate. Using special sutures that tie-down the underside of the skin to the muscle, the typical 'dead space' left behind is closed down. Dead space refers to the unhealed open area or layer between the muscle and the overlying skin which is created from the way that a tummy tuck has to be done. With little space for fluids to accumulate, the need for drains after surgery can be eliminated in many cases. This does add some extra surgery time, but to any patient who has ever had drains, that extra time would be viewed as a good investment! While not useful for every tummy tuck (really big ones still need drains), the majority of cosmetic abdominal contouring procedures can now be done without drains. Even if a fluid collection or seroma does occur, it is much smaller and needs less in-office drainage procedures later. |
