Plastic Surgery Insights from Dr. Slack

 

 

What, No Drains with a Tummy Tuck????

Drains are a necessary evil after many different surgical procedures . They are placed to prevent the complication of seroma from developing. A seroma is the collection of fluid beneath the skin within the surgical site. It forms due to the normal leakage of fluid, serum and blood , from the raw surfaces of freshly cut tissue. Serum is the clear yellow fluid that you see oozing from a scrape after the bleeding stops. In plastic surgery there are many procedures that separate the skin from the underlying tissue so that it can be tightened . This creates a space , known as “dead space, ” that can fill up with fluid. This dead space is particularly large after a tummy tuck ; hence, the collection can be significant.

In general , seroma’s are not dangerous; however, they often produce an undesirable fullness beneath the surgical site and in rare instances can become infected. Further the presence of fluid between the skin and the underlying tissue prevents them from healing together. Therefore, it would be advantageous to prevent them from forming.

For many years, JP drains have been the staple for preventing seroma formation. These tubes , placed under the skin, drain the fluid out of the area so the raw surgical surfaces can heal. They are left in place until the fluid output falls below a certain amount (typically 30cc’s in 24 hrs) . For a tummy tuck they are usually in for at least a week. JP drains are excellent at preventing seromas but not 100 % and most would tell you they are no fun to have hanging out of your body for a week.

Another solution is to close the dead space created by surgery so there is no room for fluid to accumulate. This “drain free” option uses a suturing technique known as “progressive tension sutures” to prevent seromas. Studies have shown progressive tension sutures to be as effective if not more effective at preventing seromas then JP drains. They also result in less tension on the incision which can make for a finer scar. Downsides are the potential for the sutures to cause subtle indentations under the skin where they are placed. Since the sutures are dissolvable these indentations are generally temporary.

Seroma is the most common complication after a tummy tuck and is seen frequently with other cosmetic surgery procedures as well. It is important for your doctor to explain this to you and to go over the options that he or she will utilize to try and prevent it from developing. If you are interested in learning more about tummy tucks in or near Allen, TX and specifically drain free tummy tucks, please call to set up an appointment with Dr. Slack or connect with us online here.

Dr. Slack is a board-certified plastic surgeon serving the communities of Allen, McKinney, Frisco and Plano since 2001.

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Our team would be happy to go over your options and create an individualized plan for you through an in-person cosmetic consultation. To schedule a consultation, contact us.