Drainless Tummy Tuck Surgery
An Alternative to Tummy Tuck Surgery in Seattle
No buttons to push for pain relief
No pain pump bulb to carry around
No pain pump tubes to be removed
No more anxiety about whether or not the pump is functioning properly
No more clogged or kinked catheters to interfere with a comfortable postoperative course
Together, “Drainless Tummy Tuck” and Exparel represent a quantum leap in the advancement of patient comfort and convenience in body contour surgery, and revolutionize how we treat the post-operative pain.
Drainless Tummy Tuck vs. Traditional Tummy Tuck Using Drains
As a way of continuing to improve the delivery of quality care to our cosmetic surgery patients, we have done an informal survey of our tummy tuck patients. When asked what the most difficult aspect of their abdominoplasty was, a surprisingly high number of patients stated emphatically that dealing with the drains was the worst part of their recovery. Suction drains are small plastic tubes that pass through the skin and are secured to the skin with a stitch. They often remain in place for a week — and in some cases, several weeks — and help prevent fluid from accumulating within the wound. Patients are instructed on how to measure and empty the drainage bulbs, usually two to four times per day, and they typically take antibiotics while the drains are still in.
Previous problems we have seen with drains at Pratt Plastic Surgery include:
- Pain at the exit site of the drain from the skin
- Pain from jerking on the suture securing the drain
- Pain and anxious anticipation about removing the drain
- Caretaker or patient misinterpreting drain care directions
- Infection at the exit wound of the drain
- Collection of infected fluid during or after drain removal
- Vaginal and oral yeast infections as a result of continued antibiotics
- Drain being accidently pulled out
- Clots in the tubes requiring periodic drain “stripping”
- Messy drainage of body fluid and blood around the drains onto garments & furniture
- Loss of suction (bulb or tube is defective) rendering the drain non-functional
- Strict activity limits for several weeks or more following surgery
- Strict activity limits for several weeks or more following surgery
- Additional scars
- Scar indentation where the drain tube was removed
- Prolonged wound healing at the drain site
- Delay in returning to work due to continued drain output / need for a longer healing period
- Unplanned returns to the office to manage a drain problem
- Seroma fluid collection upon drain removal requiring:
- Needle aspiration (drainage) after drain removal ($50 charge)
- New drain placement if the seroma returns after multiple needle drainages (minimum $500 charge)
- Open surgery under general anesthesia to remove the seroma capsule and closure of the space with sutures, as done with the Drainless Tuck (minimum $2,000 charge)
Why Are Drains Used in Abdominoplasty Surgery?
Dead space (the large space created by the surgery) tends to fill with varying amounts of body fluid that is naturally secreted by your tissues to aid in healing. Dead space can be thought of as similar to the space between the two sides of a piece of pita bread. A collection of fluid in this space can hold apart the tissues that are trying to heal to one another. Suction drains employed in abdominoplasty help evacuate the seroma fluid that would normally build up in the dead space and interfere with the healing of the fat layer to the underlying muscle layer. With activity limitation and prevention of fluid building up in this space, the muscle and fat layers are able to hopefully heal together and obliterate the space.
Why Does Dr. Pratt Perform Drainless Tummy Tuck?
Dr. Pratt was inspired by two things. First and most importantly, he likes to listen to what our patients have to say and make ongoing changes to our practice, depending on their feedback. Our patients have expressed significant dissatisfaction with the drains used with the traditional tummy tuck, as noted above. Drains come through intact skin and are painful, and there is discomfort when drains are removed. Drains are also quite difficult to conceal under clothing. Additionally, Dr. Pratt has been impressed by the positive results reported by other surgeons throughout the world. Dr. Pratt has had excellent results with the Drainless Tummy Tuck, with an extremely high level of patient satisfaction.
How Is Drainless Tummy Tuck Performed?
General anesthesia is used for all abdominoplasty procedures. When performed in the hospital along with hysterectomy or multiple other procedures, you may require an overnight stay. Full Drainless Tummy Tuck takes approximately three hours, whereas partial (mini) abdominoplasty takes about two hours, and full tuck with a central wedge resection lasts around four hours. A board-certified anesthetist monitors your vital signs and breathing throughout the procedure, and remains with you until your stable recovery.
Excess stretch-damaged skin and fat is removed, and the abdominal wall is tightened. The remaining skin is shifted down and sutured just at the pubic hairline. The lower abdominal scar is shorter than most, and can be placed as low as you wish. The one inside the belly button is well-hidden in its depths (see Bikini Belly Button). Dr. Pratt often will perform flank liposuction in order to produce a natural appearance, which has become his trademark. True to our PainBuster Therapy, Dr. Pratt makes sure to administer a long-acting numbing medicine directly into the abdominal wall prior to completion of your procedure in order to minimize your discomfort following surgery. An On-Q Pain Pump or long-acting anesthetic Exparel will ensure an even longer-lasting numbing effect to the surgical region, without any of the brain chemistry-altering effects of narcotics. Sterile gauze and a well-fitting abdominal binder are then applied.
How Does Dr. Pratt Perform the Drainless Tummy Tuck?
Before proceeding with final closure of the incisions, Dr. Pratt places a series of dissolvable sutures that are used to close up the dead space that remains when tummy tuck is performed when traditional drains are used. These stitches hold the tissues together securely, resulting in rapid and predictable healing, and minimize the chance for a fluid collection requiring drainage. Overall satisfaction with Drainless Tummy Tuck has been outstanding because patients are back to their regular activities more quickly, with less pain and inconvenience than when drains are used.
Drainless Tummy Tuck Techniques
There are several different techniques of performing Drainless Tummy Tuck. However, for the most part, the differences described by various surgeons are quite small and involve the type of suture used and the particular technique of suturing. Some surgeons use absorbable stitches that are placed intermittently throughout the entire wound. Others have had success with barbed sutures, one example being the Quill™, referred to as a “Knotless Tissue-Closure Device.” Some studies have shown a decrease in the time it takes to close up the dead space when using barbed sutures.
Advantages of Drainless Tummy Tuck
- Decreased pain
- Decreased anxiety and stress regarding drain malfunction and removal
- Decreased activity restriction
- Simpler bathing and more independence from caregivers
- Minimized chance of infection
- Minimized need for antibiotics, minimized nausea and minimized chance of vaginal yeast infections
- No additional scars
- Fewer seromas requiring uncomfortable needle drainage or drain replacement
Is It Safe to Have a Baby Following Drainless Tummy Tuck?
All our patients are encouraged to complete childbearing prior to considering Drainless Tummy Tuck. However, pregnancy after having Drainless Tummy Tuck is safe, with no long-term consequences other than re-stretching of the abdominal wall, skin and soft tissues with varying aesthetic affects. There is no known detrimental effect on the fetus or newborn. In fact, patients who have born full-term twins have said that all went fine, with healthy babies and mom as well.
Combining Drainless Tummy Tuck With Other Surgeries
Drainless Tummy Tuck is often part of a mommy makeover, which typically involves additional body contouring and breast enhancement procedures. An example of these surgeries includes breast augmentation, breast lift or reduction, liposuction, thigh lift, body lift and brachioplasty. Some facial and neck rejuvenation procedures can also be performed simultaneously with Drainless Tummy Tuck. The ultimate decision regarding the safety of you undergoing simultaneous surgeries will be made by Dr. Pratt, depending on your particular situation.
Is Drainless Tummy Tuck Dangerous?
Drainless Tummy Tuck has been shown to be a safe and reliable method of body contouring surgery in multiple studies, with a consistently lower complication rate than standard tummy tuck that uses suction drains if performed by skilled and experienced surgeons. Drainless Tummy Tuck is an abdominoplasty technique that is well described in plastic surgery literature including Aesthetic Surgery Journal and Plastic and Reconstructive Surgery.
“Tubeless Tummy Tuck”
Introducing Exparel, the revolutionary advance in post-operative pain management! Exparel is a local anesthetic containing a special additive that allows for three full days of non-invasive, non-narcotic pain control.
Drainless Mini Tummy Tuck
For excess skin and fat deposits primarily below the belly button, a “Drainless Mini Tummy Tuck,” or Partial Abdominoplasty, might suit you best, in which the lower abdominal muscles are tightened, and excess or stretch-damaged skin is excised in the region beneath the level of the pubic hair. Liposuction is often included in the flank region to assure a more pleasing overall result.
How Much Pain Will I Have With Drainless Tummy Tuck?
Fortunately, modern science has come to the rescue of Drainless Tummy Tuck patients. Recent developments in post-operative pain management have helped make recovery from abdominoplasty more comfortable than ever. Of course, immediately following tummy tuck surgery, patients experience varying amounts of discomfort. Most of the discomfort results from spasm of the abdominal muscles that are tightened during surgery. Dr. Pratt will prescribe both an oral pain medication and a strong muscle relaxant. Additionally, just prior to closure of your incisions, Dr. Pratt will inject a long-acting numbing medicine directly into the abdominal muscle fascia (fibrous covering). And, if you choose, he will place several pain pump catheters or the revolutionary long acting anesthetic Exparel in the space between the subcutaneous fat and the underlying muscle, which will continue to infuse a long-acting local anesthetic for either three or five days, depending on which pain pump you choose. Learn more about our PainBuster Program. Nausea and vomiting can contribute significantly to postoperative pain; thus, Dr. Pratt will prescribe an anti-nausea “patch” prior to your surgery (No Nausea protocol).
Drainless Tummy Tuck Candidacy
An ideal candidate for a Drainless Abdominoplasty is someone who is bothered or even impaired by a bulging abdomen, excess abdominal fat that does not respond to diet and exercise, excess or hanging stretch-damaged skin with loss of its elasticity following drastic weight loss or pregnancy, especially with multiple births of good-sized babies. Of course, a good candidate will have a stable weight and will be emotionally as well as physically healthy.
Your Initial Consultation
Whether your initial consultation is with our patient care coordinator or with Dr. Pratt, we will carefully review your health history, explore and clarify your treatment goals, and evaluate the specific physical features you would like to improve. Next we will give you an honest, straightforward and easy-to-understand opinion regarding the available options to achieve your goals, whether they are Drainless Mini Tummy Tuck, full tummy tuck, full tummy tuck with wedge resection or extended tuck. You will be given the opportunity to speak openly with Dr. Pratt about any questions or concerns you may have.
Drainless Tummy Tuck Preparation
Your preoperative visit with Dr. Pratt will be scheduled at least two weeks prior to your surgery date. Our patient coordinator will go over your informed consent as well as the risks and benefits of surgery, and answer any questions you might have. The prescriptions will be given to you to be filled prior to your surgery. Medications and supplements to avoid for two weeks before and after surgery will be reviewed. Smokers will be instructed to cease smoking at least two weeks before and after surgery.
You will be sent home on the same day of surgery in the care of an adult. A responsible adult should stay with you for at least 24 hours; however, we recommend that you have a caregiver around for a week or so. Although Dr. Pratt encourages patients to minimize straining or lifting heavy objects following surgery, you will be able to walk, climb a limited number of stairs and go to the bathroom, as tolerated. Because the Drainless Abdominoplasty ensures a secure bonding of the tissues, the severe restrictions previously recommended in patients having drains have been have been significantly lessened. An additional benefit of early activity and mobility immediately after surgery is helping prevent blood clots in the veins of the legs. As noted above, an optional On-Q Pain Pump or long-acting anesthetic Exparel is available, making the first three to five days of recovery much more comfortable.
Is Drainless Tummy Tuck for Me?
It could be. If you’re in good physical and emotional health and lead an active lifestyle but are concerned with excess abdominal fat and stretched or hanging skin that does not respond to diet and exercise, you may be a good candidate for Drainless Tummy Tuck. Strong motivation, such as feeling unhappy every time you look in the mirror, good physical condition and stable weight are the most important factors in determining whether you are a good candidate. Understanding that you will have a scar from hip to hip, and that it can be placed as low as you want is of course important. Drainless Tummy Tuck is very effective at removing the loose skin around the abdomen and giving you the six-pack you have always dreamed of!
If you are done having kids, you may be a candidate for a “Drainless Mommy Makeover.” In this procedure, Drainless Tummy Tuck is combined with other procedures ranging from breast augmentation and lift, to liposuction and thigh lifts. Dramatic weight loss can be a great incentive to consider Drainless Tummy Tuck, especially if associated with excess fat and saggy skin. Not only will an abdominoplasty enhance your appearance, but it can also send your self-confidence through the roof!
Why Should I Consider Dr. David Pratt to Perform My Drainless Tummy Tuck Surgery?
Dr. David Pratt has both the surgical ability and experience to safely perform Drainless Tummy Tuck with a natural appearance, including a Bikini Belly Button and a short scar which can be placed as low as you wish. Although Dr. Pratt is an expert in tummy tuck surgery, he is also noted as a top breast augmentation and lift specialist. Dr. Pratt and his staff do everything in their power to ensure their tummy tuck Everett, Seattle and Bellevue patients achieve the tight, slim midsection they desire. Dr. Pratt’s utmost concern is the comfort and safety of each and every patient. Our modern Seattle-area office offers a warm and friendly atmosphere and is outfitted with some of the most advanced and sophisticated technology found today.
I Am Interested! What Should I Do Next?
If you think that you are a potential candidate, or just want to obtain reliable answers about Drainless Abdominoplasty surgery, schedule your confidential consultation with plastic surgeon David Pratt. You may be interested in our supersaver rates or other fee-reduction plans. So go ahead and live your dreams! Contact Dr. Pratt today.