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Why go tubeless?

Written by Emily Hartmann MD

July 2, 2020

Drains are an essential part of surgery. If there’s an open space in the body it will likely fill up with fluid. If the fluid is left inside, it can lead to permanent fluid collection and even infections. In this way, helping alleviate excess fluid collection, drains can be extremely helpful… However, they do come with downsides for the patient because the drain exit site is usually very tender and they have to be drained and measured twice a day. This raises an interesting question: what if we could somehow close down this space and alleviate the need for a drain?
Tummy tucks are amazing when it comes to excising excess skin from the lower abdomen and fixing the separated muscles (diastasis). The skin and fat are completely separated from the muscle in order to get the tissue to advance as much as possible. Older techniques would use drains to remove any fluid that accumulates in the open space that the surgery created… Needless to say, these drains are a drag for the patients. Fortunately, there is a technique which allows for drainless tummy tucks, and it is precisely this method, which I employ in my surgical practice. Patients are often so surprised to find out I don’t use drains with my tummy tucks. They ask me “what happens to the fluid?” The answer is pretty simple, my technique closes those spaces and prevents the fluid collection to begin with… no space, no fluid, no drain.
Here’s how it works:
I use a series of what are called progressive tension sutures, which close down the potential space thereby not allowing the fluid to collect. This technique has been shown to decrease rates of fluid accumulation. Patients are so happy to not deal with the drains, their management, or the rather unsightly scars that they leave.
Easier recovery, less scarring= win/win in my book.
I am truly grateful to my mentors who shared their techniques with me, especially Drs. Grant Stevens, Michelle Spring and Luis Macias.
Check out the before-and-after below. She was thrilled to not have drains AND thrilled with her results!

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