The Surgeon Minute

The Painless and Drainless Tummy Tuck

The Painless and Drainless Tummy Tuck

“Everything that we do in plastic surgery is designed to enhance the patient’s experience,” explains Dr. James Namnoum, a board certified plastic surgeon in Atlanta, GA. What this means for the tummy tuck is making the procedure both painless and drainless.

An abdominoplasty, commonly referred to as a tummy tuck, is a truly effective surgical procedure for rejuvenating the contour of your abdomen. It’s designed to lift and tighten the abdominal skin, return stretched muscles back to their former state, and remove excess fat if necessary. While it sounds great, the deterrent for many patients has been the painful and lengthy recovery, in addition to wearing drains for a week or more. Thanks to the painless, drainless tummy tuck, those deterrents are a thing of the past.

What is a Tummy Tuck?

An often heard misconception about a tummy tuck is that it’s a weightloss procedure. This couldn’t be further from the truth; in fact, many plastic surgeons will strongly suggest a patient be at their ideal body weight prior to the surgery. The tummy tuck is about bringing muscles back to where they were pre-weight gain/loss and/or pregnancies. Most commonly a product of multiple pregnancies, the stretching of the female abdomen likewise stretches out the abdominal muscles; not always do those muscles stretch back. If they do not, what’s left is a loose abdominal wall where sits loose, stretched skin and exercise-resistant fat. The tummy tuck works by removing excess skin (stretched skin will not stretch back) and tissue after stitching loose muscles back together again. This leads to a tight, flat abdominal area. Coupled with liposuction, a 3-dimensional body contouring aspect can be brought to the procedure.

The surgeon in a tummy tuck procedure is trying, “to craft a solution that rejuvenates the abdominal wall, removes the extra skin and creates a tailored, lovely belly button,” explains Dr. Namnoum. This may or may not involve removing some excess fat as well.

Patients Are Fearful of Two Things

Patients who want a tummy tuck, but are reluctant to book surgery are typically scared of two things. The first is the potential pain associated with the tightening of the abdominal wall. It is basically like “having an internal corset,” explains Dr. Namnoum. To do this, the surgeon must lift, trim and stitch from the deepest layers of the abdominal wall to the surface skin. Recovering from this has historically been no trip through the tulips – whenever muscles are affected during surgery, there will be a considerable recovery period.

The second, and perhaps even bigger deterrent, has been the fact that a tummy tuck patient has been required to wear one or two drains for a week or more after surgery. A drain is a plastic pouch attached to a little tube that is placed between the wall of tissue and fat of the abdominal area and the abdominal muscles. The fluid that collects between this space needs to be drained away for complication-free recovery to take place.

Why Patients Hate Drains

Drains follow the body’s way of healing; the fluid needs an exit strategy. That said, “Who on earth wants a tube coming out of their body? No one,” shares Namnoum.

Patients hate drains because they are:

  • frightening looking
  • sometimes painful
  • cumbersome
  • limit your clothing choices
  • embarrassing

Evolution of the Tummy Tuck: Painless & Drainless

Plastic surgeons are constantly innovating, looking for new and better ways of doing a procedure. It make sense that the evolution of the tummy tuck would be towards making the procedure painless and drainless. The first part of the equation is tackled by a product called Exparel. It is a long-acting numbing medicine that is injected deep into the soft tissues during surgery. It is beneficial in a couple of ways:

  • Exparel delivers targeted local anesthesia during surgery
  • It releases bupivacaine over time for prolonged analgesia

Due to the mixture of substances and the injection site during surgery, Exparel is able to last up to 72 hours post-op. Due to this, there is less of a need for narcotics in the short term following surgery. Staying alert and non-drowsy helps patients to become a little more active a little sooner, which is everything during surgical recovery.

In order to eliminate the need for drains, plastic surgeons now use a product called TissuGlu, and it’s exactly how it sounds. TissuGlu literally glues the separated tissues of the abdomen to the muscles so that there is no cavity in which fluid can accumulate. Without fluid, there is no need for the use of drains. TissuGlu may or may not be combined with progressive tension sutures, which is a style of sutures not unlike quilting that stitches the abdominal wall back down to the muscles.

No Drain = Book Surgery

A drainless and painless tummy tuck offers game-changing improvements to a procedure would-be patients were historically hesitant about. Recovery is less intense and shorter, helping patients to mentally and physically get back on their feet more readily. This equates almost universally to better results.

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