A “tummy tuck”, or abdominoplasty, is one of the more frequent procedures done in plastic surgery for women who have lost weight or have had developed laxity of the abdominal wall from childbirth. Over the last year or so, newer techniques have developed that make this procedure better tolerated, less painful, and overall have a speedier recovery. We have been doing drain-less tummy tucks for the last nine months and have found that, whether we place sutures or glue between the skin that’s been lifted and the underlying repaired muscles, we do not need to place a drain tube into the patient. This has allowed for earlier mobility as well as less worry of having to deal with the drain. There’s also no extra hole made for the drain to pass out of the body. Pain reduction with tummy tuck is paramount to a quick recovery. Recently, we have been doing a nerve block, called TAP block, which places the long-lasting numbing medicine called Exparel™ directly into the nerves that supply feeling to the front part of the abdomen under ultrasound guidance. This has had a profound reduction in the pain experienced by our patients during the first few days after surgery. I like to think of this new method as the drain-less, painless tummy tuck. We have also been using ultrasound in our office for over five years now and feel quite competent in being able to assess the amount of fluid that can build up when these drain-less procedures are done. Should there be the necessity of removing this fluid, rather than sending our patients to a radiologist at a hospital, we can simply place a small cannula under the guidance of ultrasound directly into the area of fluid collection and remove it. This has vastly improved our patient’s recovery time compared to drains or to other practices that don’t have the expertise to provide adequate detection and removal of the small fluid collections.
