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Sieber Plastic Surgery San Francisco

f you’re considering a tummy tuck procedure, you may have heard about a new technique called “drainless tummy tuck.” This innovative approach to tummy tuck surgery is gaining popularity among plastic surgeons and patients alike. Drainless tummy tuck, also known as progressive tension suture (PTS) technique, eliminates the need for surgical drains during the recovery and process, making it a more comfortable and convenient option for patients.

In this article, we’ll explore the drainless tummy tuck technique, including its benefits, how it works, scarring and whether it might be right for you for your body contouring procedures.


Drainless tummy tuckFor many procedures, surgeons commonly put temporary drains in to collect fluid which may accumulate under the skin after the surgery. The reason they do this is because the body does not like to have spaces filled with air, so instead it produces fluid to fill that area. Anything that is removed from the body, whether it’s a lung or some excess abdominal fat, is immediately replaced by fluid to fill in the empty space.

Most of the time the fluid just occupies the space until the body is able to remove it and replace the fluid with scar tissue during the healing.

Sometimes there is too much fluid for the body to remove quickly and it gets trapped in the tissue resulting in something called a seroma. A seroma is simply a collection of fluid the body placed in muscle tissue, there to fill a space during the healing.

To avoid this from happening, surgeons started using drains to collect excess fluid so that it didn’t get trapped underneath the skin. Having drains under abdominal skin works great for removing unwanted fluid, but they are a bit of a nuisance for the patient!

“Some of my patients feel as though they still look pregnant years after having children due to diastasis recti,” says Dr. Sieber.  A tummy tuck can flatten and transform the abdomen as it eliminates loose skin and repairs weak abdominal muscles, often secondarily helping with issues like back pain and urinary incontinence.

In order to reduce the amount of space left after a tummy tuck, something called a progressive tension suture (or quilting sutures) was invented. This suture acts like an internal tuft and results in less space into which fluid can collect. In most patients, when these progressive tension sutures are used during a tummy tuck, drains are no longer needed. Studies have shown that by adding these sutures, the incidence of seromas is drastically reduced whether or not drains are used.

Putting in the progressive tension sutures does add a little bit of time to the surgery, but in my opinion the benefits are worth it. The progressive tension sutures can also be placed on separated abdominal muscles in a very precise fashion to re-create the peaks and valleys of an aesthetically pleasing mid-section!

So if progressive tension sutures are so good, why are so many surgeons still using drains? This is in part is because surgeons tend to operate in ways that they feel are most reliable and predictable, and are slow and cautious to implement new techniques.

I believe that it is important to be at the forefront of medicine and to adopt proven techniques popular plastic surgery procedures which have been developed to improve the recovery process and optimize the surgical outcome.

Another option for women post-pregnancy is a mommy makeover which can include a variety of procedures, such as liposuction, tummy tuck, breast augmentation and/or breast lift.


Are drainless tummy tucks better?

Drainless tummy tuck photosWhether a drainless tummy- tuck recovery procedure is better for you than a tummy tuck depends on your individual needs and goals. Drainless tummy tuck, also known as the progressive tension suture (PTS) technique, is a newer approach to tummy tuck surgery that eliminates the need for surgical drains during the recovery process.

Instead, the surgeon uses a series of internal sutures to secure the skin and tissue in place, reducing fluid buildup and promoting faster healing.

The benefits of drainless tummy tuck include a more comfortable and convenient, smoother recovery process, as there are no surgical drains to manage, and a lower risk of complications such as infection and seroma (fluid accumulation).

Additionally, the internal sutures used in the PTS technique may promote better healing and more natural-looking results.

However, it’s important to note that not all patients are good candidates for a drainless tummy tuck. Patients with a history of seromas or other complications may still require surgical drains, and those with significant amounts of excess skin or muscle laxity may need a traditional tummy tuck to achieve their desired results.

Ultimately, the decision to pursue a drainless tummy tuck or a traditional tummy tuck procedure should be made in consultation with a board-certified plastic surgeon. They can evaluate your unique situation, discuss your options, and recommend the best approach to help you achieve your desired outcome.

What happens if you don’t drain after tummy tuck?

After a tummy tuck surgery, the body naturally produces fluid in the surgical area as a part of the healing process. In traditional tummy tuck surgery, a surgeon typically places surgical drains to help remove excess fluid from the area to prevent fluid buildup, which can lead to complications such as seroma (fluid accumulation).

If a patient does not properly drain after a tummy tuck, this fluid may accumulate under the excess skin and fat there, causing swelling, discomfort, and increased risk of infection.

In the case of a drainless tummy tuck, also known as progressive tension suture (PTS) technique, internal sutures are used to hold the skin and tissue in place, reducing the amount of fluid buildup in abdominal area and eliminating the need for surgical drains.

However, even with the PTS technique, some degree of fluid buildup can occur, and it’s important to follow your surgeon’s post-operative care instructions carefully to ensure proper healing.

If fluid buildup occurs after a tummy tuck, your surgeon may need to perform a drainage procedure to remove the excess fluid. In some cases, this may require additional surgery, which can prolong the recovery time and increase the risk of complications.

To minimize the risk of complications and ensure a smooth recovery after a tummy tuck, it’s important to carefully follow all of your surgeon’s instructions, including caring for any surgical drains or incisions, managing pain and discomfort, and attending follow-up appointments to monitor your progress.

Is there more swelling with a Drainless tummy tuck?

Drainless tummy tuck doctorsSwelling is a natural part of the healing process after any surgical procedure, including tummy tuck surgery. However, it is possible that patients may experience more swelling with a drainless tummy tuck compared to a traditional tummy tuck or breast surgery that uses surgical drains.

This is because the use of surgical drains in traditional tummy tuck surgery can help remove excess fluid from the surgical area, which can reduce swelling.

In a drainless tummy tuck, also known as the progressive tension suture (PTS) technique, the surgeon uses a series of internal sutures to hold the skin and tissue in place, eliminating the need for surgical drains. While the internal sutures can help reduce the amount of fluid buildup and the risk of complications such as seroma, some degree of swelling is still possible.

However, it’s important to note that the extent of swelling can vary depending on the individual patient and the extent of the surgery. Factors such as the patient’s age, weight, and overall health, as well as the surgical technique used, can all affect the amount of swelling experienced during the recovery process.

To minimize swelling after a tummy tuck, it’s important to follow your surgeon’s post-operative care instructions carefully, including wearing compression garment, staying hydrated, and avoiding strenuous activity during the initial healing period.

Your surgeon may also recommend techniques such as lymphatic massage or ultrasound therapy to help reduce swelling and promote faster healing of your abdominoplasty surgery.


If you’re thinking about getting a tummy tuck or a mommy makeover, ask if you’d be a good candidate for a drain-less tummy tuck. For more information on a drainless tummy tuck or to schedule a consultation give us a call at 415-915-9000.

Dr. Dave Sieber and his staff are so awesome! Dr. Sieber is personable yet professional, his work is impeccable. He listens to his patient and works with them to achieve what they want. He’s like my hair dresser, a magician, you just want to do a happy dance with the results, only these results are lasting. Ok, but seriously, the procedure was very smooth, the staff and the doctors (Dr Sieber and the anesthesiologist) had great communication and made sure I was comfortable with very clear and concise pre op and post op directions. The healing process was very easy and the results are FABULOUS. Side note, Dr. Sieber has really awesome skin, I feel like this is impressive and important because really, would you trust a dentist with bad teeth? I am so elated and satisfied with the results, the size is perfect and they look and feel very natural. They are exactly what I wanted.*

SF Scientist

Dr. Sieber is a doctor who is not only extremely knowledgeable about the latest in cosmetic procedures, but a doctor who truly cares about his patients. I highly recommend him!*


Dr. Sieber is a doctor who is not only extremely knowledgeable about the latest in cosmetic procedures, but a doctor who truly cares about his patients. I highly recommend him!*


Dr. Sieber is attentive, responsive, and well trained. I had seen him for Botox and filler and he had done both without any pain or bruising and more importantly the results were fabulous. He has met with me on time at each appointment. He communicates what to expect, made sure I was comfortable throughout the procedure, checked on my healing every day post procedure. He couldn’t be more delightful not more talented. I had seen other plastic surgeons for in office treatments over the past decade and Dr. Sieber is at the top of the list in terms of delivering the desired outcome and high quality care.*

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