A better Abdominoplasty
One interesting thing about cosmetic plastic surgeons is that they rarely change their behavior or, by extension, their cosmetic surgical techniques. After the years of training it takes to become a board-certified plastic surgeon, the cosmetic surgeon graduates with a knowledge of certain surgical procedures, such as abdominoplasty, learned from their “professors” and usually continues to perform the same cosmetic surgery for the rest of his or her career. It usually takes a surgical generation, 15-20 years, before a new surgery is overwhelmingly accepted as being the standard. A plastic surgery professor once said,”The day a plastic surgeon is hesitant to change, its time to retire.” So, one must change.
At the May 2010 meeting of the American Society of Aesthetic Surgery in Washington, DC, I took a continuing education course on abdominoplasty. This year, it was only when the plastic surgeon started to talk that I realized that I had heard the lecture before and had taken the same course on tummy tucks five years ago! At that time, I heard the surgeon, tried out the abdominoplasty surgery a couple of times and then went back to doing what I had always done! I’m not sure why. This time, I decided to approach the new abdominoplasty technique with a more defined and systematic approach.
During an abdominoplasty, or tummy tuck as it is also known, the plastic surgeon will typically remove skin from the lower part of the abdomen and tighten the rectus muscles in the mid-line. Some surgeons—myself included—perform a liposuction of the belly and love handle areas to remove the fat from the abdomen (as you might imagine, not all tummy tucks are created equal, and different cosmetic surgeons call different operations by the same name).
The skin of the abdomen is elevated off the muscle, pulled down toward the pubic area and sutured in place. One or two drains are placed under the skin to suck out the fluid (seroma) that comes with any surgery, abdominoplasty in particular. These drains are typically a source of discomfort for the patient, a burden in terms of care and a potential source of infection. But the professor told us to put a drain in all abdominoplasties, so we did—until now.
The two cosmetic plastic surgeons from Texas presented the results of over 200 abdominoplasties without the use of drains, and there were no significant amounts of seroma (fluid build-up) accumulations. Their patients could move around earlier, had less pain and were happier. So, for the past few months I have changed my tummy tucks!
No more drains for abdominoplasty. My cosmetic surgery patients have been thrilled—no seromas, less pain and happier patients.
2020- years have passed and this technique is still the best!