Recover Swiftly with a Drainless, Low-Pain Tummy Tuck

The tummy tuck procedure has undergone a major upgrade in the last five years, surmounting two of the most uncomfortable aspects of recovery: pain and drains. Moms have more reasons than ever before to say goodbye to stretched out post-baby bellies with these advances. “We’ve introduced two things to tummy tucks that are new, making it much better for the patient,” shares board certified plastic surgeon Dr. Stephan J. Finical of Charlotte Plastic Surgery.

A painful, slow recovery is a deterrent to anyone considering surgery – especially true of busy moms. The use of a time-release anesthetic during surgery, called Exparel, eases post-operative pain and reduces the need for prescription pain medications. In addition to less pain, patients are also getting back to everyday activities faster thanks to a suturing technique that has eliminated the use of restrictive drains after surgery.

Recent Tummy Tuck Advances:

1. Exparel – a time release anesthetic used during surgery that lasts into recovery
2. New suturing techniques to eliminate the need for drains

How Painful is Tummy Tuck Surgery?

When it comes to tummy tucks, one question Dr. Finical always hears is, “Just how painful will the recovery be?” In the past, tummy tucks had a reputation of being one of the more difficult surgeries to recover from, due to the pain involved. The more pain that exists, the more challenging it is for recovering patients to move around and be active – both key components to a swift recovery. The introduction of the numbing medication Exparel during surgery has allowed patients to have their pain blocked for days after surgery, getting them through the worst of it without using narcotics.

When the abdomen remains numb in the days following surgery, a patient is much more likely to get up and move around. Movement in the days following surgery is key to optimizing the recovery process. “We’ve come a long way from people being in a lounge chair position or in a bed for several days,” explains Dr. Finical. “Walking is going to be your friend. It’s good for your lungs, good for your circulation. When people are more comfortable and are moving around after surgery, it helps. We don’t have to worry about blood clots. They breathe better. It’s really good.”

Time Release Numbing is Possible with Exparel

The excitement surrounding Exparel is it’s ability to block the pain for up to 3 days post op. By injecting Exparel in the location where all of the nerves of the abdomen come together, surgeons are able to provide maximum pain relief in the days immediately following surgery, while minimizing the need for prescription pain medications. While narcotics have their place in medicine, it is known they make many patients nauseous, as well as their ability to keep patients less active than they otherwise might be.

“We use ultrasound guidance to precisely put that medicine where it needs to be,” says Finical. “If we do that, we can really make the lower abdomen numb for about three days. That gets patients through all of the recovery, which is really the uncomfortable part.” 

The Most Common Complication After a Tummy Tuck is a Seroma

During a tummy tuck, the layers of the abdomen are separated. The outer layer is pulled back in order to reveal the deeper layers where work will be done on the muscles to restore a firm foundation. The separation between layers of the abdomen provides a potential empty space for fluid to collect once the surgery is complete. When fluid collections occur during recovery, it is called a seroma. “The most common complication of an abdominoplasty is a seroma,” says Finical. 

In the past, surgeons would insert plastic tubing at the time of surgery in order to allow the fluid to drain out of the body and into small plastic bulbs. These drains, while preventing a seroma, were often a nuisance for patients in the weeks following tummy tuck surgery. They made everyday tasks like showering and changing clothing difficult. They also required maintenance, as the drains need to be emptied and the fluid levels need to be monitored. In addition to being a nuisance, the sites where the drains exit the abdomen could potentially leave an additional scar.

 

Problems with Drains:

• Drains need to be emptied and monitored
• Drains make it difficult to shower and change clothing
• There may be an additional scar at each drainage exit

An Alternative to Drains

Instead of closing up the abdomen with drains as a means for fluid to exit the body, Dr. Finical closes up the abdomen with a new suture technique. “We’ve adapted what’s called progressive tension sutures,” he explains.  “Basically…we quilt the abdominal wall back down to the muscles so that there’s not a space created where fluid would collect.”

The day after surgery patients are placed in a binder. The binder is a surgical garment similar to a girdle. The binder helps provide support to the abdomen as the area heals. When it’s time for a shower, the binder is easily removed and there are no drains to deal with. Without the nuisance of drains, or the complication of a seroma, patients find it easier to return to a normal, active lifestyle, which, again, is essential to a speedy, proper recovery.

Recovery – Better Than Expected

Drain and pain elimination seems to allow for both a psychological and physical benefit. Patients curious about the procedure no longer have to consider if they want to endure a rough recovery full of cumbersome drains and debilitating pain and/or pain medication. For many, they might rather live with stretched muscles and loose skin rather than deal with what a tummy tuck recovery may entail.

With a drainless, Exparel-based tummy tuck however, most of Dr. Finical’s patients report that their recovery was far smoother and less challenging than they thought possible.