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If you are considering a tummy tuck (abdominoplasty) or mommy makeover, there are advanced techniques in abdominoplasty that you should be aware of. An abdominoplasty is the best technique for improving the appearance of a protruding abdomen and reducing saggy or redundant skin around the middle. It is particularly popular following pregnancy where the muscle has been stretched and among those who have lost a significant amount of weight. Typically when an abdominoplasty is performed, there is a need for patients to have suction drains left in the incision site for several days in order to prevent seroma (the accumulation of fluid). These plastic drains require being sutured to the skin and may be a cause of some discomfort and limit activity following surgery until they can be removed. They have long been one of the most uncomfortable features post-tummy tuck for my patients. I have recently been utilizing two newer techniques in abdominoplasty with great success where there is no use of drains following surgery, and I have seen no increase in seromas for these patients. Recovery is quicker and comfort is increased. One technique utilizes progressive tension sutures during the tummy tuck procedure. With the use of the progressive tension sutures, I am able to secure the abdominal flap to the underlying fascia, thereby, distributing tension over a larger area. This technique eliminates the space where the seroma formation would typically occur, thereby, eliminating the need for post-operative plastic drains. Patients remain more comfortable and mobile following their surgery and have fewer post-operative concerns. The second technique we’ve been using with great success is the Avelar tummy tuck, which also eliminates the need for drains following surgery. This technique combines the use of liposuction with a tummy tuck. When this technique was first developed there were more complications when tummy tuck and liposuction were combined. Dr. Avelar pioneered a technique that kept the fat and skin from being separated from the fascia and the blood vessels remained intact throughout the procedure. With this technique, the risk of seroma (the accumulation of fluids) is minimized, eliminating the need for drains post-operatively. The blood flow to the tissues remains intact and risk is minimized. With the improved blood flow, liposuction can be safely added to the abdominoplasty procedure. By eliminating the need for outside plastic surgical drains and improving the blood flow, recovery is quicker, providing more comfort and fewer complications for patients.
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