New surgical techniques can make abdominal pressures less painful and drain-free Health

“Dr. Polo, I want to have a tummy tuck, but I’m afraid of the pain and the drain tubes. Is there any way to avoid them?’

Abdominoplasty, or abdominoplasty, is one of the 5 most common cosmetic procedures. However, many good candidates for abdominoplasty surgery are reluctant to undergo the procedure due to the common perception that this procedure is inevitably associated with excruciating pain and that the use of uncomfortable drainage tubes is mandatory. In today’s world, abdominal surgery can be performed with manageable pain and without drainage tubes.

There are four main components to what I refer to as a full tummy tuck. These include liposuction to help contour the sides of the abdomen and waist. separating the abdominal skin and fat layers from the underlying muscle, then stretching and removing the excess skin. suture repair of midline abdominal muscle separation. and displacement of the navel. Most of the postoperative pain is related to muscle recovery.

With pregnancy or obesity, the increased content of the abdomen leads to permanent stretching of the fascia in the midline between the two rectus muscles. This dimension results in a bulging abdomen and loss of waist curvature. During a tummy tuck procedure, the separated ends of the muscles are sewn together, usually in multiple layers, to flatten the contour of the abdomen and enhance the hourglass waist.

Traditionally, after a tummy tuck, doctors used oral pain medications to treat pain. Recent medical advances now allow long-lasting local anesthetics to be administered directly to the site of muscle repair. The two options for administering the local anesthetic are by direct injection into the muscle with lysosomal bupivacaine, a high-tech formulation of the drug, which is released slowly over 3-4 days. The second method, which is my preference, is to insert small catheters during surgery, through the skin and then under layers of sutures that cut through the muscle. The catheters are connected to a pump filled with the long-lasting local anesthetic, which is continuously administered automatically for 4-5 days. This form of pain management allows for reduced use of opioid medications, less nausea, earlier mobilization and ambulation, and a reduced risk of blood clots.

During a tummy tuck, once the muscle repair is complete and excess skin is removed, the remaining skin is stretched to the point of the low incision and sutured closed. Traditionally, to prevent fluid accumulation, drainage tubes are placed in the space between the skin and the fat and muscle. An advanced surgical technique known as “progressive tension sutures” was described several years ago and has been adopted by many plastic surgeons, myself included. With this technique, the flap of skin is attached back to the muscle with sutures placed in multiple vital locations. In my experience, this technique eliminates awkward drain pipes and closes off the space even more effectively. This reduces fluid accumulation or seroma formation, which was one of the most common complications after abdominoplasty.

If you are considering tummy tuck surgery but have been hesitant due to fear of post-operative pain and drainage, consult with an American Board of Plastic Surgery-certified surgeon to discuss your options. Rest assured that recent advances have allowed the procedure to be performed with much less discomfort and a faster recovery. The use of long-lasting local anesthetics and progressive tension sutures has made abdominoplasty a more comfortable experience and made the procedure safer by reducing complications.

Dr. Polo is a graduate of University of Miami, Miller School of Medicine. He is a certified Plastic Surgeon and a partner in Miami Plastic Surgery. He has been in practice for over 20 years during which he has remained an active member of his medical staff Baptist Hospital and South Miami Hospital. Dr. Polo is dedicated to patient safety and Plastic Surgery education and has been recognized by his peers by being elected to leadership positions such as past president of the Miami Society of Plastic Surgeons and president-elect of the Florida Society of Plastic Surgeons . Dr. Polo is a specialist in Cosmetic Surgery of the face, neck, breast and body. His greatest expertise is in breast augmentation and moms. His practice also includes the full range of non-invasive treatments such as Botox, fillers, CoolSculpting, ultrasound, lasers and radio frequencies.