Drainless Day-procedure Abdominoplasty: Reduced Pain and Fewer Complications in 210 Consecutive Cases.

[BACKGROUND] Traditional abdominoplasty commonly involves drains, inpatient admission, and significant postoperative discomfort, which increases aftercare demands and delays return to normal activity. Despite technical refinements, many surgeons continue to rely on these long-standing practices. Modern techniques incorporating tissue fixation sutures (TFSs) and regional anesthesia now allow abdominoplasty to be performed as a drainless day procedure with reduced pain and fewer complications.

[METHODS] A retrospective review was conducted of 210 consecutive lipoabdominoplasties performed by a single surgeon between 2017 and 2024. All cases used a defined TFS configuration consisting of 1 vertical row above and 3 horizontal rows below the umbilicus to obliterate dead space and minimize shear forces. Bilateral transversus abdominis plane blocks were routinely administered before closure. All procedures were performed under general anesthesia in a private hospital, with discharge occurring 2-4 hours postoperatively.

[RESULTS] Ninety-nine procedures (47.1%) were standalone lipoabdominoplasties, and 111 (52.9%) were combined with other procedures, most commonly breast surgery. The overall complication rate was low: 1 seroma (0.5%) and 1 deep venous thrombosis (0.5%). Postoperative pain was effectively managed with oral analgesia, and most patients resumed light activity within 1 week.

[CONCLUSIONS] Abdominoplasty can be safely performed as a day procedure without drains using a reproducible TFS configuration and routine transversus abdominis plan blocks. This approach adds minimal operative time, reduces pain, lowers complication rates, and challenges entrenched norms regarding drainage and hospitalization in abdominoplasty.