At Oregon Cosmetic and Reconstructive Clinic, I often talk with patients about ways to make recovery smoother and more comfortable. One technique that continues to evolve is drainless surgery.

So what does that really mean? And how does it apply to both the chest and the abdomen? Let’s walk through it together.

What Is Drainless Surgery?

Traditionally, surgeons placed small plastic drains under the skin after surgery. These drains removed fluid that can collect in the space between tissue layers.

However, in drainless surgery, I use quilting sutures instead.

These stitches carefully attach the lifted skin and fat layer back down to the underlying muscle layer. As I close the layers, I gradually eliminate the empty space where fluid would normally collect.

As a result, the tissue layers stick together more evenly. This helps:

• Reduce fluid buildup

• Improve contour

• Stabilize the skin flap

• Support smoother healing

In other words, instead of draining fluid after it forms, I work to prevent the space where fluid would collect in the first place.

How Quilting Sutures Work

During surgery, I first elevate the skin and fat layer from the underlying tissue. This step is necessary in procedures like:

• Chest surgery (such as gender-affirming top surgery)

• Abdominal contouring, including a tummy tuck

Once that layer is lifted, a potential space exists underneath it. That space can fill with fluid if left unaddressed.

So instead, I place a series of internal sutures. These sutures:

• Secure the skin-fat layer down to muscle fascia

• Close off dead space

• Evenly distribute tension

• Improve positioning and contour

As the layers come together, they adhere naturally. Over time, the tissues bond more securely.

Similar Concept: Chest and Abdomen

Although the anatomy differs, the concept is the same in both areas.

Chest Surgery

In chest procedures, such as those described on our
👉 https://www.theocrc.com/gender-affirming-top-surgery/

I elevate the chest skin and tissue to reshape and contour the chest. Then I place quilting sutures to close the space underneath.

This typically adds about 15 minutes to surgery. However, many patients appreciate avoiding drains.

 

Abdominoplasty (Tummy Tuck)

In an abdominoplasty—learn more here:

👉 https://www.theocrc.com/abdominoplasty-tummy-tuck/

the surface area is much larger.

Because I elevate a broader skin flap across the abdomen, I place many more quilting sutures. In addition, I carefully adjust where the skin flap is secured so that:

• The belly button sits naturally

• The lower abdominal contour looks smooth

• Tension is distributed evenly

This step adds about 25 minutes to surgery. However, it helps stabilize the entire abdominal flap.

 

Benefits of Drainless Surgery

Patients often ask why we would choose this approach. Here are some common advantages:

• ✅ Less discomfort (no drain tubes exiting the skin)

• ✅ Less skin irritation at drain sites

• ✅ Easier showering and movement

• ✅ No need to measure drain output at home

For many people, avoiding drains reduces anxiety and improves early recovery comfort.

Are There Downsides?

There is one main tradeoff:

• ⏱ Slightly longer surgery time

  • ~15 minutes for chest

  • ~25 minutes for abdomen

However, in my experience, this added time is often worthwhile when balanced against patient comfort and contour control.

That said, every patient is unique. In some cases, I may still recommend drains depending on anatomy, surgical history, or risk factors.

Why Precision Matters

Another important benefit is improved contour accuracy.

Because quilting sutures anchor the skin-fat layer down in controlled positions, I can more precisely shape the chest or abdomen. This helps:

• Maintain smooth transitions

• Reduce shifting

• Support long-term contour stability

In the abdomen especially, careful positioning makes a meaningful difference in the final result.

My Approach at Oregon Cosmetic and Reconstructive Clinic

At Oregon Cosmetic and Reconstructive Clinic, I always focus on thoughtful planning and careful execution. Drainless surgery is one tool that helps us:

• Improve patient comfort

• Enhance contour precision

• Support safe healing

If you’re considering chest surgery or abdominal contouring in the Portland Metro area, I encourage you to schedule a consultation so we can review your anatomy, goals, and options together.

Frequently Asked Questions

Does drainless surgery completely eliminate the risk of fluid?

No technique eliminates risk completely. However, quilting sutures significantly reduce the space where fluid can collect.

Will recovery be faster without drains?

Recovery timelines are similar overall. However, many patients feel more comfortable early on without drain tubes.

Is this technique safe?

Yes. Progressive tension or quilting sutures have been studied and widely used in both chest and abdominal surgery.