The new no pain technique now in tummy tuck

The non-touch no pain technique was first introduced in breast surgery by Mr Keramidas in 2004. All these years we have presented our technique in numerous Conferences in Greece and abroad. In 2012 we presented our technique for the first time on video at the World Congress of Aesthetic Surgery that took place in Geneva under the auspices of ISAPS.

It was therefore a matter of time for this technique to be incorporated in other procedures. Here we shall look into the implementation of the non-touch no pain technique in tummy tucks.

So, what is this technique about?

Just as in breast surgery, we apply the same principles in a tummy tuck:

Watch the tummy tuck videos

Before and during surgery we use the following on every patient:

Anti-thrombosis socks
Flowtron system for mechanical calf compression
Electric blanket for maintaining right body temperature during surgery

Surgical Technique:

1. Special tool for surgical handling

This allows for:

A) Minimum tissue injury
B) Zero bleeding
C) No need for blood transfusion
D) No use of drains (tubes, etc.)
E) Immediate mobilization of the patient.

2. Preservation of lymphatic vessels left and right of the abdominal wall for hygroma restriction.

3. Preservation of the nerves and vessels on the lateral parts of the abdominal wall to limit pain and achieve better perfusion of the flap (skin).

4. Internal suture to correct laxity -diastasis recti.

5. Internal suture to attach the skin to the abdominal wall reducing the empty space and eliminating the development of hygroma (fluid gathering in the abdomen)

What do all of the above mean in practice?

Firstly: The patient can go home the same day!
Secondly: There are no drains. We use no drainage tubes.
Thirdly: The pain is minimal, and the patient can be mobilized within 6 hours after surgery. This is what we aim for.
Fourthly: Complications are reduced to minimum (e.g. deep thrombosis and pulmonary embolism, hygromas, skin necrosis).
Fifthly: Tummy tuck can be combined with many surgeries such as breast augmentation, liposuction, facelift, breast lift, etc. All procedures are safely performed. The combination of these surgical procedures on patients who are also mothers is called mommy makeover.

What remains the same?

The use of compression garment for 2-4 weeks
The patient must be very careful in the first 2 weeks
The patient can return to the gym after 4 weeks

So, we are talking about a spectacular, immediate recovery?

Yes. As the patient is in very little pain and has no drains, he/she starts moving around quickly. The patient can safely go home the same day! He/she can take a bath on the same day and go out for a coffee somewhere close to his/her home. All these features were unthinkable a few years ago. And let’s not forget that because of the immediate mobilization problems such as deep vein thrombosis and pulmonary embolism are also reduced to a minimum.

When can the patient return to work?

Depending on the type of job, he/she can return to work in 5-15 days. Nevertheless, as mentioned above, the patient can resume all daily activities almost immediately.

Patient examples

Patient-mother of 2, extremely flaccid– diastasis rectis but minimum skin laxity and no fat.

View the embedded image gallery online at:
https://www.keramidasevangelos.com/news/the-new-no-pain-technique-now-in-tummy-tuck#sigProId04d18c3e63

Patient-mother of 2, with great skin laxity and large amount of fat around the entire abdomen

View the embedded image gallery online at:
https://www.keramidasevangelos.com/news/the-new-no-pain-technique-now-in-tummy-tuck#sigProId7de4125c0b

Take a look at more pictures of Tummy Tuck cases

Are there are studies to support what you say?

Apart from our own experience and research on the matter, there are several studies conducted. Here are a few of them:

Abdominoplasty combined with additional surgery: a safety issue.
Aesthet Surg J. 2006 Jul-Aug; 26(4):413-6
Simon S, Thaller SR, Nathan N.

Does lipoplasty really add morbidity to abdominoplasty?
Aesthet Surg J. 2005 Jul-Aug; 25(4):353-8
Stevens WG, Cohen R, Vath SD, Stoker DA, Hirsch EM.

Ten years of outpatient abdominoplasties: safe and effective.
Aesthet Surg J. 2007 May-Jun; (3):269-75
Stevens WG, Spring MA, Stoker DA, Hirsch EM.

Venous thromboembolism in abdominoplasty: a comprehensive approach to lower procedural risk.
Aesthet Surg J. 2012 Mar; 32(3): 322-9
Somogyi RB, Ahmad J, Shih JG, Lista F.
Safe and consistent outcomes of successfully combining breast surgery and abdominoplasty: an update.
Aesthet Surg J. 2009 Mar-Apr; 29(2): 129-34
Stevens WG, Repta R, Pacella SJ, Tenenbaum MJ, Cohen R, Vath SD, Stoker DA.

American Society of Plastic Surgeons
444 East Algonquin Road
Arlington heights, IL 60005-4664
847-228-9900
www.plasticsurgery.org
Evidence-based Practices for Thromboembolism Prevention:
A Report from the ASPS Venous Thromboembolism Task Force
Approved by ASPS Executive Committee: July 2011
Robert X. Murphy Jr., MD, Task Force Chair
DeLaine Schmitz, Sr. Director of Quality Initiatives
Karie Rosolowski, Sr. Quality Associate