"Safety and Outcomes of Drainless Lower Body Lift Surgery: A Retrospective Comparative Study On 1002 patients".

BACKGROUND: Lower body lift (LBL) after massive weight loss (MWL) is frequently complicated by seroma and wound dehiscence. The necessity of drains in LBL remains controversial, with limited robust evidence. This study retrospectively assessed whether omitting drains after MWL influences complication rates and outcomes in 1,002 patients. METHODS: Records of patients who underwent LBL from January 2011 to May 2024 were reviewed. Two groups were compared: with suction drainage and without drainage. Complications were evaluated individually and classified using Clavien-Dindo. Statistical analyses (univariate/multivariate) assessed links between drain use and complications, controlling for relevant covariates. RESULTS: Among 1,002 patients, 598 had no drains and 404 received suction drainage. The drain group experienced longer hospitalization (4.29 ± 1.55 vs. 2.41 ± 0.94 days, p<0.001) and operative time (179 vs. 152 minutes, p<0.001). Overall complication rates did not differ significantly. However, wound complications were more frequent with drains (24% vs. 17%, p<0.01). In multivariate analysis, drain use was not an independent risk factor for complications; only active smoking predicted higher risk. CONCLUSIONS: Omitting drains in LBL after MWL was associated with similar overall complication rates but reduced wound complications and shorter hospital stays. These findings support the safety of drainless protocols in LBL surgery, suggesting they may improve outcomes and help reduce the postoperative treatment burden for patients.