Not all plastic surgeons use drains

Steven H. Schuster, MD answers: Drainage and swelling after Smart Lipo and Tummy Tuck

I had a Tummy Tuck a week ago. The doctor did Smart Lipo and then the Tummy Tuck. I ended up with a huge incision from waist to waist, and I am actually larger in my midsection than I was pre-surgery from all the swelling. I don't see any way for the liquid to come out, I don't have any drainage. My doctor wants me to do 3 sessions of ultrasonic therapy to help my healing and drainage. I am already unhappy with the results. Is this normal? Is this worth the extra pay for the treatments? Please advise.


Steven H. Schuster, MD
3 months ago

Dear Sunnysideup (sounds to me like someone very optimistic)

Not all plastic surgeons use drains. There is a technique that some of us use all or part of the time using quilting stitches to hold the fascia down to the muscle.  In some patients drains are not used, but I personally use drains for at least 6 days on all tummy tucks.

I am a little concerned about using smart lipo or any lipo of the abdomen in conjunction with a tummy tuck. There are many doctors that perform this but I prefer to separate it into 2 procedures as I can be much more aggressive with the suctioning when I do.

You must also consider the psychological roller coaster you are on during the healing period and take this into account.  Excitement of the surgery followed by the letdown that you are swollen, sore and not ready to be in a bikini.

Swelling can easily take 3 to six months to fully resolve. Speak to your plastic surgeon and express you concerns. You may need to have a seroma drained or a drain inserted, but continue your follow up with your doctor. I am sure you will be happy with your result in the end.

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A: Swelling and drainage is normal

David Rankin, MD
7 months ago

To assist with pain control and to prevent bleeding, fluid is first injected into the tissues prior to beginning liposuction. This fluid often drains out over the first 72 hours post operatively. I am a bit surprised that after a tummy tuck in combination with smart lipo that you do not have drainage tubes. Have they already been removed? If no tubes were used, then I would be concerned that you are developing some fluid underneath your surgical site. If this is the case, you may need to have this fluid removed which can be done in the office. Multiple removals will most likely be needed unless a drainage tube is placed. This is a problem that can be treated and still leave you with a very nice result. A tummy tuck takes months to fully recover from. 

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