At How Many Cc's Will Drain Be Removed After Tummy Tuck?

Many surgeons will use drains after tummy tuck. I think it helps to remove unwanted fluid from collecting beneath the skin. Surgeons have different criteria as to when they should be removed. In general most would remove them once the drainage gets below 30-50 cc per day. It also depends on the extent of surgery and whether or not quilting sutures are used, which can reduce the time need for drains.

It's been my policy for over 20 years to remove my abdominoplasty drains after 72 hours.  I have never had a hematoma and I can count the number of seromas that I have had on one hand.  I believe the drains should stay in for 3 days to allow for oozing and pickup of any serum that leaks into the wound area as well.  I think the key to not getting a problem which requires long term drainage is to be very cautious not to injure the lacy network of lymphatics (the stuff that takes up fluid) off the abdominal muscle covering (sheath). 

I have all my patients wear pressure garments and a large piece of Reston foam directly on the abdomen.  This foam equally distributes the pressure and decreases the chance of any fluid buildup.  Possibly, my lack of fluid and blood post abdominoplasty, and therefore the ability to remove the drains at 72 hours, may come from my tight approximation of abdominal muscles and my tight 30 degree abdominoplasty.  I also use 3x 10mm drains, one right, one left and one vertical. 

As to where the fluid goes, some of it leaks into the raw tissue that has been created when one does the abdominoplasty, and most of it is picked up by the lymphatics on the abdominal muscles which have not been injured.

Thank you for your question.  Drains are typically removed when there is less than 30cc in the drain for 24 hours.  In most cases, the first drain comes out by day 7 and the second drain by day 14.  Note that the drainage may increase after the first couple of days and the patient moves about more.  Each Board Certified Plastic Surgeon is different.  Best to share the goals with them, and together you will make a plan. 

Both drains are usually removed within 2 weeks. Occasionally, they need to be left in longer. It really depends on the patient and the surgeon. Your body will naturally process the fluids that are not drained.

The answer is usually between 25-30 cc over a 24 hour period.  Every surgeon is different but this is the usual range.

Dr. ES

Thank you for your post. Whenever there is a potential space in your body, your body tends to fill that space with serous fluid (the yellow type of fluid that also comes out of a 'weeping wound'. This is similar to when you get a blister: the layers of skin separate and fluid is deposited in to the space. In a tummy tuck, the space is in between the skin/fat layer and the muscle layer. Most surgeons will place a drain to remove this fluid while your body is secreting it until the fat layer grows back together with the muscle layer. At that point, no more fluid is secreted into the area, because there is no more space for fluid. The length of time that this takes varies from patient to patient. Some patients heal much faster, thus the layers seal together much faster. Also, the more twisting motion you have in your belly area, the slower the two layers grow back together because they are moving in relation to each other. The fluid coming through the drain can be initially dark red, and eventually clears to pink then yellow. This is because it takes just a little bit of blood to make the fluid dark red. Also, initially, there can be a large amount of fluid (few hundred cc's in the first day is not out of the range of normal) and this should slow down substantially over next few days. Once the fluid slows down to the amount that your surgeon is comfortable with (usually 25-50 cc in 24 hours) then they will be pulled. There is minimal discomfort in pulling the drain in most patients. More recently, 'drain free' surgery has become more popular. Fat layer is sutured down to the muscle layer starting at the ribs and progressively down to the lower incision. This makes the space for the fluid to collect much smaller, and in many patients can have surgery without drains. However, I have seen multiple patients come from other surgeons because they developed a seroma despite the suturing of the tissue. This is not the surgeon's fault, but some patients just do not heal fast enough or put out too much fluid for the body to absorb. Best wishes,Pablo Prichard, MD

Each surgeon has a standard, some based on volume, some based on time, so check with your surgeon. My particular standard is 30 cc per day. After the drains are removed, the small residual amount of fluid is absorbed by the body in most cases. In an occasional patient, the residual collects as a seroma, or fluid collection, and that must be addressed by aspiration. 

Thanks for your question, best wishes.

Hello! We use suction drains and leave them in for a minimum of 48 hours following the procedure. The removal depends on the extent of the procedure & the fat aspirated. Typically we remove the drains after the output has dropped to 150 cc over 24 hours. The remaining fluid is absorbed by the body.

Wishing you a speedy recovery.

Drains are used by many plastic surgeons after tummy tuck surgery. Drain removal will vary from one practice to another; in my practice (generally) I remove a drain when the output is less than 20 mL per drain per day. Again, this will vary from one  physician to another.

When the drains are removed, usually the patients' bodies will absorb the serous fluid in the space between the abdominal wall skin and underlying muscle. Sometimes, this natural resorption and does not occur and physician aspiration of the fluid may become necessary.

I hope this helps.

Every plastic surgeon has their own guideline.   Most recommend removal of a drain once the output of each drain has dropped below 30 cc per 24 hours.   Any remaining fluid will be a small amount and will be absorbed by your body.  Compression therapy is important after drain removal.  Wishing you speedy recovery.

Dr. Basu

Houston, TX