Drains After a TT?

I am noticing that each PS is different with drains after a TT & Lipo of flanks. I've noticed as many as 3 drains to ZERO drains. I'm more surprised with the ones that do not have drains, isn't that bad?

Doctor Answers (19)

Drain Use After Abdominoplasty

+4

Thank you for the question. As in most instances in plastic surgery there are many varying opinions. We all do what will provide the patient the best results consistently in our hands.

The use of quilting sutures to tack down the soft tissues and eliminate dead space is a good technique, but not necessarily right for everyone.For the surgeon and patient it should not be about how many drains are used but rather what type of result can be realized that should matter most.

I hope this helps.


Tampa Plastic Surgeon
5.0 out of 5 stars 7 reviews

Drains After a TT?

+4

In every aspect of plastic surgery you will find differences of opinion and each surgeon modifies techniques to get the best results for the patient. It doesn't matter how many drains are used, the goal is a patient happy with her results. That said, the most common drain useage is one drain on an average sized patient, although there are some very good surgeons who now are using no drains because they use a technique called progressive advancement sutures which has decreased the risk of fluid accumulation between the tissues.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 13 reviews

Drains after a tummy tuck

+4

Drain questions are one of the chief concerns I address in most of my consultations. After surgery, the body responds by increasing the amount of fluid to the area that was operated on.  Sometimes a fluid collection can cause a seroma or even become infected.  That is why many surgeons choose to place a drain in the area to remove this fluid.  Whether or not you will need a drain, where they are placed and the number used will depend on your surgeon, the type of surgery you have and on you.  I would not necessarily be concerned about a surgeon who does not use drains, rather, I would ask him or her how they manage fluid collections.

Andrew Jimerson, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 382 reviews

Use of drains after tummy tuck

+3

Most of the time the use of drains is a surgeon's preference, usually based on training background and clinical experiences. The use of drain, number of drains used, locations where drains are placed, criteria used to remove drains are a reflection of each surgeon's philosophy regarding how to best manage the post surgical fluid build up. The end result is what counts. Discuss the use of drains with your surgeon and make sure you understand the reasons for it.

Best Wishes,

Stewart Wang, MD FACS, Wang Plastic Surgery

Stewart Wang, MD, FACS
Los Angeles Plastic Surgeon
4.5 out of 5 stars 23 reviews

Drains are helpful to allow for proper healing after an abdominoplasty

+3

A lot of patients are concerned about the use of drains with abdominoplasty surgery.  They are annoying but they do serve a useful purpose.  In a tummy tuck the skin is separated from the abdominal wall and the muscles are tightened.  The skin is then pulled down tight and redraped over the muscles.  That space between the skin and the muscles can fill up with fluid.  Think of the fluid that leaks out from a scrape on the skin, it is the same type of fluid that leaks out from the raw tissue on the inside.  The drains remove that fluid and prevent it from accumulating.  Once the drain output has decreased the drains are removed.  That usually occurs around 5-7 days after the procedure.  If the drains aren't in and the fluid builds up that creates a problem.  That is called a seroma  Like everything there is a risk/reward to the drains.  The drains are annoying, but they help prevent an even more annoying problem.  I hope this helps.

Jason E. Leedy, MD
Cleveland Plastic Surgeon
5.0 out of 5 stars 28 reviews

Drains After a TT?

+3

Each patient is different, each surgeon is different. Those who don't use drains typically use a fair number of extra internal sutures to  minimize the chances of fluid collection. There is no consensus that one way is better than another.

The number of drains will vary by the size of the patient and the nature of the surgery--not every TT is the same. 

When you ready for an in person consultation, RealSelf has listings of surgeons in your area. You should consider cross referencing the listings from the The American Society of Plastic Surgeons (plasticsurgery dot org). A listing in the ASPS website assures you that your surgeon is not only board certified,  but also is a member in good standing of the major plastic surgery organization in the U. S.

Thank you for your question, best wishes.

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.5 out of 5 stars 31 reviews

Drainless Abdominoplasty (Tummy Tuck without Drains)

+2

When abdominoplasty (Tummy Tuck) is performed in the traditional fashion, the area under the abdominal skin and fat which sit on top of the deeper rectus abdominal muscles is left "open" and only the bottom incision at the bikini-line is closed.  In order to prevent fluid collection in this open space, traditionally, drainage tubes are placed and brought out and sewn at the skin (usually 2).  This method is a few minutes faster for the surgeon, but for the patient, has the downside and discomfort of having drainage tubes for several days to a couple of weeks. Also, the drainage tubes will leave permanent scars on the skin.

 

The more advanced way of doing this surgery involves closing the "open" space under the abdominal skin with sutures (in a quilting fashion), thus restoring the normal anatomy.  By doing so, there is no place for fluid to collect and drainage tubes become unnecessary.  The surgery takes a few minutes longer, but other than being a little more work for the surgeon, there are multiple benefits for the patient.  These are:  1. no discomfort of drainage tubes,  2.  lower chance of fluid collection,  3. no drainage tube scars and 4. the ability to shower soon after surgery. This technique can be used for tummy tuck and Mommy Makeover patients, as well as massive weight-loss patients who have lost up to 350lbs of weight. 

I hope this answers your question.

RB

Ramin Behmand, MD
San Francisco Plastic Surgeon
5.0 out of 5 stars 10 reviews

Tummy Tuck and Liposuction of the Flanks

+1

    If substantial liposuction of 2 to 4 liters of liposuction is done at the time of tummy tuck, placing two drains is not unreasonable.  The drainage can be collected neatly into the drains rather than ending up on the bedsheets.  Fluid collection will develop at some point in some patient if you do enough tummy tucks.  If you are willing to drain that, then drains are not a must.

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 209 reviews

Drains are used at the discretion of the plastic surgeon after a tummy tuck.

+1

I don't use drains anymore after tummy tuck (abdominoplasty).  For a while now, I use a "quilting" technique which obviates the need for drains in my hands.  Nevertheless, this is a lone opinion and each surgeon adjusts his technique to benefit the patient.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 8 reviews

Tummy tuck and drains

+1

Thank you for your question.  As you can see from the many answers, there are different thoughts on the use of drains after a tummy tuck procedure.  I would venture to say that most plastic surgeons use at least one drain after a tummy tuck . Most surgeons leave them in place until the drainage is less than 20-30 ml per 24 hour period.  

Some plastic surgeons do not use drains. One technique involves using progressive tension sutures to compress the space under the skin to avoid fluid buildup.  Some surgeons combine liposuction and abdominoplasty arguing that the lymph vessels left behind obviate the need for a drain.  

Be sure to ask your board certified plastic surgeon about the need for drains and if a tummy tuck without drains is option for you. Good luck!

Matthew H. Steele, MD
Fort Worth Plastic Surgeon
5.0 out of 5 stars 37 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.