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Drains Removed the Day After Tummy Tuck Surgery?

I am 7 weeks and 3 days after a tummy tuck with lipo to hips.i am still really swollen.i have had fluid aspirated 4 times with a total of 750ml.i have a little wound breakdown on scar above pubic bones.which is still leaking fluid.i want to no.was my drain removed too early.i came out of theatre 6 45pm and my drains was removed the next day at 4.00pm. Also will by abdomin ever go flat and are my hips still swollen of the lipo.as my surgeon has said it is fat that i have pit on since my operation

Doctor Answers (6)

Drains and Tummy Tucks

+1
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


Phoenix Plastic Surgeon
5.0 out of 5 stars 26 reviews

Timing of drain removal

+1

is at the discretion of your surgeon as we all have different criteria at when to remove a drain.  Unfortunately, you are having to deal with seromas or fluid collections and realize there will be an end to that someday.  And as you heal, your swelling will go down.  Your final results will not show itself for several months.  You need to maintain your weight where it is and trust your surgeon to do the best for you as he/she is just as motivated as you are for the best result possible.

Curtis Wong, MD
Redding Plastic Surgeon
4.5 out of 5 stars 16 reviews

Swelling and fluid after tummy tuck

+1

There are several different techniques for abdominoplasty or tummy tuck.  Some surgeons will use additional "quiliting" sutures on the inside to close the potential space created by surgery.  In that case, the surgeon may not place a drain at all.  With that said, I continue to use drains because I feel that it decreases the initial swelling and lowers the likelihood that a fluid collection will develop.  However, some patients still develop fluid collections even when the drains are left in place for a week or longer.  Fluid aspiration is then necessary and it sound like you have had this several times.  The good news is that the fluid will eventually resolve but you have to be patient.  With respect to your "not so flat abdomen," this is likely swelling which is may worse by your fluid collection.  It takes months for all of the swelling to disappear even if you don't have a fluid collection.  Good luck and heal quickly.

Paul B. Mills, MD
Saint Louis Plastic Surgeon
5.0 out of 5 stars 2 reviews

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Fluid Collection after Tummy Tuck

+1

Drains are usually removed based on output.  It is unusual to remove the drains at 1 day postop as they are usually kept in place for 7-10 days.    Some doctors will place quilting sutures to help the skin flap seal to the abdominal wall faster.  I would recommend an ultrasound to assess for possible seroma.  I wish you a safe recovery.

Paul S. Gill, MD
Houston Plastic Surgeon
5.0 out of 5 stars 35 reviews

Drains Removed the Day After Tummy Tuck Surgery?

+1

Thanks for your question, but there is really not enough info to offer a proper answer. What I would want to know is how much drainage there was during that first day.

There are a number of surgeons who do not use drains at all, and claim not to have any higher a rate of fluid collection than do surgeons who use drains. 

Most of us who regularly use drains have some threshold amount at which time we remove the drains. For me, that is 30 cc for a day. 

Photos would be helpful (before surgery and now) to answer the question about flatness.

All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.5 out of 5 stars 30 reviews

Drain removal after tummy tuck

+1

Depending on patients' drain output,  I remove drains.  Most patients have drains for 1-2 weeks.  Having the drain removed one day after surgery and requiring multiple aspirations indicate that your drain might have come out too soon.  It does take 2-3 months for swelling to go down.  You do want to make sure that your swelling is not due to fluid collection (seroma) in your abdomen. 

Sugene Kim, MD
Houston Plastic Surgeon
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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.