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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.

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14 Doctor Answers | Asked by Sunnysideup in Bakersfield, CA

Doctor Answers (14)
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Not all plastic surgeons use drains

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... more

Swelling and drainage is normal

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... more

Hang in there after Smartlipo and Tummy Tuck

As the other doctors have mentioned, it is still very early in the postoperative period for you. Swelling can persist for up to 4 months time. For patients who have liposuction at the same time as abdominoplasty, the swelling may even take longer before going away. As it appears in the pictures, you don't have any drainage tubes. My only concern at this point would be that there may be fluid (seroma) under the skin and fat (abdominal flap). Your doctor can determine this by simple... more

One week is very early post op.

SunnySideUp, One week is very early post op to determine whether you are happy with the outcome. You will still have significant swelling and bruising and discomfort. However, you should have some drainage. Did the surgeon place drains in you and take them out already. If not, you may have a fluid collection which needs to be drained in the office. Good luck with your recovery. David Shafer, MD New York City

SmartLipo and tummytuck

You need to find out if you have a fluid pocket (seroma) which can and should be drained, or if it is just swelling or fluid in the tissues that can't be drained but can be reduced by other means. Be patient! It's tough but it takes weeks to months to really begin to see the results of an operation like you had!

Smart Lipo

I would recommend you see a Board Certified Plastic Surgeon for an opinion. Swelling is normal and should reabsorb. However, you should be evaluated in the event you have fluid collection, especially if you did not have a drain.

Drainage issues after Tummy Tuck and Lipo

You have gotten some good advice about swelling and drainage after abdominoplasty and Lipo, mainly that one week is too early to tell much. I am a fan of the pregressive tension sutures that seem to be very helpful in reducing fluid build-up. There are those who believe that no drains are necessary with this technique, though I still use them most of the time for a day or two. One thing I have noticed is that when lipo is done simultaneously (usually in the flanks or other areas adjacent... more

Swelling after Smart Lipo and Tummy Tuck

Having swelling after this procedure is common and should be expected. Definitely give it time. Each surgeon has different methods of managing their outcomes and your surgeon may feel strongly about ultrasound. It is not unusual for patients to weigh 5 pounds or more over their preoperative weight. Take care.

Otto Joseph Placik, MD

32 reviews

Chicago Plastic Surgeon

Fluid may need to be drained

It is not unusual for the patient to be larger than preop in the first week due to swelling. I do not see any drain tubes - do you have any? It must be ascertained if you have free fluid under the flap (seroma), in which case it must be drained, or you just have swelling. Swelling will usually resolve over time, with the assistance of compression garments, etc.

Hang in there...

It is very common during the early recovery period after an aesthetic surgical procedure for patients to experience feelings of apprehension and doubt, and even distrust of the professional that only days before they themselves had selected to perform an operation on them. It's human nature to be excited and full of anticipation for your new, more shapely contour, and when all you can see is your long scar and a bloated belly full of swelling, it's difficult for you to imagine how you'll be... more

Follow up appointments with your plastic surgeon is essential!

I personally do not perform Smart Lipo, but have extensive experience with tummy tuck procedures and VASER® Liposuction. With any body contouring procedure, a week is too early to estimate your final outcomes. I would strongly encourage you to follow up with your plastic surgeon in the near future. Your treating plastic surgeon knows you the best…knows your anatomy…and, knows the operation he performed on you. You agreed to his/her surgical plan; therefore, I would stay the... more

Tummy Tuck produces Dramatic Results, but Healing takes Patience

Tummy tuck, or abdominoplasty, is a procedure that can produce dramatic results, improving abdominal contour, tone and reducing skin laxity and stretch marks. With or without liposuction, recovery takes a significant investment in time as swelling subsides, and tissues and scars soften. I ask my patients to expect two weeks off. Often though some return to work after one. At one week, you have only just begun to heal and recover. We do not recommend ultrasound at one week. Do continue with a... more

You needed drains after abdominoplasty.

This is an old question, so I hope your problem has resolved. This what I would say in general: 1) I don't know any experienced, successful, board certified plastic surgeons who use SmartLipo. 2) In New York City, we always use drains after a tummy tuck, and leave them in several days. 3) Again, in Manhattan after an abdominoplasty, if there is unusal swelling, we do a sonogram to see if there is a liquid collection (seroma) that can be aspirated.

Tummy tuck and smart lipo

Post-surgical swelling is very common after a tummy tuck and certainly even more so after combining it with liposuction. This should get better with time. Just be patient.