How Does a Tummy Tuck Binder Help with Drains and Recovery?

I actually don’t use a binder after TT unless I am also doing liposuction of the tummy or hips. I place one drain and I have had very very low incidences of seroma or fluid buildup. I am always worried about the garment rolling down and cutting across the tummy flap and damaging the circulation…But it really is personal preference!

Hello!  Thank you for your question!.  The tummy tuck procedure is an excellent method for contouring of your abdomen, often removing the excess skin as well as tightening the abdominal wall.  After nearly all surgical procedures, a potential space is created from where the surgical procedure/dissection was performed.  This is especially true for the tummy tuck, in where the abdominal flap is raised off of the abdominal wall and then redraped atop the area to contour the abdomen.  The procedure alone promotes swelling and inflammation, which typically lasts for 6-12 weeks.  This may even last longer if liposuction has been performed in addition.  During this time, a few things may be done to allow adherence of the abdominal skin/soft tissue to readhere to the abdominal wall and close that space.  Many surgeons use drains to evacuate the expected serous fluid from building up.  Stagnant fluid as such may be a nidus for infection as well as does not allow the tissue to adhere back to its normal anatomic position.  Drains usually are removed once output is <30cc/day - usually removed within 3-4 weeks on average, sometimes longer.  When this occurs, a seroma may develop - which may require aspiration or surgical evacuation to rid this in order to optimize your result.  This is not an uncommon reason for persistent swelling and/or bulging in a certain area of your belly.  Of course, thwarting the development of a pseudobursa, or seroma capsule, is always best, to provide the best result as well as avoid any future procedures for this.  This may be a troubling consequence and often compromises your overall result.  Thus avoiding this complication, in whatever manner, is the objective.  "Drainless" tummy tucks are becoming more popular - basically, the overlying tissue is physically sutured to the abdominal wall to close the potential space.  In addition, most surgeons typically restrict vigorous activity/strenuous exercise as well as lifting restrictions of usually <20#, especially the core, for 6-8 weeks to allow healing to continue.  Most also often recommend an abdominal compression-type binder, which will serve to provide compression as well as assist to decrease swelling and eliminate the dead-space of the area for at least 6 weeks as well.  Most patients are able to return to most activities within a couple of weeks, provided they adhere to the restrictions.  Overall, this is a procedure with a high satisfaction rate.  Discuss the procedure and postoperative instructions/restrictions with your surgeon, as these will vary among surgeons.  Hope that this helps!  Best wishes!

In my practice I have patients wear a binder for six weeks.  The binder protects the muscle repair while the sutures internally are healing.  The binder also has a role with post-operative swelling.

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

time to take out the drain after a tummy tuck can vary from a patient to another, drains are often taken out from 7 to 10 days but sometimes it takes more time to do it. i take it out when  i see less than 35 cc collectet in it in 24 hours.

Thank you for the question.

Drains are used to remove fluid from the space between the abdominal wall skin (that has been elevated during the coming procedure) and the underlying abdominal wall muscles. This space can be called a “dead space” and tends to fill with fluid that can be troublesome if left in place.  I will remove drains when the output is low (typically less than 20 mL per drain per day).

Abdominal wall binders also are helpful in keeping a moderate amount of compression along the tissues that have been elevated during the abdominoplasty procedure. The binder also serves to keep dressing someplace minimizing the need for irritating tape.  Some patients actually appreciate the “security” the binder and/or other compressive garments seem to provide. We usually get rid of the binder at the one-month postop. And replace it with moderately compressing garments (granny underwear).

 I hope this helps.

The drains are very important post surgery they prevents any fluids collection that might cause trouble like infections. The decision to remove the drains comes from your doctor it can be few days up to 10 days, and usualy there is a specific number that surgeon would consider to remove them. Wearing the binder is very imporant to achieve the same goal, and they have to be worn consistantly. Good Luck

Thank you for your question. A binder is often used after a Tummy Tuck to improve your comfort, and possibly to reduce drainage and certainly to provide support.It is important that a binder not be placed too tightly on the abdomen after Tummy Tuck. An extremely tight binder could interfere with blood supply to the skin and cause necrosis or damage near the suture line.

Some form of compression garment is used after a tummy tuck for two reasons.  1.) It protects the repair of the muscles so that intra abdominal pressure from coughing or straining will not disrupt the stitches before healing is complete. 2.) The garment helps to keep down fluid collection in the tissues, combats swelling or seroma formation.  Some surgeons prefer a a binder  and others a girdle designed specifically for plastic surgery.   Wearing your garment consistantly contributes to a good outcome.  Drainage is variable from person to person, but generally heavier patients have more drainage that persists longer.

A firm fitting binder or garment is helpful to reduce swelling after liposuction and tummy tucks, however, it should not be tight! During a tummy tuck, the skin is undermined meaning that it has been separated from the muscle. In doing so, much of the blood supply to the remaining skin and fat has been reduced. If the binder is too tight, more blood supply to the skin and fat can be reduced and if it gets to a critical level the skin and fat can die resulting in worse scars and delayed healing. Wearing the garment tighter probably does not allow the drains to come out faster. I like the word 'snug' when referring to the tightness of the binder.