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How to Stop Tummy Tuck Drainage?

At 4 weeks post abdominoplasty, my drainage is still 60cc/day. What else can be done and what likely outcome am I looking forward to at this point?

I am a healthy 42 years old with large weight loss (without surgery) 3 years ago.

Doctor Answers (11)

Pronlonged drain output after Tummy Tuck

+3

AS the other physicians have said, 4 weeks is a long time because most drains come out at 1-2 weeks in over 90% of patients. Having said that, occasionally I have had a patient in whom drainage persists far longer than that and I take each patient as an individual and discuss the options. Therefore you should discuss this with your surgeon whose management options may differ from mine.

In these situations, I have clamped off the drain for several hours to try to "train" the body to absorb the fluid. After several hours, I place the drains to bulb suction and measure the quantity to see if their body responds. If it does, I will remove the drain with relative confidence. In situations where it does not, I would remove one drain at a time and watch the response. Usually by 4 weeks, I have done this because the drains begin to cause discomfort at the exit site. I inform patients they may need to come back for repeated aspirations if the fluid recurs. Fortunately the skin tends to be numb. Repeated aspirations usually result in successful management despite the incovenience of multiple trips to the office.


Chicago Plastic Surgeon
5.0 out of 5 stars 44 reviews

Significance of drainage

+2

You will always have some drainage with suction drains. If you have two drains and your total drainage is about 60 ccs., then each drain is evacuating 30ccs. or about a little over 1 cc. per hour. Because of the vacuum effect when the bulbs are placed to suction, you will always draw out fluid from tissue around the drain. Of course your surgeon will determine the cause of your specific drainage situation but if you and he are concerned about it and there is no immediate reason for increased drainage and the color is clear suggesting serous fluid, you can either take one drain out or at least take it off suction and see if the other drain increases accordingly, or you can use the drains passively off suction and see if the drainage decreases without evidence of subcutaneous collection of fluid. If you wait for the drainage on suction to go to zero, you will wait forever. Unless there is a reason, four weeks is plenty long enough for tissue to heal.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 7 reviews

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

Pablo Prichard, MD
Phoenix Plastic Surgeon
5.0 out of 5 stars 27 reviews

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Continuation of drainage through drains following a tummy tuck after 4 weeks

+1
Continuation of drainage following a TT is one of the uncommon complications occasionally seen. Drains will continue draining for months until they become clogged. The negative pressure from the drain bulbs will suction the fluid out of the lymphatics and  tissue until the suction itself is discontinued.

30 ml of clear drainage per drain is an acceptable amount to start backing out the drains. An alternative is to remove the suction device from the drains and let them gravity drain. With either techniques I have found that the drainage will diminish to the point that they can be removed, providing you do not have an infection and the drainage is clear and not red, as in blood. This of course has to be done by your PS, so these are only suggestions.

Good luck.

E. Ronald Finger, MD
Savannah Plastic Surgeon
5.0 out of 5 stars 33 reviews

Stop Drainage

+1

The fact that you have had your drains for 4 weeks is some what normal usually in most patients the drains come off after 1 week or 1 week and a half , but it does happen usually aside from the fact that it happens in large surgeries it is also caused when to much movement is made when the patient does not follow the indications properly which is doing the minimum activity that causes there to be more accumulation of liquid. But if you are now draining 60 cc your are ready to take them out and with lymphatic massages or aspirating the liquid that you have left. 

Hope this helps , Regards 

Luis Suarez, MD
Mexico Plastic Surgeon
5.0 out of 5 stars 16 reviews

Continue using drains for optimum healing

+1

I am sorry for your continued drainage.  Unfortunately increased drainage is seen in larger tummy tucks. 

I always use drains on my abdominoplasties and feel it is essential for optimum wound healing.  If you were my patient I would l continue using the drains until they have drained at less than 30 cc for 2 continuous days. 

I suggest you consult with your surgeon if anything can be injected into the drain ports to sclerose the cavity.  With patients that have persistent drainage from their wounds, I sometimes inject a sclerosing antibiotic into the drain site to help promote rapid collapse of the fluid chamber.  It is also possible that you have developed a seroma in your abdominal cavity.  You and your surgeon need to discuss this possibility and to determine the next step. 

Other less invasive procedures include wearing a tight abdominal binder to maximize external pressure on the wound.

 

Thank you,

J. Timothy Katzen, MD, FACS

J. Timothy Katzen, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 25 reviews

Thrombin

+1

I had a patient such as yourself and I read about a study using Tisseal, a product that is used to aid in clotting, for this purpose. I used it and the results were miraculous. Ask your doctor to research using this product. Good Luck.

Robert M. Freund, MD
New York Plastic Surgeon
4.5 out of 5 stars 18 reviews

Could be many reasons for increased drainage after Tummy Tuck

+1

As the other surgeons have already mentioned, there may be many reasons for increased drainage at 4 weeks. In my experience, liquifying fat, which might also cause areas of firmness in your lower tummy, might be a possibility.

Low grade infection should also be ruled out. At this point, it might be wise to back the drain out slowly. This is sometimes called, "converting the drain to a Penrose." It protects you, somewhat, from the possibility of a seroma (fluid collection), which would require drainage with a needle. Hope this helps.

Daniel Sherick, MD
Ann Arbor Plastic Surgeon
5.0 out of 5 stars 3 reviews

Continued drainage after tummy tuck

+1

In my experience over the last 30 years, one month seems to be a long time to have drains in place. BUT the amount of drainage can depend upon many factors:

1.The type of abdominoplasty,and surgical technique.

2.Was suction done and to what extent

3.Type of drains and post op care.

4.General health status

5.Previous abdominal operations

6. Use of compression garments post op.

7.Activity post op.

Speak with your surgeon about your concerns and hopefully they'll come out soon. .

Barry H. Dolich, MD
Bronx Plastic Surgeon
5.0 out of 5 stars 1 review

I would remove the drains

+1

Sometimes, just having the drains present in the abdomen will cause drainage. I would remove the drains now and then see you every 3 days or so for 2 -3 visits. IF you accumulate a lot of fluid (which is unlikely) your surgeon can always aspirate this fluid easily in the office.

David E. Berman, MD
Sterling Plastic Surgeon
5.0 out of 5 stars 22 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.