After a Tummy Tuck, I Have a Drain in and Output is 50cc After 20 Days, What Can I Do?

Thank you for your question.  Drains are typically removed when there is less than 30cc in the drain for 24 hours.  In most cases, the first drain comes out by day 7 and the second drain by day 14.  Note that the drainage may increase after the first couple of days and the patient moves about more.  Each Board Certified Plastic Surgeon is different.  Please communicate with your Plastic Surgeon your concerns.  Together, you will make a plan.

           

Thank you for your question.  At 3 weeks, it is not uncommon to have a drain remaining.  Check with your surgeons about their recommendations.  Generally it just takes time.  In my practice, I would recommend thae patient continue to wear their compression garment and keep their activity limited to help minimize drain output.  If you continue to have drains after 6-8 weeks, you may ask you surgeon about placing a medication (sclerosant) through the drain into the space under your skin to cause some inflammation and scarring to help close down the space.  This is not required very often.  Good luck. 

Thank you for your questions regarding drain output after a tummy tuck. Drains are very important after a tummy tuck. It help to remove excess fluid. If there is no drain, fluid collects and causes distention of the abdominal wall. If the fluid collection is significant, it may require needle aspiration every 48 hours. If the fluid collection is extensive, it may require insertion of a drain. Therefore, drains are very important after a tummy tuck. Also, it is not the number of days that the drain has been in place but rather the amount of fluid that they drain is draining, that is important. Compression helps to minimize the collection of fluid. Therefore, I would suggest you wear your compression garment. Also, activity can increase fluid output. Therefore, I would suggest minimal activity. There is some special medication that can be injected into seroma cavities which may help to decrease the secretion of fluid. It is best that you discuss this with your plastic surgeon. In y practice, this is rarely needed.  Rest assured, this pain will eventually be removed. However, for now, this drain is draining too much. Thank you for questions regarding increased output from your drains after a tummy tuck. If you have any more questions regarding a tummy tuck, recovery ,or drain care after a tummy tuck, please contact my office.
Sincerely, Dr. Katzen

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

Occasionally, one finds that there is persistent drainage from the Jackson-Pratt which may need to stay in as long as a month. I have found that placing a patient at bedrest combined with wearing the binder tightly maybe all that is necessary to allow the abdominal wall to adhere to the underlying fashion. You may ask your physician to place a low dose steroid such as Kenalog diluted in 20 mL of saline through the tube and allow this to stay in place for a few hours before you place the drain once again on suction. I have on several occasions found that this diminishes or stops the drainage altogether within 48 hours.  

Although most drains come out after 1-2 weeks, it is not unusual to have the drain for 3 weeks.  If your drain output is not decreasing, you want to make sure that 1) you are not too active and 2) wear compression garment.  If the trend of drain output does not decrease (with decreased activity and wearing compression garment), your plastic surgeon may inject sclerosing agent through the drains to speed up the process.

Every Patient is different in how long they may expect to have drain output after their Tummy Tuck, it just depends on how quickly your body heals.  The surgical drains may be removed in as little as 3-5 days for the first drain and as long as 15 days or more for the second drain.  You should limit any excessive activities, because over doing it will lead to increased drain output.  Wear your binder as much as possible to help reduce fluid and swelling.  If the drain is taken out to soon you might have fluid accumulate (seroma) and have to have fluid aspirated from the abdomen.  As long as there are no signs of infection you should not be concerned about having the drain tube in too long.  Your surgeon will remove the drain when your drain output diminishes, be sure to follow up with your surgeon.

 

 

 

SOmetiems drainage form the tube can last a few weeks especially after a tummy tuck and liposuction.  If taken out too early it could lead to a seroma requiring repeated aspiration.

Thank you for the question.

Given the output that  your drain is still having,  I would suggest that you leave the drain in place.  Occasionally, it is necessary to leave drains in  a longer period of time;  it is  rare that doing so causes any problems.

Continue to follow-up with your plastic surgeon.

Best wishes.

In the majority of cases in my practice, I would never leave a drain in a Tummy Tuck for more than a few days.  I have never left a drain in for 20 days.  Hopefully, you are keeping your post op appointments.  Every patient heals different, but this is unusual.  Be sure you are wearing your compression garment day and night.