Why does JP drainage increase at night while sleeping, yet I have no drainage during the day?

Hello, and thank you for your question regarding why your JP drainage output increases at night but remains minimal during the day. You are 3.5 weeks post-op from a circumferential body lift and brachioplasty, and it is understandable that you are eager to have your last drain removed. Based on your description, this increase in drainage at night is a normal occurrence and can be explained by several factors.

During the daytime, when you are up and moving around, fluid within the body is more evenly distributed due to gravity and natural lymphatic circulation. Walking, sitting, and general movement help redistribute the fluid, preventing it from accumulating in one specific area. Additionally, your body absorbs some of the fluid throughout the day, which is why you see minimal drainage during this time.

At night, when you are lying down for several hours, gravity no longer helps to distribute the fluid, allowing it to pool in one area. This pooled fluid then drains more efficiently into your JP drain when you wake up and begin moving around again. This phenomenon is common and often temporary as the body continues healing.

Your last drain is still producing 80-100cc per day, which is above the typical threshold most surgeons use for safe removal (usually 30cc or less over a 24-hour period for at least two consecutive days). The remaining fluid production may be due to residual swelling, inflammation, or minor lymphatic leakage, all of which should gradually improve with time.

To help reduce fluid accumulation at night, you may consider:

Elevating your legs and torso slightly while sleeping to encourage better fluid circulation.
Wearing your compression garment consistently as instructed by your surgeon to minimize swelling and promote lymphatic drainage.
Increasing lymphatic massage, if approved by your surgeon, to help move fluid more effectively.
At 80-100cc per day, it may take another week or two before your drain is ready for removal, but this timeline can vary. If drainage output suddenly increases, turns cloudy, or changes color (yellow-green or bloody), or if you experience pain, warmth, or signs of infection, contact your surgeon immediately. Otherwise, you are likely on the right track, and your body just needs more time to reabsorb excess fluid and regulate drainage naturally.

I hope this helps to answer your question. Good luck with the rest of your recovery!

Sincerely,
Dr. J. Timothy Katzen, MD, MBA, FASMBS, FICS

It is most likely that the fluid is accumulating with the dependent area of the abdomen when you are sleeping. When you are elevated, the serous fluid uses gravity to drain through the Jackson Pratts drains that are on suction. Should the amounts accumulate or the drains stop flowing, it is imperative to seek your Board Certified Plastic surgeon for evaluation. 

Thank you for your question.  The drain that is still producing fluid at night was likely placed in a non-dependent area of your surgical site.  When you are walking around it likely is sitting above the fluid that needs to drain.  When you lie flat the fluid spreads out, coming in contact with the inflammatory fluid and removes it.  I remove drains when there is