If drains are not used in a TT, BBL or lipo, how are the fluids going to drain if sutures are used to close the surgery sites?

Doctor Answers 6

Drains and tummy tucks

Drains are used commonly in tummy tuck surgery. Some surgeons do not use them. Your body can resorb some fluid on its own but if the fluid starts to accumulate, you can form what is called a seroma or fluid collection, which will then need to be drained. These are great questions to discuss with your surgeon and learn their philosophy for not using drains. Drains are not routinely used in liposuction or BBL.

If drains are not used in a TT, BBL or lipo, how are the fluids going to drain if sutures are used to close the surgery sites?

I use drains for the tummy tuck given the amount of surface area dissected.   I do not use drains for liposuction and BBL.

Kenneth Hughes, MD

Beverly Hills, CA

Drains or not

Hello. Oftentimes drains are used with a TT but that depends upon your surgeon's philosophy. Your body can absorb much of the fluid after surgery but not always in the case of a TT.  Please discuss with your surgeon. 

Dr. B

Drains

 In my opinion, the purpose of the drain is when you create what we call in plastic surgery a flat, where tissue is separated over a large surface area from its base. Here, until the flap can it here to the base there is potential for liquid to develop in that interface. With liposuction, there is not really one big space but many little tiny spaces were fluid can collect. In this situation, the body will resorb the extra fluid. One of the new techniques is to use a tissue glue to fill in the space between this flap and the base to obviate the need for a drain. I've used this principle for many years in facelifts and now a new glue called tissue glue is available for tummy talks. Good luck. 

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 44 reviews

Tummy Tuck and drains

The standard over many years is for surgeons to leave small drains in a tummy tuck for a period of about one week.  This promotes adhesion of the stomach wall to the underlying fascia and removes collecting fluids.
This has been my standard treatment and has worked quite well.  I numb the incision sites before removing the drains and find it to be nearly painless (a fear that many patients have).

Quilting sutures have been used successfully to close off the space beneath the skin and have been used successfully to avoid placement of drains.  This adds to the surgical time and is a personal choice for some surgeons but probably not the majority of us.

As a patient I think you should trust the surgeon's advice whom you have selected to perform your procedure.  He/she will use their best judgment.  I certainly would not choose a surgeon simply because drains are not used.  Best of luck and enjoy your results.

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 30 reviews

Drains and the fluid that comes out of them

Good question!  Whenever the body sustains an injury, a part of the healing process is leaking of fluid from the circulation into the tissues.  When this fluid leaks into skin or fat or muscle, it creates swelling.  A good example of this is a sprained ankle.  The injury causes fluid to leak into the surrounding tissues and your ankle swells up.  In this case, there's not an empty pocket or space for the fluid to collect into, so it just integrates into all of the surrounding structures.  This is called edema and it's kind of like a sponge filled with water.  Over time, the body reabsorbs this fluid, but it can take a while.  Edema can be uncomfortable, inconvenient, and unsightly but is otherwise not usually a problem.

When you've had surgery, particularly a plastic surgery procedure where the skin is lifted up and an empty pocket is created under the skin, the leaky fluid can collect in this space.  This is called a seroma and it's similar to a balloon filled with water.  Many of our procedures use drains to allow this fluid to escape, because if it accumulates, it can increase the risk of infection or long-term contour irregularities.  Whether a drain is necessary depends on a number of factors.  The larger the space under the skin, the more likely a seroma is to develop.  Some areas of the body are also more prone to the development of seroma than others.  Generally, the body is able to reabsorb about 30 cc/day of this fluid from an area.  If it's producing less than this amount, then the body can keep up with the re-absorbtion.  If it's creating more than 30 cc/day, then the fluid accumulates. 

Drains are commonly used for a tummy tuck, but some surgeons prefer to use internal sutures to tack the skin back down, thus decreasing the size of the empty space under the skin so fluid is less likely to accumulate.  Both options are appropriate and each surgeon has their preference as to which way is better.  I've tried both and prefer using drains, but there are others that would certainly disagree with me.  In lipo, many small tunnels are created as the fat is removed, but a large space is not created.  A seroma is possible with this procedure, but not very common.  A BBL transfers additional fat into the buttocks, so there's even less space for fluid to accumulate, so a seroma is not likely and edema is much more common.

I hope that helps.

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.