Why did I only get 1 drain with my tummy tuck?

Question

I had lipo of the mons, back, flank and a tummy tuck. My PS just inserted one jp tube. I was wondering why only one was inserted instead of 2? The drain was discontinued after 5 days, was that to soon? Was it taken out because there was very little drainage and the risk of infection would be greater if it was left in?

Richard Baxter, MD · Answer

I usually use one drain unless it is an extended tummy tuck. With the use of progressive tension sutures, drain removal is typically at 5 days or less. There's a fair amount of debate among plastic surgeons about drains with tummy tucks, but all would agree that when they are used it is a good idea to remove them when the output is low.

Francis Johns, MD · Answer

Thank you for your question.
It is hard to say why your PS decided to use only one drain. Usually only one drain is used when there is very little undermining done to the tissues.  Drains can come out after a few days, it all depends on how much drainage you are having. If there was very little drainage at 5 days, that is more than likely why they removed it. In some cases drains can stay in for up to a month or longer if needed.

Curtis Wong, MD · Answer

is surgeon dependent and I have used both one and two drains, depending on the procedure and how much dead space was left behind. Removal is dictated by how much is coming out.  If you had a drainless tummy tuck done, what you are experiencing is completely normal.  Bottom line, no surgeon wants to deal with seromas and if you do not have one developing after your drain removal. then everything was done perfectly.

Tim Sayed, MD, MBA, FACS · Answer

Your surgeon obviously has reasons for the selection of one drain and the timing of removal. This is highly surgeon- and patient-dependent, related to these factors:1. How deep is the fat plane and how likely is it that the patient will accumulate seroma fluid in the space between the fat and muscle after surgery2. Can the space be adequately drained with one drain across the bottom or do individual sides/pockets need to be drained3. Are there quilting/tacking sutures used by the surgeon to try to minimize drainage4. Does the surgeon use a numeric threshold for removal (e.g., 20cc or less/24 hours) or is it a prescribed timeline?Certainly leaving drains unnecessarily long may create a conduit for infection, though that is uncommon; alternatively, taking them out early may increase the risk for seroma formation. Every surgeon balances these risks in the decision making with drains. Speak to your surgeon.

Anthony J. Taglienti, MD · Answer

Thank you for your question. A lot of the answer to this is, it depends - it depends on the amount of undermining, or lifting of tissue, and how much potential space is created whether or not one or more drains - or any at all - are placed. As far as when to discontinue the drains, there's no reason to keep it in if your drainage has decreased to an acceptable level or if it's not working. If you have further questions, I'm sure your Plastic Surgeon would be willing to address them. Best of luck!

Camille Cash, MD · Answer

Your surgeon would need to advise you as to why only one drain was used versus two.  The drains are removed based on the output.  If you had very little output for two days in a row, then it is typical to remove it.  The length of time they are left in varies by patient.  You are correct that they do pose a potential entry point for infection, so they are removed when no longer needed.

Gehaan DSouza, MD · Answer

It is hard to tell why your surgeon only added one drain during your procedure rather than 2 drains.  I use anywhere from 2-3 drains during my tummy tuck operations.  Further, I ask my patients to keep track of the output from each drain.  Once the drainage is less than 20 ml the drains are ready to come out.  
I also am very diligent to get all bleeders controlled during the operation and close the open space with special stitches under the surgical incisions.
Hope this helps!

Lisa Lynn Sowder, MD (retired) - Account Suspended · Answer

Surgeons vary in their use of drains based on their training and experience and in some cases the way they do a particular procedure.  I have been using progressive tension sutures in my tummy tucks for several years and find that I can get drains out in 3 - 5 days (as opposed to at least twice as long) and sometimes, in a thin patient, I don't use drains at all.  Your surgeon did what he/she feels comfortable with and if the drainage was minimal, it was time to remove them.

Vincent D. Lepore, MD (retired) · Answer

There is no absolute correct number of drains for a tummy tuck surgery.  Depending on the size and complexity of the procedure, and the judgement of your individual surgeon 0,1, 2 or more drains may be appropriate.  Also the amount of time a drain should stay in place is more a factor of the amount of drainage rather than a specific number of days.  Although patients who have increased drainage may have increased risk of infection, in general the number of days a drain needs to be left in should not significantly affect the overall outcome of the surgery.  Best wishes, Dr. Lepore.

Why did I only get 1 drain with my tummy tuck?

Answers (9)

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