Dr out of country, but my TT Drainage tubes might need to come out? (photos)

I had a TT with lipo on flanks 2.5 weeks ago, my first drain was removed after a week, but the second is draining 30-45ml per day, it fluctuates and my dr is out of the country. His colleague won't take it out unless I'm consistently at 30ml, but it fluctuates regardless of my lack of activity, and my binder can't be any tighter. What is your recommendation? I'm worried about infection if it stays in much longer.

Doctor Answers 9

Reasonable treatment plan

At this point it is probably still safe to have the drain in place.  The surgeon that is taking care of you will be responsible for whatever happens after the drain comes out, so you have to follow his protocol.  He is treating you in a reasonable and normal way.

Dr out of country, but my TT Drainage tubes might need to come out?

Thank you for your question.  Based on your supplied photograph your tummy tuck drain site looks very clean and does not demonstrate any signs of infection.  This is important as an infection usually forces a drain's removal.  That said I agree that your drainage is a bit much for now and would favor keeping it in place until its output diminishes further.  Hope this helps. 

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 43 reviews

Drain Removal

Thank you for your picture.  If you are seeing your surgeon's partner and the partner in his or her medical opinion would like to continue with the drain then there are no alternatives.  If your surgeon trust the partner to manage his or her patients then you must trust the partner's judgement.  Best wishes.

Dr out of country, but my TT Drainage tubes might need to come out?

Your final drain does indeed need to come out at some point in time, but infection is unlikely with good drain care. Recurrent seroma is the flip side worry of "too soon" drain removal. Less than 30cc in 24 hours is a common point at which drains are removed. You should follow the advice of your surgeon (or his colleague).

But having said that, there is another option that nobody has mentioned--sclerotherapy. Ask your surgeon or his colleague about adding tetracycline (or doxycycline) in saline via the drain to your body's residual cavity. This may burn or be uncomfortable for a day or so, but it can cause adherence and inflammation that will more rapidly lead to drain removal. It's safe, worth a try, and also adds an antibiotic if you're worried about infection, though it is really about adding an inflammation-inducing agent to stimulate adherence and healing.

Discuss this with your surgeon or his colleague. Best wishes! Dr. Tholen

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 240 reviews

Drain removal after tummy tuck

While every surgeon may have a slightly different protocol, it is best to follow the advice of your plastic surgeon's colleague who is entrusted with your care at this point. Follow with him regularly, drains can stay much longer and its not unheard of them being in place for even a month.

Shwetambara Parakh, MD
Paramus Plastic Surgeon
5.0 out of 5 stars 12 reviews

Drainage Tube

Thank you for your question.

I would continue to follow the recommendations of your doctor, or your doctor's colleague.  Infections around drain sites aren't really that common, and if the output continues to be elevated, that's your body's way of saying that the drain is still helpful.  I agree, at some point, if the drainage continues to be above 30, then you just have to make a decision to pull the drain and see what happens.  That timing is best left up to your doctors.

In the interim, continue to monitor the drain site for redness.  Redness directly around the drain is very common (actually, it's expected) and this is due to local irritation from the drain (and not really an infection).  Redness that spreads away from the drain site would be more concerning.

Congratulations on your tummy tuck.  Best of luck!

Take out drain

 Your operating surgeon will be the best person to make the judgment of when your drain should be removed. While there is no hard and fast dictum of less than 30 mL over 24 hours, there is a balance between taking the drain out too soon and having then to remove a seroma versus leaving a drain into long which can allow for an ascending infection through the drain tract. Follow your covering surgeons recommendation would be adviced.

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

Follow up instructions with drains

Hello 

Thank you for your question. It is always best to follow the instructions of your board certified plastic surgeon. Every surgeon has a different follow up schedule, as well as a different approaches.

Best regards

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 426 reviews

Drainage after a tummy tuck

It seems you would do best to follow the instructions of your doctors colleague.  Experienced surgeons have been through this scenario many times and get a feel for when it is most appropriate to remove the drainage tube.

Ira H. Rex lll, MD
Fall River Plastic Surgeon
4.6 out of 5 stars 44 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.