Drainage and Swelling After Smart Lipo and Tummy Tuck

I had a Tummy Tuck a week ago. The doctor did Smart Lipo and then the Tummy Tuck. I ended up with a huge incision from waist to waist, and I am actually larger in my midsection than I was pre-surgery from all the swelling. I don't see any way for the liquid to come out, I don't have any drainage. My doctor wants me to do 3 sessions of ultrasonic therapy to help my healing and drainage. I am already unhappy with the results. Is this normal? Is this worth the extra pay for the treatments? Please advise.

Doctor Answers 17

Not all plastic surgeons use drains

Dear Sunnysideup (sounds to me like someone very optimistic)

Not all plastic surgeons use drains. There is a technique that some of us use all or part of the time using quilting stitches to hold the fascia down to the muscle. In some patients drains are not used, but I personally use drains for at least 6 days on all tummy tucks.

I am a little concerned about using smart lipo or any lipo of the abdomen in conjunction with a tummy tuck. There are many doctors that perform this but I prefer to separate it into 2 procedures as I can be much more aggressive with the suctioning when I do.

You must also consider the psychological roller coaster you are on during the healing period and take this into account. Excitement of the surgery followed by the letdown that you are swollen, sore and not ready to be in a bikini.

Swelling can easily take 3 to six months to fully resolve. Speak to your plastic surgeon and express you concerns. You may need to have a seroma drained or a drain inserted, but continue your follow up with your doctor. I am sure you will be happy with your result in the end.

Boca Raton Plastic Surgeon
4.0 out of 5 stars 6 reviews

Swelling and drainage is normal

To assist with pain control and to prevent bleeding, fluid is first injected into the tissues prior to beginning liposuction. This fluid often drains out over the first 72 hours post operatively. I am a bit surprised that after a tummy tuck in combination with smart lipo that you do not have drainage tubes. Have they already been removed? If no tubes were used, then I would be concerned that you are developing some fluid underneath your surgical site. If this is the case, you may need to have this fluid removed which can be done in the office. Multiple removals will most likely be needed unless a drainage tube is placed. This is a problem that can be treated and still leave you with a very nice result. A tummy tuck takes months to fully recover from.

David Rankin, MD
Jupiter Plastic Surgeon
4.9 out of 5 stars 163 reviews

Hang in there after Smartlipo and Tummy Tuck

As the other doctors have mentioned, it is still very early in the postoperative period for you. Swelling can persist for up to 4 months time. For patients who have liposuction at the same time as abdominoplasty, the swelling may even take longer before going away.

As it appears in the pictures, you don't have any drainage tubes. My only concern at this point would be that there may be fluid (seroma) under the skin and fat (abdominal flap). Your doctor can determine this by simple physical exam and look for what we call a "fluid wave".

If there is fluid, then it can simply be aspirated in the office. That would be the first thing to rule out prior to the ultrasounds and hopeful waiting.

Hang in there, you still have a while to go to see your final results. Good luck.

Farbod Esmailian, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 77 reviews

SmartLipo and swelling

I agree that it is still too soon to assess what the final results will be.

After liposuction, there will always be some drainage and we typically do not see it last more than a couple of days, post-op.  After that, any fullness/swelling tends to be from the procedure itself, and this can take at least a couple of weeks to subside.

The best approach would be to wait for at least a month after your procedure to see where you are at, especially with a more aggressive treatment such as lipo in combination with a tummy tuck.  You may not need any follow-up treatments unless you have looser skin that needs tightening.

Hope that helps

Reza Tirgari, MD
San Diego Physician
5.0 out of 5 stars 4 reviews

Swelling after lipo

At one week after surgery, it is normal to be very swollen, especially since you also had a tummy tuck. Are you wearing your compression garment? Follow your surgeon's instructions on care. Your body will get rid of fluids naturally, one way is through urination. You may also want to consider getting checked out by your surgeon to see if you have a seroma.

Michael Constantin Gartner, DO
Paramus Plastic Surgeon
4.7 out of 5 stars 137 reviews

Ask Why Drains Weren't Used during Smart Lipo

As with most of the other comments I have seen, this seems a little unusual that the surgeon would not have used drains following the surgical procedure. I would first find out why, and I would be hesitant to do anything else at this time until your swelling is down and that things are back going according to plan. Make sure you are seeing a board-certified plastic surgeon here — and if you need a second opinion, go get one.

Michael Gold, MD
Nashville Dermatologic Surgeon
4.0 out of 5 stars 18 reviews

SmartLipo and tummytuck

You need to find out if you have a fluid pocket (seroma) which can and should be drained, or if it is just swelling or fluid in the tissues that can't be drained but can be reduced by other means. Be patient! It's tough but it takes weeks to months to really begin to see the results of an operation like you had!

M. Dean Vistnes, MD
Bay Area Plastic Surgeon
5.0 out of 5 stars 47 reviews

Smart Lipo

I would recommend you see a Board Certified Plastic Surgeon for an opinion.  Swelling is normal and should reabsorb.  However, you should be evaluated in the event you have fluid collection, especially if you did not have a drain. 

Sonia Badreshia-Bansal, MD
Bay Area Dermatologist
3.9 out of 5 stars 12 reviews

Drainage issues after Tummy Tuck and Lipo

You have gotten some good advice about swelling and drainage after abdominoplasty and Lipo, mainly that one week is too early to tell much. I am a fan of the pregressive tension sutures that seem to be very helpful in reducing fluid build-up. There are those who believe that no drains are necessary with this technique, though I still use them most of the time for a day or two. One thing I have noticed is that when lipo is done simultaneously (usually in the flanks or other areas adjacent to the tummy tuck), there is more drainage since additional fluid has to be injected where the lipo is done.

One thing I can't tell in your case is where the lipo was done. If it is an area adjacent to the tummy tuck surgery then swelling is certainly normal (it woulnd't have been necessary in the same area).

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 52 reviews

Swelling after Smart Lipo and Tummy Tuck

Having swelling after this procedure is common and should be expected.

Definitely give it time.

Each surgeon has different methods of managing their outcomes and your surgeon may feel strongly about ultrasound.

It is not unusual for patients to weigh 5 pounds or more over their preoperative weight.

Take care.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 81 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.