4 weeks out still drain over 65cc a day. Drain will be removed week 5. How concerned should I be about seroma? (Photo)

My drainage has been high from beginning, lost my first drain 2nd week, snagged it. That side has done fine and is less swollen then the side with drain. I also feel an achy crampy feeling along where the drain lies. I'm large frame, removed 9lbs of lose skin. Nurse said sometimes the tube irratates and causes the drainage. Dare I hope this is the case? So afraid I'm going to blow up like a puffer fish or get a seroma. Also have my drain is taped on as the stitch came out

Doctor Answers 7

Drain should not be removed if still draining 65cc a day.

This high an amount of daily output is too much for drain removal, though 4 weeks post-op is extremely unusual for an abdominoplasty.

Before the drain is removed, I would ask your surgeon (NOT the nurse) what the plan is for follow up after the drain is removed "automatically at 5 weeks." If aspiration with a needle is planned, you will need to be seen every few days, which is a burden for both you and your surgeon. I would ask about sclerotherapy first, as this requires a drain in place for insertion of the sclerosant (antibiotic used as an irritant to help seal the seroma cavity shut, but also helpful antimicrobially).

Taped drains can move around a bit at the skin, so careful cleaning and application of Bacitracin (not Neosporin) would be advisable, but follow your doctor's advice here. You have valid concerns, so talk this out before the drain is pulled, or you may need another one inserted, or pseudobursectomy surgery. Best wishes! Dr. Tholen

Minneapolis Plastic Surgeon
4.9 out of 5 stars 238 reviews

Drainage Tube and Seroma

Dear Plus size hopeful, As you can see by the responses every surgeon is going to handle this a little bit differently. I have found since instituting the drainless procedure with tacking sutures from the flap to the abdominal wall the rate of seroma drops dramatically. I do think if you remove the drain next week you will have a seroma for sure. Most likely too your seroma pocket has already organized meaning the walls are already slick and are not going to adhere down to eliminate that dead space. My suggestion would be to leave the drain in a full six weeks. If it still persists then you are going to need re-operation to remove any kind of a “rind” that have formed on the seroma cavity. Best of luck to you. Robert D. Wilcox, MD

Robert D. Wilcox, MD
Dallas Plastic Surgeon
4.1 out of 5 stars 13 reviews

1 month post op, some advices:

Thanks for the question. In my practice, after performing a BA I recommend to my patients to limit the movement of the arms for two weeks. After that, you can move your arms taking care and always with common sense. 
In this regard, it's not advisable to carry heavy weights to prevent the implant out of position, and allow the formation of the physiological capsule around the implant, also to avoid pain and breast swelling. Kind regards,Dr. Emmanuel Mallol.-

Emmanuel Mallol Cotes, MD
Dominican Republic Plastic Surgeon
4.7 out of 5 stars 145 reviews

Seroma Risk After Drains

Unfortunately you have a 100% chance of a seroma, and may even develop an infection once the drain is removed. This is why some surgeons are opting not to place drains in the first place; the risk of seromas are much smaller. At this point, waiting to week 5 has no evidence to improve your chances, and the drain should be removed sooner than later. 
Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 78 reviews

Still draining 65cc/24 Horus from my drain. Should I be concerned about seroma?

Thank you for your question and for sharing your photograph.  At 65cc/24 hour period I would maintain the drain until this slows to less than 30cc/24 hour period.  Assuming that your drain insertion site is not causing you pain, difficulty, or is at risk for an infection it can be maintained in place longer with little risk.  Talk to your surgeon about your concerns. 

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 38 reviews

Drainage after tummy tuck

Thanks for your inquiry and picture.  You appear to be getting a nice result.  If you were my patient, I would not remove the drain with that much output.  Please discuss with your surgeon about compression, your activity level, and possible sclerotherapy-putting medicine in the drain to try to reduce it's output.  Good Luck

4 weeks out still drain over 65cc a day. Drain will be removed week 5. How concerned should I be about seroma? (Photo)

I personally wouldn't remove a drain that is putting out 65cc a day but everyone is different. Just make sure the surgeon assesses you beforehand rather then just letting the nurse blindly follow a recipe that says pull the tube at 5 weeks. Hope that helps! 

Mathew A. Plant, MD, FRCSC
Toronto Plastic Surgeon
5.0 out of 5 stars 21 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.