Drains or not drains after BBL? What are the pros and cons?

Question

What are the cons and pros of having drains in the liposuction areas after BBL? Do drains give better results?

Stan M. Valnicek, MD · Answer

Thank you for your question.  Individual surgeons will vary as to use of drains in this procedure.  Every surgeon's technique and technology (Vaser, vibration, safelipo, etc.) varies and good surgeons will do what they feel is best for their patients based on their experience.
In our practice we use drains routinely.  I find patients can put out 1-2 liters of fluid over the first few days and if this is not drained then I worry the contour will not be as flat and smooth as possible.  Patients understandably worry about drains and there are certainly a hassle to deal with.  Fortunately they are usually removed within a week in most cases and I personally feel they improve my results while reducing seromas and irregularities in my patients.

George Marosan, MD · Answer

Thank you for your question. As a Total Definer surgeon who specializes in body sculpting,I always use drains in the areas liposuctioned. Two drains up front in the groin area and one in the back at the top of the buttock crack. I use the VASER Hi Def Lipo technique for creation of an hourglass figure. I routinely do liposuction 360 degrees, which means all areas are connected. I also use "stealth" incisions, so there's no sign that the person had surgery. The excess fluid that the body creates into the liposuctioned areas needs to be removed, otherwise seromas and poor contour will result from excess fibrous tissue formation. The small skin incisions tend to close in a couple of days, thus trapping this excess fluid in the tissues. Not even to mention, that without drains, this is a very messy procedure. In my cases, the back drain puts out upwards of 400cc for the first 24 hours. Most surgeons who just do fat reduction liposuction and spot liposuction do not understand this concept.See a board certified plastic surgeon experienced in advanced body sculpting techniques for an in person consultation/evaluation. Good luck.

Kenneth Hughes, MD · Answer

The risk for infection with drains may be higher. I try to avoid them unless someone is having a problem with fluid collections.Kenneth Hughes,MD, ABPS Board Certified Plastic SurgeonLos Angeles, CA

Daniel Barrett, MD · Answer

Dear Latina1101,
some plastic surgeons use drains others don't. Drains can help in seroma prevention but they can irritate patients and cause some discomfort. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD

Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Joshua A. Halpern, MD, PA · Answer

It is not uncommon for different plastic surgeons to use different techniques when performing surgery. Some surgeons will drain the tummy after liposuction, and others do not. Some surgeons drain the central area above the behind and some do not. It depends on the individual surgeon. I’m very excited about a new high tech device used to perform BBLs. It’s called the Vibrastat. (Please see the Vibrastat video on our page). I hope you find this information useful. Please see the enclosed video.

Nicholas A. Flugstad, MD · Answer

Brazilian Butt Lift is a great and natural way to enhance your curves and add a little or a lot of shape to your buttocks. It is done with liposuction to of key areas most often in the hips, waist, and abdomen. The fat is then used to transfer to the areas of your buttocks that needs shape and volume. Regarding drain use, it is not super common in BBL. I find short term drain use helpful for reducing swelling and fluid during the first few days after the procedure. I use drains for about half of my BBL's. The downside is that drains are temporarily painful for some patients. Have a consult with and American Board of Plastic Surgery certified, ASAPS member surgeon who specializes in this procedure.

Mats Hagstrom, MD (license on probation) · Answer

drains are only needed for liposuction and even then the great majority of plastic surgeons do not use them.  Fat transfer alone never creates a fluid issue.  When potential spaces are left in the body from surgery the body often responds by filling them with fluid.  With liposuction the spaces are typically very small and true fluid that builds labs typically do not happen.  If they do they are referred to as a seroma  These can be prevented from the placement of drains.  Certain types of liposuction have a higher propensity of fluid buildup.  Most notably VASER. Highly aggressive forms of liposuction also have a higher chance of this happening.  Some plastic surgeons believe placing a drain well create better definition and contour especially in the area of the lower back as a transitions to the buttocks. Personally I do not use drains during liposuction. You should let the surgeon make the decision of what works best for them and their technique. Don't choose  your surgeon based on using drains or not. Don't tell your surgeon to put in drains or not put in drains. If you choose the right plastic surgeon everything falls into place and you don't have to think about these things. You simply are never going to be able to play catch-up with understanding all the nuances of these procedures that plastic surgeons have spent 20 years figuring out including medical school, residency and years of practice.  There's an expression in plastic surgery. It goes like this " i've never regretted having put in a drain" when we do get fluid buildup is in hindsight we wish we would've been in the drain at the time of surgery.  Best, Mats Hagstrom MD

Arian Mowlavi, MD, FACS (license on probation) · Answer

If you are not using drains, it is a red flag that appropriate liposuction has not been performed. When you use VASER liposuction, you will achieve optimum results with high end contouring and sculpting which allows for maximum waistline narrowing, optimal and permanent BBL results. If you are a good candidate for a Brazilian Butt Lift (BBL), the optimal outcomes are achieved with: 1) use of VASER liposuction to harvest the fat, 2) a closed looped system such as Puregraft to process the fat, and 3) strategic micro-packet transplant technique. These three processes have demonstrated over 95% fat graft take. This means that your results will be stable as long as you maintain your weight. As an official VASER trainer, I am routinely referred unhappy BBL patients. One of the most common reasons for disgruntled BBL patients is that patients are not able to accurately communicate their desired buttocks goals to their surgeons.  A buttocks assessment tool can be an invaluable tool to communicate to your surgeon the exact buttocks size and shape you are desiring. A Skype or FaceTime consultation with a BBL specialist can help you get an accurate recommendation and pricing.
Respectfully,
Arian Mowlavi MD,FACS
Realself 100 Hall of Fame Inductee

John E. Nees, MD - Account Suspended · Answer

Hi and welcome to our forum!You will get many differing responses on this question with good reasoning on both sides.The use of drains will prevent fluid collections. However, a drain communicates from the skin to the operative area, increasing the infection risk.As our rate of seroma is quite low, we do not routinely use drains in our BBL patients. Best wishes...

Drains or not drains after BBL? What are the pros and cons?

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