Tummy Tuck Drains Removal

I am scheduled for a tummy tuck and June and my surgeon has told me that he will be removing the drains the next day. Everything I read tells me that they generally stay in for about a week. I am wondering what the effects could be from taking them out the next day.

Doctor Answers 17

Drain removal post Tummy Tuck.

Thank you for your question.  Drains are typically removed when there is less than 30cc in the drain for 24 hours.  In most cases, the first drain comes out by day 7 and the second drain by day 14.  Note that the drainage may increase after the first couple of days and the patient moves about more.  Each Board Certified Plastic Surgeon is different.  Best to share your thoughts with them, and together you will make a plan. 



Las Vegas Plastic Surgeon
4.6 out of 5 stars 16 reviews

Each patient is unique.

Drains are frequently used in the post-operative period in abdominoplasty patients to minimize the potential for seroma formation.Drains are typically left in place for 7 to 14 days following surgery.They are usually removed when drainage drops below 25 cc per 24 hours.
The management of surgical drains varies from patient to patient.Each patient has unique surgical anatomy and surgical procedures are modified for each individual patient for these reasons.In some cases, drains aren’t used while in other cases, multiple drains are used.
In addition, each surgeon has his own drain protocols.In some patients, drainage may persist for longer periods of time, especially if patients are physically active.When drains are removed too early, there may be an increased complication rate.This might result in seroma formation which requires multiple aspirations or replacement of the drain.Although drains seem to be a major nuisance, they serve a very important function in most abdominoplasty patients.

Drains and Tummy Tucks

Thank you for your post. Whenever there is a potential space in your body, your body tends to fill that space with serous fluid (the yellow type of fluid that also comes out of a 'weeping wound'. This is similar to when you get a blister: the layers of skin separate and fluid is deposited in to the space. In a tummy tuck, the space is in between the skin/fat layer and the muscle layer. Most surgeons will place a drain to remove this fluid while your body is secreting it until the fat layer grows back together with the muscle layer. At that point, no more fluid is secreted into the area, because there is no more space for fluid. The length of time that this takes varies from patient to patient. Some patients heal much faster, thus the layers seal together much faster. Also, the more twisting motion you have in your belly area, the slower the two layers grow back together because they are moving in relation to each other. The fluid coming through the drain can be initially dark red, and eventually clears to pink then yellow. This is because it takes just a little bit of blood to make the fluid dark red. Also, initially, there can be a large amount of fluid (few hundred cc's in the first day is not out of the range of normal) and this should slow down substantially over next few days. Once the fluid slows down to the amount that your surgeon is comfortable with (usually 25-50 cc in 24 hours) then they will be pulled. There is minimal discomfort in pulling the drain in most patients.
More recently, 'drain free' surgery has become more popular. Fat layer is sutured down to the muscle layer starting at the ribs and progressively down to the lower incision. This makes the space for the fluid to collect much smaller, and in many patients can have surgery without drains. However, I have seen multiple patients come from other surgeons because they developed a seroma despite the suturing of the tissue. This is not the surgeon's fault, but some patients just do not heal fast enough or put out too much fluid for the body to absorb.
Best wishes,
Pablo Prichard, MD

Pablo Prichard, MD
Phoenix Plastic Surgeon
4.9 out of 5 stars 42 reviews

Each surgeon's approach will vary, but....

Hi there-

I'm not sure what the thinking here is....

Some surgeons (myself included) place drains every time they do a Tummy Tuck, and leave them in for a period between 1 and 3 weeks- in order to eliminate (I haven't had a patient experience a seroma in many years) the risk of fluid collecting.

Others use "quilting sutures" which lower the risk of this problem and do not use drains at all.

Once the drains are in, what makes most sense to me is to leave them in until you are confident the risk of fluid collection is minimized- you've already had them placed, right?

In other words, if they are removed too soon and fluid collects.... you'll wish they had just been left in a bit longer.

Only your surgeon know what works for him/her, and I don't ever like to second guess a colleague... But I'm not sure this makes sense to me.

TIMING FOR DRAIN REMOVAL AFTER TUMMY TUCK

I agree with the comments, if drains are going to be placed, why removing them one day after surgery?

The purpose of the drain is to collect fluid and minimize the chance of seroma. For this reason, I keep the drains in at least 7 days or longer, depending on the output.

Perhaps he/she is talking about a pain pump catheter? Even then, those are usually removed at 3 days.

Michael A. Jazayeri, MD
Santa Ana Plastic Surgeon
4.7 out of 5 stars 13 reviews

Drains after a tummy tuck

Removing drains the next day may cause you to develop a seroma.  This is to say you're having a standard tummy tuck.  A seroma is a fluid collection that is easily drained in the office, but most seromas can be avoided by waiting until the drain output is less than 30 ml/day for 2 days in a row.  Check back with your plastic surgeon and make sure he said the next day for drain removal.  Also, having the drains in for 2-4 weeks is not unusual, and the drains themselves are very tolerable.  

Internal quilting stitches minimize need for drains in tummy tuck.

Hi.

Drains are used in a tummy tuck to avoid fluid collection under the skin.  We are now closing off the space under the skin in a tummy tuck with quilting absorbable sutures before the end of the operation. No space means no fluid, so sometimes we don't use drains at all.

This is very new and not yet on our web site, but it is on our latest blog.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
4.8 out of 5 stars 9 reviews

Tummy tuck drains removal

Usually the drains stay in from 5 days to 3 weeks depending upon the amounts of drainage in these drains. Removal after 1 day is VERY unusual. Please discuss with the surgeon again!

From MIAMI DR. B

Drain Removal following Tummy Tuck

In my practice it would be very unusual to remove the drains one day following a tummy tuck.  The timing of drain removal by mosy plastic surgeons, including me, is determined by the volume of drainage during a 24-48 hour period.  Typically drains in my patients stay in place for about one week.

John Whitt, MD (retired)
Louisville Plastic Surgeon
5.0 out of 5 stars 2 reviews

Drain removal after abdominoplasty

Drains are placed after abdominoplasty to collect any accumulated fluid.  Removal of the drains is not really guided by time, but actually by how much drainage you have.  So, if the drainage is low, the drains are removed.  If the drainage is high, then the drains are left in place.  Good luck with your procedure.

David Shafer, MD
New York Plastic Surgeon
4.9 out of 5 stars 72 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.