Two Weeks Post OP Tummy Tuck Why Am I Still Draining?

A surgical drain is intended to be a conduit for the inflammatory fluid that forms between tissue planes.  It is not uncommon for this to be more bloody at first and then gradually clear up in consistency although they may remain pink or turn more yellow with time.  If there is a lot of shearing between tissue planes, i.e. the tissues are not sealing as readily, then fluid production may go on longer than usual.  Surgeons tend to have their own guidelines for taking drains out, and I would wait  until the drainage decreases and your surgeon feels that it is safe to take out.  Despite these precautions, a seroma may develop after a drain removal which can be more problematic to address.

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. 

Both drains are usually removed within 2 weeks, but they could stay in longer if necessary. Therefore it is not unusual for you to have your drains still. It really depends on the patient and the surgeon. 

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

Having a drain two weeks after tummy tuck is NOT uncommon. Although a lot of my patients have their drains removed within 1-2 weeks, some others have kept it for 3-4 weeks.  The drain output is dependent on your activity as well as your body.  Some post-bariatric patients tend to make fluid more than thin patients.  I would not worry that your drain has been in the body for two weeks unless you are experiencing pain or bloody output.

Hello,

Hang in there as a drain putting out 50cc/24 hrs at 2 weeks out is not completely uncommon and will likely be ready to come out soon.  I would keep the drain in until it is ready to come out 30cc/24 hrs or less and keep your abdominal binder on very snug and almost around the clock as this will also help.  There are a variety of reasons for the drain still putting out 50cc per 24 hrs at 2 weeks and none are necessarily something that will negatively impact your final result. 

All the best,

Dr Remus Repta

It's not that unusual and mostly this is a nuisance problem.  Typically the drainage will taper down and the drainage will be bloody for perhaps 24 - 48 hours and then turn pink and then mostly light yellow or slightly pink. In patients who are bigger to begin with or who have a significant amount of liposuction with the tummy tuck there may be more drainage for longer.  Patients who are more active after surgery may have more drainage as well. In any case I would keep in close contact with your plastic surgeon.

Thank you for the question.

Assuming the drain output is gradually decreasing and is not associated with “active bleeding” I do not think you have much to worry about.  at this point, the fluid draining should be turning more yellow in color (serous).  

Over the years, I have had many patients who continue to have significant drainage from drains between 2 to 4 weeks after surgery. None of them have developed a “larger problem”.

I would suggest continued close all up with your plastic surgeon.

Best wishes.

Your doctor must be young because this is very common especially if you had lost significant weight or if there was a small hematoma that is now liquifying.  As long as it is draining it should stay in.  I keep my patients on antibiotics while the drain is in place.  I did a TT on one of my nurses, no weight loss history etc, just this summer and her drain was in for 17 days.  Then it came out and she is perfect.  No worries for now...