Drainage and drains after tummy tuck
I have been in practice for 23 years and have struggled with prolonged drainage and fluid collection after tummy tucks as many surgeons do. As you can see by the answers here, very good surgeons have different protocols for handling drainage and drains. Some people believe progressive tension sutures and no drains are the answer and some believe the problem has to be solved by leaving drains in until the drainage is less than 25 to 30 cc over a 24 hour period and becomes light in color. This may last up to 3 to 4 weeks in some extreme cases.
The single greatest advance in my practice in the last 5 years is that I have gone to infiltration of fluid into the abdominal flap(containing adrenalin diluted) which cuts down on blood loss significantly and allows me to use the scalpel for dissection. The bovie electrocautery unit is often utilized in the dissection extensively but produces unneccessary collateral damage in my opinion. I was taught this bovie technique and utilized it for many years. It is widely taught and accepted. However, the change to cold steel dissection has reduced my average time of drain removal from 14 days with electrocautery dissection to 5 to 7 days with cold steel. It is amazing and my patients are the beneficiary of this change. This is certainly not the only way to approach and improve on the drainage problem, but this technique continues to work wonders for my patients.
Drain removal for a tummy tuck
The appropriate time to remove the drains following a tummy tuck varies among patients. Most plastic surgeons use the 24 hour total amount of drainage in order to determine when the drains can be removed but the specific amount used to make this determination differs among physicians. On average, most patients have the drains removed around 1 - 2 week with some even remaining in place for 4 weeks or more.
Drains after a Tummy Tuck
A tummy tuck may have 1 or 2 drains and most of the time they are removed by 7 days, but sometimes a bit longer. However, some surgeons can do a "no-drain" abdominoplasty or mini-abdominoplasty. For more details, Google Search: gutowski progressive tension suture abdominoplasty
Drains are removed when drainage is low enough.
Each surgeon has their own protocol for drains after a tummy tuck. Some doctors don't use drains, but most do insert a drain to minimize the potential for fluid collection under the tummy tuck flap. When the drainage gets down to about 30cc per day for a day or 2, the drains are ready for removal. The time till the drainage gets to this level depends on several factors, such as the size of the patient, smoking history additional surgery in addition to the tummy tuck, etc. Larger patients, smokers and people who have liposuction done at the same time will require drains for slightly longer.
Drain removal depends on the patient and the surgeon
Drain(s) is usually removed about one week after surgery, but this depends on each patients body, type of tummy tuck, and the surgeon. The bigger the patient, the bigger the tummy tuck the longer the drain tends to remain. When the drain output decreases to about 30ml per 24 hours, most surgeons will choose to remove the drain.
All the best,
Typically- 7 to 14 Days Post-Op
frequently used in the post-operative period following abdominoplasty to
minimize the potential for seroma formation.Drains are typically left in place for 7 to 14 days following surgery.They’re usually removed when drainage drops
below 25cc per 24 hours.
The management of drains varies from
patients 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 case 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 servevery important function in
most abdominoplasty patients.
Tummy Tuck Drain Removal Timing
#TummyTuckDrains timing for removal varies from surgeon to surgeon. One to two weeks is the usual time for my patients for drains to be left in place and are generally removed when they drain less than 30 cc per 24 hours. If a lot of liposuction is done at the same time, it may take a bit longer.
Everyone is different. I usually remove drains when the drainage is less than 30cc for 48 hours. It can take 1-2 weeks to achieve this goal.
Drain Removal after Tummy Tuck?
Thank you for the question.
You will find that every surgeon as a different “protocol” regarding the use of drains. Some do not use drains. Therefore, for the most accurate information you should ask your surgeon how he/she typically handles drain removal. In my practice, I removed tummy tuck drains when their output is sufficiently low enough; average 1 to 2 weeks after surgery.
I hope this helps.
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.
Pablo Prichard, MD