TUMMY TUCK FAQ’S ABOUT DRAINS
During a tummy tuck, why are drains necessary?
During a tummy tuck, the abdominal skin and fat are separated from the underlying fascia and rectus abdominis muscles. The abdominal flap extends from the pubic region to the rib cage. This flap creates a significantly large surface area. In an attempt to glue the edges together like a sandwich, the body creates serous fluid. One of the problems is that the body makes too much fluid. Just like super glue, whenever there is too much fluid, the edges float away from each other and cannot stick together. The drains minimize the amount of fluid that collects under the abdominal flap. Abdominal drains allow the flap to stick together. Also, the drains absorb any residual blood. Too much blood can also separate the abdominal layers and decrease healing time.
Are both drains removed at the same time? Can one drain be left in place?
Typically, both abdominal drains are removed at the same time after a tummy tuck. Usually, the amount of fluid draining from each drain is somewhat equal. However, sometimes one drain drains more fluid than the other. In this case, one drain can be removed, and the other drain is left in place. When this is the case, the remaining drain may increase in output since it is the only drain left. Usually, this increased output in the remaining drain is normal.
After my tummy tuck, can I return to work with my drains in place?
Yes, usually, after a tummy tuck, you can return to work with your drains. For most jobs, you can return to work with your drains. However, if your job entails an environment that could potentially be infectious, it may not be wise to go back to work with your drains. Jobs that may be potentially hazardous include jobs at the hospital, operating room, sanitary cleaning or taking care of animals. In these types of jobs, there could be potential contamination of your drains by others, or your drains could contaminate someone else.
After my tummy tuck, can I fly with drains in place?
Yes, you can fly with your drains in place. The cabin pressure of the airplane will not cause the drains to explode or implode. So there are no issues, I would suggest you tell airport security that you have recently had surgery. You may want to consider bringing a note or letter to the airport from your plastic surgeon stating that you have recently had surgery. While going through the security checkpoint, be sure you do not use safety pins or anything sharp to attach the drains. Metallic objects like safety pins may set off metal detectors and increase security awareness. Also, for your general safety, when you are on the plane, you may want to let the flight attendant know that you recently had surgery.
After my tummy tuck, are there drains?
Yes, drains are used during a tummy tuck. Usually, two drains are placed. The drains are placed to drain fluid from each side of the abdomen. Usually, I place the drains in the pubic or mons region. This location causes the least pain, easiest access, and the best drain site scars. Other plastic surgeons sometimes will bring the drain through the sides of your tummy tuck scar. Drains placed in the tummy tuck incision are less optimal because the drains are on your side and can interfere with the incision healing. Also, if the drain is brought out through your tummy tuck scar, this leads to poor scarring.
After my tummy tuck, how long will the drains be in place?
Everyone heals differently after a tummy tuck. In general, drains can be removed seven to fourteen days after a tummy tuck. However, drains are not removed by the length of time they’ve been in place. Drains are removed by the amount of fluid they are draining. If the drains are not draining much fluid, it is possible that the drains can be removed earlier. However, if the drains are absorbing a lot of liquid, then the drains are left in place. Though rare, some drains need to be left in place more than two weeks.
After my tummy tuck, will the drains hurt when they are removed?
Yes, the drains hurt a little bit when they are removed. When the drains are ready to be removed, I use numbing spray and/or numbing cream to anesthetize the skin. Once the skin is anesthetized, the drain is removed. It stings a little bit during the drain removal, but the pain quickly dissipates. If you anticipate the drains being removed and to minimize your pain, you may consider taking your pain medication an hour before the drain removal.
How are the drains removed?
The suture that holds the drain in place is cut. Then the skin is locally anesthetized with numbing spray and/or numbing cream. The drain is then pulled. A small pad is put on the drain site.
Are the drain sites closed?
No, I do not seal the drain site. The drain site is purposely left open so more fluid can leak out. It is good to have more fluid leak out. The more fluid that leaks out, the faster your healing. However, do not press on your abdomen to express or “milk” more fluid out the drain site hole. Just let your body drain naturally.
How do the drain sites heal?
After the drain is pulled, there is a soft tissue tunnel that has been created by the drain. The body secretes fluid to seal the drain tunnel. Usually, the drain site and tunnel seals itself within three to four days after the drain has been pulled.
What happens to the fluid after the drains are pulled?
If the drains are removed at the appropriate time, there is only minimal fluid being produced. Since the fluid is minimal, your body naturally absorbs this liquid. However, if the fluid is too much, the fluid can collect. This fluid collection can turn into a seroma.
I want my tummy tuck drains out now. What happens if the tummy tuck drains are pulled too early?
During a tummy tuck, drains are placed to remove blood and serous fluid. If the drains are removed too early, you may develop a collection of blood (hematoma) or serous fluid (seroma). If the fluid collection becomes large, you may require needle aspiration. Needle aspirations to remove the excess accumulation of serous fluid or blood are done in the office. These needle aspirations may need to be done every two to three days depending on the amount of liquid. If the fluid collections do not resolve, you may need an office procedure to drain the fluid. During this procedure, another drain may need to be reinserted. In summary, it is best to be patient and to leave the drains in place to absorb all the fluid.