Having a tummy tuck (abdominoplasty) can help provide a flatter, firmer abdominal contour by removing excess skin and fat. During the procedure, the abdominal muscles are often tightened as well. Tummy tuck surgery frequently requires the placement of drains to help remove any accumulated fluid and prevent seromas (fluid build-up) under the skin.
When are drains placed during abdominoplasty?
Drains are usually placed at the end of a full tummy tuck procedure before the incisions are closed. The surgeon will insert a drain tube through a small opening in the skin of the lower abdomen on each side. The drain tubes will have bulbs attached to the external ends, as well as straps so they can be secured in place. Drains help remove any fluid that accumulates after surgery, including:
- Blood
- Lymph fluid
- Serous fluid from tissue inflammation
This helps prevent seromas from building up under the abdominal skin flaps created during the tummy tuck. Seromas can cause swelling, discomfort, and may increase the risk of infection if not properly drained. The drains typically remain in place for 1-2 weeks after surgery.
How do drains work after a tummy tuck?
The drain tubes have small perforations along the portions that are inserted under the abdominal skin. This allows fluid to be suctioned out into the bulb at the other end. The bulbs need to be kept compressed in order for the drains to work properly. As fluid collects in the drain bulbs, it creates suction that pulls more fluid from the surgical sites through the perforated tubing.
The drain bulbs must be emptied periodically as they fill up. The output is typically measured, and the color and consistency of the drained fluid are noted. This allows the surgeon to monitor and assess the status of healing and fluid accumulation. Over time, as less fluid accumulates, the drains can be removed.
When can drains be removed after a tummy tuck?
Drains are usually left in place for 7-14 days after a full abdominoplasty. They may be removed earlier or later on a case-by-case basis depending on factors such as:
- The amount of fluid drainage
- Any complications like excessive bleeding or infection
- How the patient is recovering overall
General guidelines for drain removal include:
- Output less than 30mL within a 24 hour period (for each drain)
- Fluid is serosanguinous (thin, yellow/red tinged) rather than thick or bloody
- Minimal swelling, bruising, or signs of fluid accumulation in the abdomen
The timing of drain removal may vary between practices, so follow your surgeon’s specific recommendations. Premature removal when output is still high increases the risks of seroma development.
Can I remove my own drains after tummy tuck surgery?
It is strongly advised that you do not try to remove surgical drains yourself. Allow your plastic surgeon to remove the drains in the office when it is appropriate.
Reasons you should not remove your own drains include:
- Improper technique can leave drain fragments behind and increase infection risk.
- Removing drains too early may result in fluid build-up and seroma development.
- There is potential for excessive bleeding if the drain tracts do not properly seal off.
- Pulling drains out without care can damage the surrounding tissues.
- Drains left in place too long increase discomfort and infection risk.
Your surgeon knows the intricacies of safe drain removal based on your specific procedure and recovery. They will gently remove the drains only after making sure the drainage output is ready for removal and discontinuation. This prevents complications and helps ensure optimal results.
What should I expect when the drains are removed?
Drain removal is usually a quick, relatively simple in-office procedure. Your surgeon will take care to minimize discomfort when the drains are removed. You can expect:
- The drain area skin will be sterilized.
- Any anchoring stitches are clipped.
- Gentle steady traction is applied to withdraw the tubing.
- A sterile bandage is applied over the exit site.
- Instructions are provided for drain site care and what to watch for.
There may be a small amount of drainage from the removal sites for a day or two. Watch for any increase in swelling, redness, pain, or fluid leakage from the drain holes that may indicate bleeding or fluid accumulation issues. Contact your surgeon promptly about any concerns.
Caring for drain sites after removal
Proper aftercare of the drain exit holes is important to reduce risks of complications like infection. Guidelines include:
- Follow your surgeon’s instructions carefully regarding bandaging and site care.
- Change any bandages as directed and keep the area clean.
- Avoid soaking the drain sites until they are well healed.
- Inspect the areas daily for increased redness, swelling, pain, warmth, or drainage issues.
- Avoid exposing the healing drain holes to dirty or contaminated environments.
- Do not submerge the drain sites in bath water until approved.
- Contact your surgeon if you have any healing concerns or signs of infection.
The drain holes generally heal quickly once the tubes are removed. However, you may have some internal stitches that dissolve over several weeks. Take care not to disrupt the underlayers of abdominal tissue while they stabilize.
Can drains be avoided with abdominoplasty?
Drains are commonly recommended after full tummy tucks for safety, but may not be required with less extensive variations such as:
- Mini tummy tuck – focuses only on the lower abdomen below the navel
- Endoscopic tummy tuck – uses smaller incisions and an endoscope
- Low tension abdominoplasty – does not tighten the muscle layer
Your surgeon will evaluate factors like the scope of your procedure, health status, risk factors, and goals to determine if drains are necessary. In some cases, they may use selective drain placement, temporary drains, tissue adhesives, or other techniques to avoid standard drain use.
Can drains be managed at home?
Surgical drains can usually be managed safely at home as long as proper instructions are followed. Guidelines for at-home drain care include:
- Empty drain bulbs as needed to prevent overfilling.
- Keep track of the timing and amount of drainage.
- Maintain compression on the drain bulbs.
- Record the color and consistency of the fluid.
- Secure drains to prevent dislodgement or pulling.
- Keep drain sites clean and dressed.
- Avoid activities that could displace the drains.
- Know signs of problems like infection or clogged drains.
Make sure you understand the specific instructions provided by your plastic surgeon and medical team before leaving the facility. Follow up as directed to monitor drain output and determine appropriate timing of removal.
Tips for managing drains after tummy tuck
Having drains after an abdominoplasty involves frequent care and attention. Tips to help make drain management easier include:
- Set up a comfortable station for drain care activities.
- Have gauze, tape, wipes, notebook, and other supplies on hand.
- Consider devices to secure drains rather than just safety pins.
- Keep a record of output, time, color, consistency, and other details.
- Wear loose, comfortable clothing that won’t rub or displace drains.
- Ask for help with logistics like emptying bulbs or getting supplies.
- Find positions that keep pressure off the drain sites.
- Use pain medication as needed for comfort.
While drains require vigilance, most patients find the process manageable, especially when they are prepared. Focus on following your doctor’s instructions to help the drains do their important job.
What are signs of problems with surgical drains?
Many patients have no issues with their postoperative drains. However, it is important to watch for potential problems and contact your surgeon if you notice:
- No fluctuation in fluid levels within the drain bulbs.
- Little or no output from drains over a 24-hour period.
- Thick, creamy, or bloody drainage.
- Foul odor coming from drainage.
- Drain displacement, leaking, or clogging.
- Severe pain near drain sites.
- Signs of infection – redness, warmth, swelling, pus.
Drains help avoid complications like seromas, so it is vital to monitor how they are functioning and communicate any concerns promptly. Your surgeon can assess for issues and take any needed action.
Conclusion
Surgical drains are important for recovery after abdominoplasty procedures like a tummy tuck. While drain care demands vigilance and diligence, most patients can manage well at home by following their surgeon’s instructions closely. Never try removing drains yourself, as complications like infection, bleeding, or seroma can occur. Your plastic surgeon will determine when it is appropriate to carefully withdraw the drains. Once removed, continue caring for the exit sites until fully healed for optimal results.