Drainage after tummy tuck

Tummy tuck: To drain or not to drain?

The vast majority of surgeons still use drains. A small percentage do not.

The reason for placement is to evacuate the space that is created between the muscle and skin.

Surgeons who do not use the drains sew this layer closed with special stitches called quilting sutures. (Otto Joseph Placik, MD, Chicago Plastic Surgeon)

Drainage is commonly used in tummy tuck surgery

The drainage after tummy tuck

There is an old adage from biology that applies here ‘Nature abhors a vacuum’- in other words, when a space is created in the body, that space will become filled with something if left alone.

During a tummy tuck procedure, a very large space is created between the abdominal soft tissue flap and the abdominal wall.

Since this flap will be closed, its important to place drains in the space to reduce the collection of fluid that can occur. The temporary discomfort and inconvenience of a couple of abdominal drains is certainly less of an inconvenience than a chronic seroma that requires drainage later on. (Scott C. Sattler, MD, FACS, Seattle Plastic Surgeon)

Drainage with Tummy Tuck

Drainage after tummy tuck surgery

Most plastic surgeons will use drainage following a tummy tuck. A very large potential space is created when the skin and fat are elevated from the underlying muscle. If drainage is not placed, fluid (seroma) accumulates here which interferes with healing.

Some surgeons attempt to place “quilting sutures” to prevent the seroma formation, but the placement of drainage is much more commonplace. (John Whitt, MD, Louisville Plastic Surgeon)

Pros and cons

Drainage after tummy tuck procedure

Over 50% of patients will have some element of a seroma (collection of fluid) after a tummy tuck. This fluid has to go somewhere and most patients would prefer it come out as opposed to walking around with a water balloon. The drains are inconvenient, awkward, and cumbersome but they are also, in most instances, necessary. (Robert Frank, MD, Munster Plastic Surgeon)

The previous posters have answered the reason for a drainage system after tummy tuck. From my point of view it borders on malpractice not to drain a tummy tuck. It is for safety and the standard of care. Be careful out there. (Darryl J. Blinski, MD, Miami Plastic Surgeon)

You need a drainage with a tummy tuck

Drainage after tummy tuck drain tubes

There is a space between the skin and the muscle after a tummy tuck that will fill up with fluid without a drainage (seroma). This creates a barrier between these two layers and significantly inhibits their chance of knitting together.

Some have tried to use sutures to obliterate this space and avoid a drainage, but I personally do not believe in this technique. (Richard P. Rand, MD, FACS, Seattle Plastic Surgeon)

Tummy Tuck and drainage

Can you lose weight after a tummy tuck surgery

As a general comment, drainage is placed whenever a surgeon anticipates the continued creaton of fluid which in turn would slow proper healing. There is no reason to place drain tubes when this does not happen.

The lifting of the skin and fat of the tummy to allow muscle repair and removal of all loose skin creates a large cavity which commonly secretes fluid. Failure to drain will always result in a seoma. Some surgeons believe that by stitching the raised skin/fat flap to the underlying muscle such fluid formation can be markedly lowered or prevented.

BUT – those of us who tried these progressive stitches can attest that they often are not sufficient to prevent seroma formation. (Peter A. Aldea, MD, Memphis Plastic Surgeon)