Do I Need Drains with Abdominoplasty?

Surgical procedures create raw surface areas, which are areas not covered with epithelium. These raw areas typically release serum and small amounts of blood during the healing process. In general, the larger the surface area that is raw, the larger the potential for serum drainage. When a large amount of this fluid collects in a space, it is termed a “seroma.” If the seroma becomes clinically detectable and significant, it is treated by evacuation (draining).

As with any health issue, prevention is always much better than a cure. If a seroma can be prevented, it is better than treating it after it occurs. The process of treating a seroma can create its own problems. If the seroma is drained with a needle, there is the potential of introducing bacteria into the wound, which could cause a wound infection. If the seroma is drained “open” (with an incision), the potential for wound infection also exists. If a clinically significant seroma is not drained, it may result in a pseudobursa (false lining), which may require additional therapeutic measures, including surgery.

Drain(s) can be and are commonly placed during abdominoplasty. Drains are placed during abdominoplasty for two reasons, one obvious and another not so obvious. The obvious reason to place a drain is to remove serum during the healing process. The drain could prevent a clinically significant seroma and additional treatment. The second and not so obvious reason a drain is placed during abdominoplasty is to facilitate the plastic surgeon and the patient in monitoring the wound status. By observing the volume, color, and consistency of the drainage, one can acquire valuable information regarding the status of the wound. If there is an issue that requires intervention after abdominoplasty, the drain can assist with the diagnosis.

The abdominal anatomy is different from other areas of plastic surgery. First, it is a large area of raw surface with the potential for drainage. Second, the abdominal area is very distensible, which is different from other areas. The distensibility of this area and the size of this area can make it more difficult to diagnose problems as compared to areas that are less distensible. This provides a large safety factor.

The disadvantages of placing a temporary drain are minimal. First, the drain is in place for a few days. Second, there is a small scar where the drain is placed. Other than the temporary inconvenience, the downside to a drain is minimal. While some plastic surgeons may choose not to place a drain during abdominoplasty, many place a temporary drain on a routine basis.

Dr. Stephen Herring is a board-certified plastic surgeon renowned for his personal approach to body contouring procedures like abdominoplasty and liposuction. For more information about any of our body contouring treatments, or to schedule a consultation, we invite you to contact our practice today. Whether you live locally in Fayetteville or are considering traveling from out-of-town to see Dr. Herring, our team can help you achieve your plastic surgery goals.