Plastic Surgery Drains: What You Need to Know

Written by Timothy McGee, MD, Board Certified Plastic Surgeon on November 21, 2022 No Comments

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Many prospective plastic surgery patients experience stress or anxiety around the idea of plastic surgery drains, primarily because they are unsure of what they are and how they work. Plastic surgery drains should not be feared! They are simple devices that aid in healing process. Learning more about plastic surgery drains can help ease your mind about post-surgery recovery.

Here is what you need to know about drains used in plastic surgery:

What Are Surgical Drains & How Do They Work?

Surgical drains are soft, thin, plastic tubes which are placed during surgery to help drain excess fluid. Fluid naturally accumulates in areas where tissue was removed. A build-up of fluid can cause complications. Inserting a drain allows fluid to be removed, and is an important part of the healing process in some surgical procedures.

Drains are typically the width of a pen or pencil and less than 20 inches long. One end of the tube is inserted into the body and held in place with a small stitch. The other end is inserted into a round, squeezable bulb. Compressing this bulb creates a gentle suction, which helps draw fluid from the body.

Why Are Drains Used in Some Plastic Surgery Procedures?

Drains are beneficial after certain surgeries. Inserting a drain helps prevent fluid from accumulating. If too much fluid remains trapped in one place, a seroma can occur. A seroma is a pocket of trapped, excess fluid.

What Happens If a Drain Is Not Used?

If a seroma is allowed to build up, it can put pressure on the tissues around it. This not only can slow down the recovery process, but can also cause a build-up of scar tissue and or asymmetrical cosmetic surgery results. In very rare cases a seroma can become infected. Any of the above may require corrective surgery.

What Type of Fluid Comes Out?

At first, the fluid drained will appear red and thick as it is fresh fluids like blood from the surgical site. In the first 24-48 hours the fluid may become a darker shade of red and you may see some small blood clots in the fluid. After 1-2 days the drainage will begin to appear lighter red and thinner, taking on a pinkish hue. As you continue to heal, the fluid will become less pink and more yellow, then finally clear yellow color.

If the fluid in your drain remains dark red for more than 3 days, or if it becomes cloudy or foul-smelling, call your doctor immediately. These could be signs of complications or infection.

What Types of Surgeries Use Drains?

Surgical drains are most commonly used for surgeries in which tissue was removed. The larger the amount of tissue removed the more like the use of a drain. This includes the following surgeries:

Between 1-5 drains may be needed depending on how extensive the procedure was. Surgical drains are typically not necessary for breast augmentation surgery.

How Are Drains Put In?

Drains will be placed while you are still under anesthesia. The drain will be inserted near the surgery site and secured to your skin with 1-2 small stitches. This area will then be covered with gauze to catch any fluid that may leak out onto your clothing.

You may be given a special garment or bag to hold the opposite end of the drain tube, which includes the drain bulb.

What Do Drains Feel Like?

Most people can’t really feel the drainage tube underneath their skin unless they are doing certain movements like stretching, twisting or turning. Mild pain at the drain insertion site is common.

If you feel increasing pain associated with your drain, or redness, swelling or hardness at the drainage site, it could be a sign that the drain needs to be evaluated by your surgeon.

How Should Patients Care for Their Drains While Recovering? 

Drain care will be discussed in your preoperative appointment. Before you leave the surgery center, your doctor or a nurse will review how to care for your drains as part of your post-operative recovery instructions. Your instructions will likely include the following:

  • Keep the insertion point clean and dry
  • Keep your drainage tubes clean and dry
  • Note the color and consistency of the fluid that is draining
  • Empty your drains into the toilet 2-4 times daily (when half full)
  • Keep a record of how much fluids drains per day

Showering within the first 48 hours of surgery is not recommended, but after that it is perfectly fine. Use a mild soap and water. Avoid soaking in baths, hot tubs or swimming until your drains are removed and your surgeon has given permission to resume those activities.

How Long Do Drains Stay In?

How long your drains stay in will depend on the type of surgery you had and how quickly your body heals. Drains are typically left in place until at least 2 days have passed in which no more than 2 tablespoons(30cc) per day of fluid have drained.

After face lift, neck lift or arm lift surgery, drains generally stay in place for one week. For more extensive surgeries, such as tummy tuck, drains may be in place for 2 weeks. It’s rare to keep drains in for longer than 2 weeks, since this increases the risk of infection. However, complex breast reconstruction and secondary surgeries can have drains in for up to 3 weeks.

Patients who are active, or not following their doctor’s post-surgical advice, may have greater fluid output, requiring their drains to stay in longer.

What Happens If the Drain Comes Out Prematurely?

It’s not always a crisis if your drain falls out too soon. Do NOT try to reinsert the drain. If the drain comes out partially or all of the way, contact your doctor. They will decide if the drain needs to be put back in place, or if your healing has progressed to the point where you don’t need it.

How Are Drains Removed and Does it Hurt?

Drains will be removed in your doctor’s office during a follow up visit. First, the stitch holding the drain in place will be cut, then the tube is gently pulled from underneath your skin. Most patients report minimal pain. Some patients feel some slight movement, but pain medication is not required.

A tiny drainage hole will remain, which will close within just a few days and heal completely within a few weeks. Drains can leave behind a small scar, which will fade over time.

Timothy McGee, MD

Dr. McGee has been practicing plastic surgery for more than 18 years in all areas of the field, including cosmetic surgery and reconstructive breast and facial surgery. Dr. McGee is board certified by the American Board of Plastic Surgery and the American Board of Surgery. He has numerous hospital affiliations in the Round Rock and greater Austin areas and is a member of the American Society of plastic Surgeons, American Society for Aesthetic Plastic Surgery, American College of Surgeons and Austin Smiles.

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