When you have surgery you might not know about drains. I still remember when I was in my first year of general surgery residency, and I walked into a patient’s room and saw all of these tubes sticking out of his abdomen. Thoughts raced through my mind. EGADS! Does someone know about this? Isn’t something bad going to happen? I should tell someone! What about infection?
Drains are not used in every surgery.
In plastic surgery, they are used in only a few types of cases. These cases are ones where we are elevating tissue and creating a space. Not all doctors will use them in these cases, but common ones are:
- abdominoplasty
- facelift
- breast reduction
- implant removal
Why use a drain?
The body doesn’t like to have spaces between tissue, so it reacts by releasing fluid. This fluid is called serous fluid. When mixed with a little blood (which is usually the case right after surgery) it looks like pink koolaid. The drainage fluid will get lighter as time goes on.
If fluid accumulates between the tissue layers, the tissue can’t heal and glue itself back together to seal off. We put drains in to suck out the fluid.
When the tissue has healed together, your body stops making fluid, and it is safe to remove the drain. How long a drain stays in can vary from a few days to a few weeks. Once the tissue has glued itself back together, there is no “space” there anymore, and the fluid production stops.
If the drain comes out too early, the risk is the fluid is forming and will collect under the skin. This can form a seroma (a fancy way for saying a collection of serous fluid). If you get a seroma, we will remove the fluid with a syringe and needle in the office.
What does it look like?
The drain itself is a plastic tube with little holes inside to drain the fluid. It carries it through a clear plastic tube and ends in a bulb which looks like an egg. For the drain to work the bulb needs to be collapsed to create suction. The drain is placed during the surgery and usually sutured to the skin, where it comes out through a tiny opening in the skin. A commonly used drain is called a JP or Jackson Pratt drain.
How do you take it out? Does it hurt?
Drains are removed in the office. They rarely hurt to remove, but it can be slightly uncomfortable. No medication is needed. You are able to take out the drain safely when the amount of fluid is low. For every doctor the exact number varies for when it is okay to remove.