Surgery Today–But No Drains are Involved!!

[sider]

What do you think of  a Surgery without using drains?

[Dr. Elliot Jacobs]

Drains are very useful but it is up to the individual surgeon to determine when to use them.  There is no absolute right or wrong in this decision.

I use them only in selective cases -- in probably 98% of my cases, I  DO NOT use drains.  But that is my practice; other surgeons may differ.

Dr Jacobs

[sider]

thanks a lot Dr, my Dr told me the same

[damianz]

I just had my surgery yesterday, performed by Dr Vishal Kapoor in Los Angeles.  He put in drains which he'll be taking out on Monday, three days after surgery.  I don't think he uses them in every procedure, I know one guy from the boards here who recommended Kapoor, but didn't have drains.

I like the idea of the drains helping with the reduction of swelling, and other than being kinda annoying hanging off my compression vest, they're really no big deal.

[Dr. Elliot Jacobs]

As I have previously said, the use of drains is the surgeon's call -- and it is often determined by his assessment at the time of surgery.  Drains may be thought of as a "safety valve" -- to be placed if the surgeon believes there may be a collection of fluid or blood under the skin.  Drains have very little to do with prevention of tissue swelling.

Dr Jacobs

[damianz]

Huh... I had thought the collection of fluid influenced swelling.  At any rate, my main point in commenting was to share my experience that the drains weren't that big of a deal.  I know I did have quite a bit of lipo and gland removal, so my doc must have chosen to use them.  I did have a lot of drainage the first day, it has since tapered off (I'm two days out of surgery), but I can't imagine all that fluid remaining in the area.  Yikes.

[Dr Kapoor]

Huh... I had thought the collection of fluid influenced swelling.  At any rate, my main point in commenting was to share my experience that the drains weren't that big of a deal.  I know I did have quite a bit of lipo and gland removal, so my doc must have chosen to use them.  I did have a lot of drainage the first day, it has since tapered off (I'm two days out of surgery), but I can't imagine all that fluid remaining in the area.  Yikes.

The main reason in your case to use drains was to prevent a fluid collection from forming. With the amount of gland and lipo that we did, we more than likely would have had to aspirate some fluid with a needle after a few days. In the long term, I don't think the drain necessarily prevents or helps tissue swelling or even blood collections, but it does prevent me from having to drain fluid with a needle externally after a few days. yes the drains are inconvenient and somewhat uncomfortable, but i probably use them 80% of the time. Like Dr Jacobs says, it is personal preference and individualized on a case by case basis.

[RSXracer]

Huh... I had thought the collection of fluid influenced swelling.  At any rate, my main point in commenting was to share my experience that the drains weren't that big of a deal.  I know I did have quite a bit of lipo and gland removal, so my doc must have chosen to use them.  I did have a lot of drainage the first day, it has since tapered off (I'm two days out of surgery), but I can't imagine all that fluid remaining in the area.  Yikes.

The main reason in your case to use drains was to prevent a fluid collection from forming. With the amount of gland and lipo that we did, we more than likely would have had to aspirate some fluid with a needle after a few days. In the long term, I don't think the drain necessarily prevents or helps tissue swelling or even blood collections, but it does prevent me from having to drain fluid with a needle externally after a few days. yes the drains are inconvenient and somewhat uncomfortable, but i probably use them 80% of the time. Like Dr Jacobs says, it is personal preference and individualized on a case by case basis.

my doctor used drains. in 3 days they drained about 80 cc of blood and a somewhat clear fluid. they were taken out at the 3 day mark. my right side is still very swollen 9 days post op and i'm worried. i was told that fluid would be drained with a needle today and i was looking foward to it, but the nurse just looked at it, wrapped me up with a tensor bandage and told me to get lost. WTF? i want that shit drained but the surgern wasn't there.

[Dr Kapoor]

I think you need to see your surgeon - you should insist on it. While i'm sure the nurse you saw is qualified, it's really not her decision whether or not you need to be drained. I have had some patients in whom I performed fairly large amounts of lipo / gland excision such that they were very swollen to the point where i thought they might have fluid collections 2 weeks after. I usually tried to aspirate them with a needle, but in most of these patients, it was just prolonged swelling - this is maybe what you are seeing. Nonetheless, I would get in to see your surgeon. Good luck.

[RSXracer]

I think you need to see your surgeon - you should insist on it. While i'm sure the nurse you saw is qualified, it's really not her decision whether or not you need to be drained. I have had some patients in whom I performed fairly large amounts of lipo / gland excision such that they were very swollen to the point where i thought they might have fluid collections 2 weeks after. I usually tried to aspirate them with a needle, but in most of these patients, it was just prolonged swelling - this is maybe what you are seeing. Nonetheless, I would get in to see your surgeon. Good luck.

thanks for the reply. i wish the got rid of some of the swelling with a needle but the surgern wasn't around. i hope next appointment they do. how bad does it hurt to "aspirate" with a needle what should i expect?

[Dr Kapoor]

It's usually not painful at all because your skin is numb for the first several weeks due to the liposuction. It should be pretty straightforward and simple if there is a noticeable collection of fluid- I would get in pretty quick to see him mainly because if there is fluid there for a prolonged amount of time, it can cause a small cavity to develop, not allowing the skin to stick down completely. Good luck

[MA1980]

HI dr Kapoor

I had my surgery two months ago, and still have some kind of swelling under my nipples and beside my armpit, Is it really sweeling eventhough it;s been two months from the surgery. some time I afraid it is fat not a coolection of blood

please advise??

[Dr Kapoor]

HI dr Kapoor

I had my surgery two months ago, and still have some kind of swelling under my nipples and beside my armpit, Is it really sweeling eventhough it;s been two months from the surgery. some time I afraid it is fat not a coolection of blood

please advise??

It is really hard to say without looking at your preop photos and knowing what you had done specifically (liposuction or liposuction plus excision of glandular tissue). In my experience, while swelling may last up to several months (5-6), the vast majority (90%) is usually gone by 2 months, and whatever small amount is left, will continue to resolve over the next few months. It is unlikely at this point that things will change significantly.

Also, did you have lipo in your axillary (armpit) region? And with regards to your nipple - areola area, can you feel anything hard or a discreet mass (just wondering if you have some residual glandular tissue)? It is unlikely to be a collection of blood at this point, mainly because any small amounts that you might have had would have become liquefied and absorbed by your own body's natural mechanisms. Post your preop and current post op pics if possible or send them to info@drkapoormd.com. Feel free to inbox me with any direct questions.

[helloHELLO]

i also had surgery a little over 2 months ago and i wonder if my chest is still somewhat swollen.
i had lipo by the armpit and an incision.  the aerola and the skin that leads to where the lipo is done still feels a little numb, and even a bit sore if i lightly pinch those areas.  and is the skin still tightening after 2 months post op, or has it tightened all it can by 2 months??

[Dr Kapoor]

The numbness is normal for up to several months, so I wouldn't be too concerned about that. In regards to the skin, it probably won't tighten up much beyond this, although if you still have some residual swelling, your shape may continue to change, usually for the better.