My PS does not use drains, I am wondering the difference and the reasoning why a doctor may or may not choose to use them?
What is the Difference Between Using Drains and Not for a Breast Reduction?
Doctor Answers (9)
Use of drains in breast reduction
I agree with Dr. Pousti that there's not much science to the use of drains and it comes down to preference, tradition, weighing of factors, and individual situations.
The purpose of a drain is to prevent a collection of tissue fluid or blood and to allow the skin and tissues to close over the underlying tissues and not sag, scar, or retain fluid that might get infected. The other reason is to not compromise the blood supply to the nipple-areola or other tissues that might be affected by the pressure of a blood or fluid collection, particularly in the first 24-36 hours. Drains will not prevent a hematoma but they can avoid some blood supply and healing problems such as pressure on incision scars. On the other hand they are a nuisance to take care of and have to be removed.
Breast reductions are more likely to bleed into the space under the skin after the procedure because of the tissue removal. Breast lifts are less likely to bleed but there are still blood supply issues. I tend to use drains in breast reduction but not for augmentations or lifts. Other plastic surgeons will handle it differently. There is no correct answer for all patients or all situations.
Drains are not required for breast reductions
Drains are a two edge sword. They might be able to remove some extra fluid in the early time period but if left in place very long they can cause infections. Most patients would rather not have drains in place and the discomfort to remove them. My practice is to not use drains and if there is a fluid collection problem (rarely) I can remove it will a needle aspiration.
Let your surgeon do his or her normal practice and not worry about the drains.
Should surgical Drains be used for a Breast Reduction?
The usage of surgical drains for a breast reduction is personal prefernce for a surgeon. The use of drains has never been shown to reduce complications on a breast reduction. Quite frankly, sometimes I choose to use them and sometimes I do not. If I do use drains I only leave them for 24 hours, even with very large reductions.
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Drains and Breast Reduction Surgery
Drains have been traditionally used to remove excess fluid or blood that may occur from the large dissections necessary for breast reduction. Evidence based medicine shows that they are not necessary for most reductions. There are patients that do benefit from drains however, and those are patients that have liposuction of the low axilla and back areas.
Drains for Breast Reduction?
Thank you for the question.
The use of drains during breast reduction surgery is based on surgeon preference and not any “science” that I am aware of. The use of drains (or not) should not necessarily be a factor in your selection of plastic surgeon.
Using drains with breast reduction surgery
Using a drain with breast reduction is usually surgeon dependent. It is probably unnecessary in most cases, however it may serve to remove excess fluids in the early post-operative period. I routinely use either a suction drain or passive drains (no suction bulbs) for 24hours. I would follow the advice of your surgeon as whether they use them or not is best left to his or her judgment depending on your particular case.
Drains after breast reduction
Drain usage is s personal preference. It also depends upon how much dead space there is created and how much drainage that is expected at the end of surgery. Some techniques limit the dead space more than others. I prefer drains inmost situations.
Drain Usage after Breast Reduction
Drain usage after breast reduction really depends on the surgery performed. In most cases, I do not use drains. However, there are patients with very large reductions or use of acellular dermal products which sometimes require use of drains for a few days. Drains or not, should not be a limiting factor in having the surgery. You should leave it up to the judgement of your surgeon about whether the drains are required.
Web reference: http://www.ShaferPlasticSurgery.com