What can I do to decrease my fluid output so that I can have my JP drains removed after having them for 3 weeks already?

Question

I had a bilateral mastectomy with TE's in Oct 2014. My swap was 3/2015. On 6/29, I had a revision done - larger implants with Alloderm above/below each breast and fat grafting. Tomorrow is 3 weeks since my surgery and my fluid output is 40-50cc in both my drains. I have worn my surgical bra and stayed inactive during that time. What else can I do to help decrease my output? I've read that a low-dose steroid injected into the drain can sometimes help? Any advice is appreciated. Thank you!

John Michael Thomassen, MD · Answer

Drains after mastectomy typically stay for 3-4 weeks so you are close to having them removed. The issue is lymphatic drainage from excision of breast tissue in the area of the axilla.  It is best to not rush this process and allow it to resolve on its own.

Damian Marucci, MBBS, PhD, FRACS · Answer

I'm sorry to hear of the problems you've been having. Prolonged drainage following implant based reconstruction, especially those using an ADM like alloderm, is pretty common. You need to make sure you have no signs of infection like redness, swelling or fever. Make sure the fluid in the drainage tube is straw-coloured. I don't advise putting anything down the drain as that may introduce bugs to the implant site.I know the drains are painful and not being able to shower is annoying (well, I don't let my patients shower with drains following implant surgery), but a drain is infinitely better than a fluid collection (seroma) that would result if your drain was removed too early. A seroma can lead, in turn, to implant infection and loss. Hang in there! See you plastic surgeon regularly to make sure everything looks ok.Good luck and I hope things dry up soon.

Tracy Kayan, MD · Answer

I have found that particular patients just always have higher drain outputs, no matter what the surgery. There is usually a sign of this with the 1st stage of reconstruction when the tissue expanders are placed. I've had patients have their drains in as long as 5 weeks. It sounds like you are doing all the right things so far with compression and staying inactive in your upper half. Additional compression can always help, as I find that post op bras don't always fit everyone tightly enough. You can try an ACE wrap or a sports bra that zips up in the front. I try to avoid injecting any type of foreign substance into the drain, as it's sitting next to the implant, and I'm not completely comfortable with injecting any sort of particulate matter (such as steroid) into the area around the implant. Every surgeon has his/her own preferences regarding steroid injection, but you want to make sure you are not doing anything to increase your chances of introducing infection to your implant.In terms of activity, you really need to limit your upper body movements. I had a patient once who used her arms very enthusiastically every time she talked, and this was causing her drain outputs to be high due to the added activity, so we ultimately solved this by having her keep her hands in her pockets whenever talking, and that seemed to do the trick. It could just have been a coincidence in timing, but some people use their chest/arm muscles a lot more than they notice in everyday activities.

Jonathan Zelken, MD · Answer

Dear BBBaker,I imagine three weeks surely feels like an eternity, but you are almost there.  Depending on your surgeon's preferences you are getting close, and it sounds like you've done everything you can to get the drains pulled. Compression/surgical bra, rest, and a healthy diet are your best bet. I do not know of any further interventions that are safe and proven. I hope this helps!

What can I do to decrease my fluid output so that I can have my JP drains removed after having them for 3 weeks already?

Answers (4)

Answer: You're doing everything you can.

Answer: You're doing everything you can.

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Everything you need to know about Breast Reconstruction Revision

Our mission is to create a world where every investment in modern beauty is Worth It.

What can I do to decrease my fluid output so that I can have my JP drains removed after having them for 3 weeks already?

Answers (4)

Answer: You're doing everything you can.

Answer: You're doing everything you can.

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Recommended reading

Everything you need to know about Breast Reconstruction Revision

Our mission is to create a world where every investment in modern beauty is Worth It.