How Much Drainage from Tubes is of Concern?

Question

I'm emptying about 40 mL out of both breasts every 4 hrs., the 3ed day after breast augmentation surgery. It seems like a lot. We are hoping it will slow down greatly over the next few days and get my tubes out on day 6. Just worried over the amount I am loosing, and has anyone had a similar experience, or any advice?

Richard H. Tholen, MD, FACS · Answer

I am sorry to be a spoilsport, but I believe that any surgeon who uses drainage tubes for "standard" breast augmentation is causing their patients to have a higher risk of infection, capsular contracture, and re-operation. If the pocket is created atraumatically, without blunt dissection, and with precise and complete bleeding control, drains are neither necessary nor desirable!

	Sure, if this surgeon's type of breast implant surgical technique causes so much bleeding that a drain is "needed" to evacuate the blood and serum from their patient's breast pockets, a drain may reduce the re-operations for hematoma. But allowing a portal for blood and serum to drain out also can allow bacteria IN, which is an absolute major problem when implants are involved. Bacterial contamination can occur, and biofilms (even from "normal" skin or intraductal bacteria) can stimulate capsular contracture. I have done thousands of breast augmentations for over 24 years without one drain being used or "necessary." Ask an orthopedic surgeon if he or she uses drains in "standard" hip or knee replacements. Too much risk of infecting the hip or knee components! The same goes for breast implants!

	240cc drainage per day at 4 days post op is a lot of drainage, and I personally think you are right to be concerned. I truly hope this turns out to be "no problem" after your drains are removed, but I already question the judgment that allowed their use in the first place. If you have problems of any kind, please consult with several ABPS-certified experienced plastic surgeons who do lots of breast surgery before doing anything else! Good luck and best wishes!

Adam Hamawy, MD · Answer

It is very uncommon to have drain tubes placed after a routine breast augmentation. However, there are some situations that may require there placement. As long as the drainage is decreasing and not bloody then I wouldn't be too concerned, however, you should check with your plastic surgeon just to be sure.

J. Gregory Kjar, M.D. (retired) · Answer

First of all, I usually don't use drains for the breast augmentation procedure. Drainage should start to chage to a watery yellow or ink drainage unless bleeding is actively going on. You should contact your physician to see if this is normal for his patients. Personally, I like to see under 30 ml in 24 hours to remove the drain hence the 40 ml every 4 hours is 8 times that amount. I would suggest that you see your doctor soon.

Mark B. Constantian, MD, FACS (retired) · Answer

That much drainage calculates to 240 cc or 8 ounces each day. That's more than usual. If it is clear, you may just need time. If it is blood, call your surgeon and get checked. Either way you should be seen.

How Much Drainage from Tubes is of Concern?

Answers (4)

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