Are drains or a urinary catheter necessary?

Question

I have been waitlisted for breast reduction surgery. Right now I have no idea when I will go in as the wait time is unfortunately 1-2 years. I will admit that the more I read these stories the less afraid I am, however I wondering about the drains. Are they mandatory? That is the part that scares me the most. I can't imagine getting something yanked out of my skin after surgery. Do you also get a urinary catheter inserted? I do not want that either.

Vincent N. Zubowicz, MD · Answer

I personally do not use drains with breast reduction and seldom use a Foley catheter into the bladder. Different surgeons have different ideas about this however.

Andrea Marando, MD · Answer

Thank you for your question. There is a wide variability in surgical techniques for breast reduction, in relationship with the size to the breasts, the amount of reduction desired and planned, position of the nipples, etc.In my practice, the use of drains in breast reduction is rare (less than 10% on average), the use of urinary catheter even more rare (I do not remember last time one has been used).However there are situations where the use of drains and urinary catheters is appropriate.In the case majority of cases, removing the drains is not a very unpleasant experience.Make sure you ask all the questions you have to your surgeon when you meet him/her and they will be able to clarify their preferences in their practice for breast reduction.Best of luckAndrea Marando

John J. Edney, MD · Answer

I personally rarely used drains after breast reduction.  I don't normally use a urinary catheter either.  Each surgeon however has their own routine.  It will be important for you to discuss this with your surgeon prior to your surgery.

Adam David Lowenstein, MD, FACS · Answer

The answer to your question has more to do with your surgeon than anything else.   Some surgeons use both drains and urinary catheters, others, such as myself, do not use either.  This is a question you should ask your surgeon so you are aware of all of the expectations you should have at the time of your procedure.Good luck, Dr. Lowenstein

Erik Hoy, MD · Answer

Thanks for your question-- The decision to use a drain or not varies by surgeon, and there is good evidence for either using drains or no drains.  This is best to discuss with your surgeon.  They are placed to avoid a fluid collection or seroma, which could cause problems postop.  In terms of the urinary catheter, if your surgery is over 4 hrs, that may be an indication for one.  You'll be getting IV fluids, and the catheter helps the anesthesiologist decide how much fluid to give.  Another option is to have a catheter placed when you're asleep, and removed before you awaken.  Again, these are best addressed with your particular surgeon since he or she will know how long your sugery should take, how much IV fluid is anticipated, and whether or not you'd benefit from drain placement.

Tom J. Pousti, MD · Answer

Congratulations on your decision to proceed with breast reduction surgery; this operation tends to be one of the most patient pleasing operations we perform. The use of drains or urinary catheters may vary from one plastic surgeon to another;  therefore, for relevant/accurate information you will need to run this question by your plastic surgeon. In my practice, urinary catheters are not necessary and drains are usually used. Drain removal can be relatively painless if local anesthesia is used at the time of drain removal. Best wishes.

Alan M. Engler, MD, FACS (retired) · Answer

Not necessarily...but each case is different.  And different surgeons have different routines.  I use drains for larger breast reductions but not for smaller ones, although I use them whenever they appear to be needed (ie, when there is some oozing, or larger spaces in which fluid could accumulate).  Removing them is relatively painless as I bring them out through the incision; the spot where the drains were do not need to be sutured (stitched) closed, and heal up well (since they're within the area that will be a scar anyway).The longer the procedure the more likely I am to recommend a urinary catheter as it allows the anesthesia team to monitor urine output (and function) and if you don't have one, and have a several hour surgery, the first thing you want to do when you wake up is go to the bathroom.  Having a catheter in place often allows for a smoother procedure and recovery.Again, though, each surgeon has his or her own routine.  And I would advise you to select a surgeon based on reputation and how comfortable you are with that person, rather than details - however much the thought bothers you - such as these.I hope that this helps and good luck,Dr. Alan EnglerMember of RealSelf100

Are drains or a urinary catheter necessary?

Answers (7)

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