What is current practice for JP drain removal after strattice augmentation due to prior capsular contracture of one breast?

Question

I had implant removal (3 year old implants ~330cc) with a moderate capsular contracture of only one breast- replaced with approximately same sized impants. I am in my 30s and very active and healthy. I understand JP drain removal varies by surgeon, but my drains have been in for 12 days and they are draining less than 15 ml per day per drain of serosanguinous fluid, but my surgeon will not remove them. They are very irritating to me.

Jeffrey J. Roth, MD, FACS · Answer

Thanks for the question. Typically JP drains are removed after at least a week if the output is less than 30cc per 24 hours. That said, each Plastic Surgeon is different, and each patient is different. This is especially true of your operation. How extensive was the capsulectomy/capsulotomy? What did the Plastic Surgeon see when they were looking at the pocket? There are many variables. Best to ask your Board Certified Plastic Surgeon. They should be able to inform you of the reasons behind the management.

Jeffrey J. Roth, M.D., F.A.C.S.

Board Certified Plastic Surgeon

Las Vegas Plastic Surgery

Jeffrey J. Roth, M.D., F.A.C.S.

Board Certified Plastic Surgeon

Las Vegas Plastic Surgery

John Michael Thomassen, MD · Answer

Most surgeons wait until less than 30cc per day is coming out to remove a drain.  The use of biologic mesh may increase the risk of seroma so some surgeons wait a definitive time frame like 2 weeks regardless.

Tracey H. Stokes, MD · Answer

I typically remove drains when they are consistently less than 30cc over a 24 hour period.  You should discuss with your surgeon his/her reluctance to remove your drains.  There is probably a specific reason he/she wants to leave them in.

Jeffrey A. Sweat, MD · Answer

A general guideline for removing drains is less than 30cc of drainage in a 24 hour period for a couple of days in a row, but your surgeon may be using more caution since he used strattice.  The Strattice needs to heal into place and a fluid collection could prevent that.  You should address your concerns with your surgeon and make sure you understand why the drain tubes may be left in longer.

Richard Baxter, MD · Answer

Drains are important after capsulectomy and placement of an acellular dermal matrix such as Strattice, in order to prevent fluid accumulations called seromas and to help ensure that the material incorporates. Your surgeon must have a specific reason to leave the drains in at this point. A common guideline is minimum 7 days or so, then based on less than 25 cc's per day for 2 days.

Steven Wallach, MD · Answer

Each surgeon is different. This is something to specifically address with your surgeon.  The less fluid the better when it comes to breasts and foreign materials.

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What is current practice for JP drain removal after strattice augmentation due to prior capsular contracture of one breast?

Answers (6)

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