Can drains cause capsular contracture?

My surgeon used drains after surgery and they were taken out the next day. One year post op I started to develop CC in one of my breasts. Could the usage of drains have caused the hardening of the capsule?

Doctor Answers 6

Can drains cause capsular contracture

 Thank you for your question. There are several theories why capsular contracture occur. The use of the drains in itself should not be the reason. I have performed thousands of breast augmentations and have NEVER used a drain.  I see my aug patients yearly and have an extremely low capsular contracture rate. There is no need for a drain if the dissection is meticulous and essentially blood less. Good luck. 

Scottsdale Plastic Surgeon
4.9 out of 5 stars 35 reviews

Drains do not cause capsule contracture

The use of drains is to remove the collection of bloody fluid which may accumulate around a breast implant after surgery.  The degree of fluid collection will vary with the individual.  I've noticed most Caucasians do not drain very much and often the drains become light and serous in color within a day or so after surgery.  Many Asians tend to drain much longer usually 5-6 days.  It may a factor of their diet and how active they are after surgery.  Eating lots of garlic, ginger and spicy food leads to a prolonged bleeding time. 

It is a known fact that blood around an implant can stimulate more scar formation.  Also more blood around the implant can increase the chance for colonization of the pocket with bacteria which subsequently causes a biofilm to occur.  These are some of the factors which cause capsules to form.  A capsule that forms a year out in only one of your breast is related to some type of traumatic injury of the breast.  Often it is the dominant side i.e. the right side in a right handed person.  Overuse of the arm and pectoralis muscle can lead to tears in the capsule of the breast with subsequent scarring.  The scars which forms depend on where the tear is and where the blood accumulates.  If the tear is on the top near the pectoralis muscle the upper pole will close.  If the blood collects along the bottom of the breast then the lower pole of the breast will tighten and contract.  This will push the affected implant up higher and create a condition where that contracted breast sits higher than the unaffected side.  Certain activities which is quite vigorous can lead to tears in the breast capsule.  Weight lifting, tennis, golf, surfing, paddling canoes, etc. has been shown to injure the breast capsule when these activities are done within 6 months of the surgery.  It takes time for the capsule of the breast to soften.  Once softened and pliable the capsule is less easily torn and more resistant to injury. 

Benjamin Chu, MD, FACS
Honolulu Plastic Surgeon
4.8 out of 5 stars 92 reviews

Can drains cause capsular contracture?

Thank you for your question.  Drains should be used when there is excess bleeding burring of breast augmentation and a removal of blood and fluid should lessen the risk of capsular contracture.  Preferably the drains are taken out  the day after.  There are some studies however that suggest when drains are routinely used during breast augmentation there is a 1.5% increase  in the risk of capsular contracture.  However that risk is definitely outweighed by the importance of using drains when there is excess bleeding during the procedure.

Drains causing capsular contracture

Drains are not thought to cause capsular contractor. As a matter fact in my opinion they help prevent it by removing blood and fluid from the pocket . Blood is extremely stimulating for causing capsular contracture.  In your case the drain was not possibly an issue because of the late occurrence. Capsular  contracture is thought to occur from bacterial contamination from your skin or breast during surgery.  At a later date capsular contracture is still  somewhat of a mystery. However I have seen it associated with dental surgery or a dental cleaning which is thought to be bacterial contamination from the mouth into the bloodstream  in addition I have seen it associated with a severe cold or flu.  Sometimes it can happen years after the surgery for no apparent reason.  At this point you should consult your surgeon to see what he wants to do. There are medications and laser treatments which can help prevent a secondary surgery. Sometimes despite all efforts a secondary surgery is needed 

Andrew Kaczynski, MD (retired)
Sacramento Plastic Surgeon
4.9 out of 5 stars 110 reviews

Can Drains Cause Capsular Contracture?

Drains are not associated with an increased risk of capsular contracture, especially if used short term like yours were. Capsular contracture does occur late after surgery and is typically associated with a low grade bacterial infection that inflames the tissues. The infection rarely causes fever and illness, it just makes the breast capsule tighten up and can distort the shape of the implant.

There are other causes of CC like excessive bleeding during surgery, but this usually presents earlier after the procedure.

I would recommend that you follow up with your surgeon. Massage may soften the contracture or you may need surgery. Some of the implant companies do have a warranty that covers implant replacement costs if you need additional surgery.

Don W. Griffin, MD
Nashville Plastic Surgeon
4.8 out of 5 stars 73 reviews

Can drains cause capsular contracture?

Thank you for sharing your question and I am sorry to hear of your capsular contracture issues.  Drains are not thought to be a risk factor for capsular contracture development, especially if placed for less than 24 hours.  Leading thoughts on the development of implant hardening is the result of bacterial colonization of the implant and/or any blood that remains in the surgically created implant pocket.  Hope this helps.

Nelson Castillo, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 68 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.