Can drains cause capsular 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. 

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.