How Long Can You Keep a Drain I After Breast Surgery?

Question

I had a breast reduction 10 days ago. One drain was removed the other not. It is still draining at least 20cc a day is this normal? How long can you keep it in?

J. Timothy Katzen, MD, FACS · Answer

Typically, drains are removed when they are putting out between 20 and 30 cc a day. 
	Every plastic surgeon is different. I do not often use drains for my breast reductions.  Drains may need to stay in as long as the fluid is continuing to build up. 
	As long as fluid is being produced in an excess of 20 cc a day, I would leave the drain in even if it takes several months.
	
	Thank you,
	J. Timothy Katzen, MD, FACS

David Shafer, MD, FACS · Answer

In most cases I do not put drains after breast surgery.  However, if you do have a drain, generally it is removed a few days after surgery.  At 20 cc per day, it can likely be removed.  However, you should discuss this with your surgeon since we do not know all the details of your surgery.

	 

	Good Luck.

Barbara L. Persons, MD, FACS · Answer

Your question is a good one! A notable variation between surgeons is use of drains: when they are used, how long they are left in, and what purpose is served. Still, (and despite their widespread use) there is not much evidence-based data on the management of closed-suction drains. Many surgeons use volume criteria, such as removal after a drain puts out less than a certain amount of fluid per 24 hours. Others will discontinue the drain at the same time post-op antibiotics are stopped (antibiotics are another topic that varies) while still others consistently take out the drain on a designated post-op day. One question you might want to pose to your surgeon is, "What is your criteria for drain placement and removal?" This way, you know what to expect; it's always good to be a part of the process.

	 

	Congratulations on your surgery!

	 

	Best,

	Dr. Barbara Persons

Robert L. Kraft, MD, FACS · Answer

Use of drains is a function of training and experience.  I prefer to use them in breast reduction and abdominoplasty. The drains are removed once drainage has reached a baseline level.  Certainly there is a balance between retaining the drains and risk of infection.  This should be determined based on the facts and circumstances of each case.

Tom J. Pousti, MD · Answer

Congratulations on having undergone the breast reduction procedure; this operation tends to be one of the most patient pleasing operations we perform. You will find that the management of drains will vary from one surgeon to another (if they use them at all).  Some will remove the drains 1 to 2 days (regardless of the output), some will remove the drains when the output is below a certain level (as long as a few weeks). For the most precise  information regarding removal in your case,  you will be best off running the question by your plastic surgeon.

	Best wishes.

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