Are drains necessary when getting capsulectomy?

Unfortunately, there is no 100% correct answer to this question, and it can depend on the procedure, surgeon preference, and the implant chosen. One reason for using drains is to decrease "dead space" (for example the space left after an implant is removed or changed to another location). Another is to help drain excess fluid that can surround the implant. I'm more likely to use a drain if I am removing an implant and leaving it out or repositioning an implant to a different pocket (in which case a graft or sling is sometimes needed to help keep the implant in the right place). I'm also more likely to use a drain if a textured or shaped implant is being used. As as far as whether it's appropriate to switch your implant to under the muscle, it depends on a few things, but mainly which type of implant you are using.  Above the muscle, a shaped/textured implant will have a lower rate of capsular contracture. If you want a smooth round silicone or saline, you will decrease your risk of recurrent capsular contracture, at least statistically speaking, by going under the muscle. Unfortunately, for each individual, there is no guarantee. Best wishes. 

I prefer to use drains following a capsulectomy for multiple reasons. A true capsulectomy causes a lot of inflammation and can lead to significant fluid accumulation around the new implant. The new capsule which forms will be influenced by this inflammation and this may lead to a recurrence of contracture. This is why drains are beneficial - they drain that fluid. Typically, the drains are only necessary for 5-7 days. As for switching the implant position from above to below the muscle, this is more complicated. It depends upon the amount of breast tissue covering the upper pole of the implant. If the edge of the implant is obvious, a site switch to a submuscular pocket will camouflage the implant and give you a better look. Switching to a submuscular position can also help reduce the recurrence rate of a capsular contracture, but care must be taken to prevent the implant from "flipping" back into the old space. I would recommend seeing plastic surgeons who specialize in breast implant revisions. Redoing a redo can become expensive quickly!

Removing the capsule can leave a raw surface which oozes. Despite the skill and care provided at surgery, conditions can cause fluid to accumulate.  This is why many surgeons advise drains. With a dry surgical field, and easy capsule removal,  occasionally, drains may not be necessary.  Please follow the advice of the surgeon you select and take good care after surgery.