Drainage Post- Capsulectomy on One Breast

Hello! Thank you for your question! It is a matter of surgeon
preference as well as what is seen during your procedure that will
determine whether or not a complete capsulectomy is performed. If
significant capsule formation is seen intraoperatively, a full capsule
removal may be warranted with a drain in order to completely remove all
of the tissue and allow better adherence of your breast back to its
normal anatomic position down on your chest wall. If minimal contracture
is seen, it may be possible to leave the capsule, or place cuts within
the capsule to allow better adherence. It truly is dependent on what is
seen with your capsule and the issues that may be causing you to have
such a procedure (e.g., contracture from ruptured implant vs pain vs
simple pocket adjustment, etc). Implants mayor may not be replaced depending on your discussion and reason for capsulectomy.  Drains will usually be removed when less than 30cc/day.  Typically they stay for as long as needed.  It is not uncommon to have such drainage after a complete capsulectomy.Without
knowing your issues and
without an examination, it is difficult to tell you what may be the
best thing for you. I tend to favor performing capsulectomies (in an en
bloc fashion) in order
to create a fresh pocket, reshape the pocket, allow better shape and
adherence of the overlying breast. I would discuss your issues with your
plastic surgeon who will assist you in determining the right modality
for you. Most patients tolerate this procedure very well with minimal
downtime. It is typically an outpatient procedure with most being able
to resume activities within a few days along with restrictions for a
week or so. Many surgeons will recommend a postoperative garment for
several weeks postop as well. Hope that this helps! Best wishes!

Thank you for the question.

Drains are commonly used after capsulectomy. Removal of the drains will vary from one practitioner to another;  it is a judgment call made by the surgeon who knows your situation best.

Best wishes.

Placing a drain after a breast capsulotomy is common.  Although there is no standard amount in which surgeons decide to pull a drain, most will do so after it's draining less than 25 or 30 ml/day.   Individual surgeons may modify that based on specific findings during surgery.

It is fair to ask your surgeon when he or she is planning on pulling it out and what daily output they are comfortable with.   You also have an idea of how much is too much so that you know to call your surgeon if a problem should develop.

Having had at least one Capsular Contracture complicating your breast Augmentation which required surgical removal of the scar and releasing its squeezing of the implant I can understand why you would want everything to go well after the scar removal. We usually put a drain in in surgery when we anticipate the body will produced fluid which may either get infected or prevent the walls of the wound from coming together and healing. As long as fluid is coming out at a certain daily volume, it is best to leave the drain in. When the volume falls beyond a certain number the drain can be removed. The volume of drainage at which a Plastic surgeon would remove his drains VARIES widely and is based on the surgeon's experience and preference; it is the ART of practicing Medicine.  If I were your surgeon I would be VERY unhappy to find out you were shopping for advice on-line and second guessing my treatment. Please, call your surgeon and ask him when he would like to remove the drain.

Dr. Peter A Aldea

Every doctor has different criteria for drain removal. I usualy wait until it is less than 30 cc/24 hours.  You should just check with your doctor.

This really depends on surgeon preference and on your specific procedure and to some degree any special findings at surgery. Who better than your surgeon should be answering this question for you?

This is an individual decision made by your doctor, not appropriate for on line input.  I personally take them out when under 25/day but your doctor may differ.  Why did you bother to ask this on line rather than just calling the office???