Why do some people have drains post breast augmentation surgery?

A surgical drain is a tube that’s
inserted during surgery. It’s used to remove fluids or blood from a wound so
that the tissues heal together better. I have never used drains and don’t
recommend drains to my patients for elective cosmetic breast augmentation
surgery. During this surgery, no tissue is removed and there is minimal
bleeding.



A study conducted by two British
surgeons who placed drains after breast augmentation surgery reported a 10
percent infection rate in their patients. They suggested that the drains, which
could act as entry site for bacteria, possibly caused this high rate. The
bottom line: The advantages of using a drain have to outweigh the possible
disadvantages. That’s likely the case in breast reconstruction surgery after a
mastectomy, where drains are commonly used. For more information on this topic
and others, I recommend a plastic surgery Q&A book like "The Scoop On
Breasts: A Plastic Surgeon Busts the Myths."

Although drain tubes are very useful in operations which require elevation of large pieces of skin such as the tummy tuck and breast lift reduction, they are not necessary for first time breast augmenation.  Having a drain next to an implant increases the risk of infection, which is not wise when performing breast augmentation.

Typically you should not require a drain after a primary augmentation. Revisionary surgery may necessitate the use of drains depending on what was done but if your surgeon is suggesting drains for a primary then that should raise some red flags. Get a consultation with a board certified plastic surgeon near you to discuss your options. Best of luck!

Drains are used to remove fluid from the breast pocket. Blood in the
pocket (hematoma) can lead to capsular contracture (hardness of the
breasts).If the breast pocket is dry, without bleeding at the
time of surgery, drains are unnecessary, when having a primary breast augmentation.Yours,Jon M. Grazer, MD, MPH, FACSPlastis SurgeryNEwport Beach, CA

 The vast majority of plastic surgeons do not use drains with breast augmentation. The occasional plastic surgeon does. It is not a right or wrong thing to do. Discuss your surgeon's philosophy about drains with him or her.

Drains are typically used to remove fluid or blood that collects in the breast cavity after surgery. This can help to prevent a long standing fluid collection or infection. Drains are removed once the body is able to absorb that fluid itself (1-2 weeks post). The use of drains after a breast augmentation is based on surgeon preference. I don't typically use drains in my breast augmentation patients because the amount of fluid produced after surgery is minimal. 

Usually for a primary breast augmentation surgery you will
not need drains. There are some situations such as revision breast surgery or
having to remove implants and the capsule that forms around them that a drain
will need to be let behind. Drains are placed to help any dead space that may
exist where fluid can collect. In a primary breast augmentation this is not an
issue.

     Drains are becoming less and less common in plastic surgery procedures.  The vast majority of plastic surgeons do not use drains with breast augmentation surgery and there is no evidence that drains improve the outcome of the surgery.  Drains do contribute to more post-operative discomfort.      In some situations, however, drains may be used to assist in approximating tissues that have been widely dissected (separated from their normal attachments), such as in body lifts or extensive abdominoplasties.

There are a very few plastic surgeons who place drains with a primary breast augmentation. Their belief is that the drains may decrease capsular contracture and/or the development of fluid around the implants. To my knowledge there are no scientific studies that support those theories. Consequently, the vast majority of plastic surgeons do not use drains with a breast augmentation. Having said that, it is not wrong to use drains but rather a difference in philosophy. Some plastic surgeons would argue that the presence of drains near an implant can increase the risk of infection. I personally believe that drains can increase the risks with little potential gain and therefor I do not use them for this operation.For the best results seek the consultation of a plastic
surgeon certified by the American Board of Plastic Surgery. They have a website
listing all the certified plastic surgeons. Members of the American Society of
Aesthetic Plastic Surgery will all be board certified in plastic surgery and
have demonstrated an interest and competence in cosmetic plastic surgery as
well.

You will find the different plastic surgeons have different “methods”. Personally, I do not use drains for breast augmentation surgery; I do however use them for some revisionary operations. Key to success with breast augmentation surgery: select your plastic surgeon carefully and communicate your goals carefully as well.  You will find a lot of useful information (in this regard) on this website and on the attached link as well. Best wishes.