Are drains required to prevent seroma after implant removal?

Question

I’ve read stories from women who had explant + fat transfer and suffered from seromas after surgery. They did not use drains. Will the use of drains help prevent seromas from forming after explanation?

Daniel Barrett, MD · Answer

Dear botched2017,
every plastic surgeon has his preferred technique. Some will use drains others won't. Drains are use to drain fluid and prevent seroma which can often occur after implants removal. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Gary M. Horndeski, MD · Answer

After the implant is removed the empty space can accumulate fluid.  A drain can help prevent that.  However, women who undergo explant alone are frequently dissatisfied because of the empty appearance, hanging skin and require a lift.  The technique I recommend is explantation and a lift using The Bellesoma Method.  The implants are removed, your breast tissue is reshaped creating upper pole fullness, elevated higher on the chest wall and more medial to increase your cleavage.  Vertical scars are avoided, nipple sensation and the ability to breast feed are maintained, if not injured during your previous surgery.  At the same time or later, fat transfers can be performed if additional volume is desired.    Best Wishes,Gary Horndeski, M.D.

Kenneth Hughes, MD · Answer

Drains may assist in reducing the risk for fluid collection in this scenario (breast explanation, fat transfer). Some PS will use drains; others will base their use on the patient's surgery and anticipated problems with healing.

Ryan Couvillion, MD · Answer

In general, I use drains when doing an explantation, especially when performing a capsulectomy.
I like to explain it like this - The implant has created a cavity that the body needs time to heal.  The drain helps to remove any extra fluid that the body puts into this space during the healing process.
Drains cannot completely prevent a seroma, but they can decrease the chance of it happening.
The drains are usually present for about a week, but this time period varies by how much is draining.

Jeanette Padgett, MD, FACS · Answer

Not every surgeon uses drains after removal of implants.  I prefer to use drains when implants are removed, to decrease the chance of seroma formation.  Discuss with your surgeon your concerns.  Best wishes.

Joshua A. Halpern, MD, PA · Answer

A seroma a is a fluid collection. It’s not uncommon for surgeons to use drains when performing explant. There are different types of drains one can use. I prefer to use small diameter ones. They tend to be very well tolerated by the patient. I hope you find this information useful.

Camille Cash, MD · Answer

The use of drains varies by surgeon and patient circumstance.  Drains are helpful to prevent seromas which can sometimes occur when implants are removed.  I encourage you to discuss your surgeon's preference and rationale.  It's important to feel comfortable and confident in your surgical plan.

Connie Hiers, MD, FACS · Answer

Drains do help prevent seromas, but a seroma still may form even with a drain. Each surgeon decides when he/she thinks it is best to use/not use a drain.

Susan Buenaventura, MD, FACS · Answer

Hello, drains are beneficial after implant removal to prevent seroma.  Seromas are difficult to treat sometimes and best to avoid rather than treat.   Your surgeon will likely recommend whatever has worked best for them previously.  Best wishes to you.

Tom J. Pousti, MD · Answer

Thank you for the question.
In many areas of plastic surgery, including breast implant removal surgery, you will find many different (often strong) opinions as to the best way to handle a specific situation. In my practice,  I always use drains (to evacuate fluid from the space where the breast implants were removed).   Seroma formation is unusual after drain removal.   
Hopefully, you have chosen your plastic surgeon carefully; do not hesitate to address your questions/concerns directly to him/her and ask about the rationale behind any decisions that you question. Best wishes.

Are drains required to prevent seroma after implant removal?

Answers (11)

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