Why do some surgeons use drains after Breast Reduction Surgery and others don't?

I find drains to be very useful after breast reduction.  There is very little downside to using drains.  However, fluid collection after surgery which can result from not using drains can be a significant problem.

Many surgeons use drains because that's just what they do.  That's how they were taught and that's how it's going to be.  Most surgeons that have trained within the last 10 or 15 years use drains when they are needed.  Decisions that tend to lead me to use a drain would be if there was abnormal bleeding/oozing during the case or or if multiple cysts were ruptured during the case, and I was concerned about an infection.  Other times I may use drains would be with the shorter scar breast reductions that limit scarring but have potential to leave a 'dead space' (an open area) within the breast.  Your body will not tolerate such a space and quickly will fill the area with fluid.  In that case a drain would be used.  All that being said, drains are not the end of the world, and after a couple days they will come out.  If you are comfortable with your plastic surgeon, and you trust him or her, then go for it.  Best wishes.

Some surgeons were trained to use drains, most surgeons who are trained more recently do not.  There may be a reason to use drains in some cases, but routinely drains for breast reductions are not necessary.

Thank you for the question.Congratulations on your decision to proceed with breast reduction surgery; it is one of the most patient pleasing operations we perform.You are correct in that some surgeons use drains, some don't;  if I were you I wouldn't be too concerned either way. As long as you have picked your plastic surgeon carefully you can be confident that you should do very well.Best wishes.

This is a good question but as has been mentioned there two ways doctors approach this procedure.  There is no hard evidence that drains have an advantage over no drains.  Drains do not decrease the incidence of bleeding but I do use them to decrease the swelling and bruising which helps the patient recover faster. Neither approach is wrong.

The use of a drain is largely related to the amount of breast tissue removed. The more that is removed the more likely a drain will be necessary. It does not decrease the incidence of postoperative bleeding (hematoma) however, it does decrease the the edema (swelling ) in the area. 

You will find all sorts of variations in personal preference between equally good surgeons. I'm in the no drain camp for 90% of my breast reduction patients as I find they provide no significant benefit. Other doctors will feel differently.