Drains after BA? Pros/cons? Surgeon's discretion?

Hi! I'm wondering why some surgeons choose to use drains after a breast augmentation, while others don't. What are the risks and benefits of using the drains, and what are some reasons that you would choose to use them or not use them? Thank you!

Doctor Answers 14

Breast augmentation

Hello and thank you for your question.  Most board-certified plastic surgeons will not use drains in primary breast augmentation.  For complex revision cases in which extensive capsulectomy is performed, then drains should be used.  The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon


New York Plastic Surgeon
5.0 out of 5 stars 79 reviews

Drains

I do not routinely use drains after a primary breast augmentation, but I often use them in secondaries where a capsule may have been removed or extensive work was done and I am concerned about fluid accumulating.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

No drains after breast augmentation

In over 4000 breast augmentation procedures, I have never used a drain for primary breast augmentation. Nevertheless in order to avoid the use of drains, the procedure must be performed in the most atraumatic way possible, with close to zero blood loss as in our Rapid Recovery approach. Drains are only required if there is excessive bleeding or oozing of fluid at the end of the procedure, and the Rapid Recovery approach using meticulous technique minimizes the risk of bleeding or excessive oozing. Even with textured implants which I occasionally use, use of a drain does not decrease the risk of fluid accumulation or seroma, as when these do occur they often occur some time after the procedure due to the rubbing of the rough textured surface. In more complex breast revision surgery, with removal of scar tissue, combined breast lifts etc, it might be advisable to place a drain for a maximum of 24-48 hours. The risk of a draw is that it may allow contamination of the implant from bacteria tracking back from the outside along the drain

Jeffrey Hartog, MD
Orlando Plastic Surgeon
4.5 out of 5 stars 59 reviews

Old School

If your surgeon is old or in a different country, you might have drains. There is zero reason for drains in a primary breast augmentation and then only have cons: pain, risk of infection, etc.I would absolutely never let a family member have an augmentation by a surgeon who is recommending drains.

BA and use of drains

Thanks for posting your question. 
The use of drains in primary (initial) breast augmentation is typically only associated with the use of textured/shaped implants. The need to use drains in these procedures relates to making sure that the implant has no ability to rotate within its pocket.
When using round silicone implants, there is typically no reason to use drains unless it's a revisional surgery.
Hope that clarifies things a bit.

Breast augmentation

A drain can allow bacteria to migrate from the skin surface to the implant pocket.  Achieving meticulous hemostatis intraoperative is preferable.  

John Burns, MD
Dallas Plastic Surgeon
4.6 out of 5 stars 33 reviews

Breast surgery

I do not use drains with breast augmentation.  I selectively use drains with breast mastopexy and augmentation.  I use drains when they are necessary but I always discuss with patients at the pre-operative appointment if drains will be necessary.  Please discuss with your surgeon prior to surgery if he/she thinks drains will be necessary.

Saira Saini, MD
Fayetteville Plastic Surgeon
5.0 out of 5 stars 3 reviews

Drains after BA? Pros/cons? Surgeon's discretion?

Thank you for your question.  In my experience, surgical drains are not used following a primary breast augmentation. I typically use a transaxillary approach to breast augmentation, which leaves no scar on the breast itself, but rather a very tiny incision under the armpit and have never used a surgical drain post-operatively.  Many plastic surgeons use a surgical drain following tummy tuck to reduce the incidence of seroma (collection of fluid)  but with newer techniques such as progression tension sutures, I have not used surgical drains post-operatively for tummy tuck for the past 5 years with no increase in the incidence of seroma. You might want to seek a second opinion from another board certified plastic surgeon with extensive experience in breast augmentation before proceeding with your surgery.  Best of luck to you.  

Steven L. Ringler, MD, FACS
Grand Rapids Plastic Surgeon
5.0 out of 5 stars 61 reviews

Drains with breast augmentation

hello.  Thanks for your inquiry. We use drains when there is a lot of space created---like a big reduction or lift  when there is just a simple augmentation.  Adding an implant should not require a drain to help since there is no increase in empty space( like a breast reduction).  Hope that helps answer your question.  Thanks

Sanjay Lalla, MD, FACS
West Orange Plastic Surgeon
4.9 out of 5 stars 45 reviews

Drains after BA? Pros/cons? Surgeon's discretion?

This would be rare after a first-time augmentation. However if you are having additional work done to the breast pocket such as placement of mesh or another material to reinforce the fold, drains are commonly used. If your surgeon has a good reputation and you trust them, I would suggest following their suggestion. Hope that helps!CDK

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.