Breast Augmentation & Surgical Drains

Recently, a patient asked me if I used surgical drains as part of my routine when performing breast augmentation surgery. It's a thoughtful question - as there are a few surgeons locally who do use drains during breast augmentation surgery, removing them at the first or second postoperative visit. Drains, by the way, are small diameter, soft plastic tubes, which are used to remove fluid from a surgical area. They commonly have a bulb-type collection reservoir at one end of the tubing, while the other end has a perforated segment placed beneath the skin, near the involved surgical area.

I don't think they are necessary for the routine, first-time breast augmentation patient. In my opinion, drains are uncomfortable, they leave a small additional scar at their exit site, slow down the speed of the patient's return to everyday activities, and complicate a straightforward post-operative recovery process. In general, I only use drains if their benefit outweighs their drawbacks.

Here's the science: In a recent review, published in Aesthetic Plastic Surgery, a retrospective study of over 3000 breast augmentation patients in the United Kingdom showed that the use of surgical drains actually increased the risk of postoperative infections fivefold! No benefits of drains were seen in this study.

I do use drains in breast cases where there is a significant chance of a postoperative seroma, such as following capsulectomies, some forms of complex revisional breast surgery, large volume breast reductions, and explantations.