by Terrye Tebbetts

I saw this question on the forum and I think it deserves more attention – the use of drains in a primary breast augmentation is really 30 year old surgical technique – archaic!  Better surgical alternatives have been published and proved by John B. Tebbetts, M.D., plastic surgeon in Dallas, Texas, in his renowned 24 Hour Recovery series in Plastic and Reconstructive Surgery Journal.

Question ~

Hello! This is my first time posting anything on here (or any other website) so I hope I’m doing it right! My BA is scheduled for Feb. 7. I had my pre-op with my doctor yesterday. I’m SO EXCITED and nervous. Wish it would just get here so I can stop thinking about it! One thing I wanted some info on though, is anyone of your doctors planning on using drains? I know alot of people with BA’s and none of them have had drains. My doctor said I will have them for a couple days. I trust my doctor and am going to do whatever he says. Just wondering if anyone else had them. And…how bad are the drains? Doesn’t sound very fun. Thanks!!!

Answer ~

I know you got a few personal accounts of recovery with or without drains which is a good reference for how you might feel and what it may be like, but I thought you might like to have  a clinical peek at the use of drains.

In a primary breast augmentation – how the pocket – the space for the implant to sit – is dissected will determine whether or not drains are needed.  If the pocket is blunt dissected – the tissue is simply torn – that creates a lot of trauma – bleeding and fluid in the pocket  – - no surgeon wants blood and fluid between your tissue and the implant surface, so if that environment was created during the dissection process, then it has to be corrected during your recovery.  Blood and fluid in the pocket increase risks – risks of seroma, infection and capsular contracture.  To correct it drains are placed to draw the fluid out, sometimes compression garments are used too (surgical bras, or bandages or straps).

In today’s world of breast augmentation, in a primary breast aug (nothing else like a lift etc going on), there is NO need for drains.  Instrumentation and surgical techniques exist that allow the surgeon to precisely dissect the pocket – leaving a very dry surface of tissue for the implant to meet.  Having this dry environment eliminates the need for bras, bandages and drains and has facilitated our 24 Hour Recovery process that allows patients to return to normal activity the afternoon of surgery.  But most importantly, in the absence of blood in the pocket, our capsular contracture rate has dropped to 1.5%.

If there is a better alternative that will eliminate drains, investigate that alternative.  As with everything else, there is a time and place/need for the use of drains.  Primary breast augmentation is not one of them!

About the Author: Terrye Tebbetts is one of the most knowledgeable women in the world about breast implants, with 27 years of experience educating patients and 11 years as a patient herself. For more information about breast implants or breast augmentation Dallas surgeons, please visit www.thebestbreast.com.