During a recent Instagram Live Q&A with the founder and Chief Medical Officer of Atlantic Coast Aesthetics, Dr. Thomas A. Pane and Zee received a question about drains implanted subsequent to breast augmentation. This question is important because aftercare is rarely considered or asked about in open forums. Usually this is addressed on a one-on-one basis during the initial in-office consultation and/or when the patient is given aftercare instructions while in recovery. Because of this, Dr. Pane wanted to take some time to discuss this and what patients can expect after breast augmentation in a little more detail than usual.
A surgical drain is essentially a plastic tube with an attached bulb which is placed into the body during or at the end of a surgery, to prevent accumulation and facilitate the draining of air or fluid such as blood or pus from the area where the surgery was performed. Generally, a drain is kept in place until the drainage falls beneath a specified minimum threshold, usually 25mL, for at least two days in a row. Depending on the nature of the area, rate of healing, postoperative complications and other factors, a drain may be removed fairly quickly or left in place for anywhere from 1-5 weeks. When a drain is placed, the surgeon will set benchmarks for healing activity and fluid drainage to determine when and how the drain may be removed.
Dr. Panes says leaving drains in after breast augmentation are very rare as opposed to other procedures. For a tummy tuck, for example, Dr. Pane doesn’t feel the drainless techniques work as well, largely due to the size of the typical area he’s having to work with. Leaving the drains in place in this scenario serves a highly practical purpose, allowing wound drainage while expediting healing as much as possible.
In the breasts, this is not typically the case. In rare situations when Dr. Pane is performing an implant removal or mastopexy where a pocket is left behind and needs to be drained, then it would make sense to implant a drain to allow fluid out while allowing the rest of the tissue to heal. If such a drain were left, it would almost certainly only be for a short time, usually less than a week. Dr. Pane says he cannot remember the last time he had a case where leaving a drain after breast surgery was necessary, but believes it has been at least a year or more, which speaks to the rareness of this eventuality.
As with any medical procedure, every patient and every body is a little different. This means the approach, methodology and expectations may be different. It is perfectly possible to have literal identical twins standing side by side for the same procedure, but one twin has a key difference from the other which means this twin heals faster or slower than the other. Because no two people are exactly the same, sometimes the method which works for this one will be completely inappropriate for that one.
This makes aftercare, including drain placement, a matter of education, experience and reliance on knowledge of trends to set standards for what the best way forward is under what circumstances. Dr. Pane, as a double-board-certified emergency and cosmetic surgeon, has the skill, knowledge and experience to achieve results using procedures less well-equipped surgeons might not. He can and does take on cases many cosmetic surgeons would refuse as too risky or too complex, but he also refuses cases a less competent but more self-interested physician might accept because he places the welfare of the patient above all other considerations.
Of course, even a comprehensive in-person clinical evaluation with a full medical history can only tell anyone so much. Every effort is made to make your cosmetic procedure as safe and as likely to achieve the results you’re looking for as possible, but because every person is different, sometimes surprises do happen. Because of this, it’s important to remember that although placing drains for breast-related procedures is rare, it may be necessary in your specific case, as may other aftercare protocols which others who’ve undergone the same procedure may not require. Always remember aftercare protocols and procedures are designed to optimize your results and minimize ongoing risks to your health and wellbeing! This includes taking any medications you are prescribed as instructed, avoiding alcohol, cigarette smoke and direct sunlight, and any other precautions or follow-up recommendations the doctor or the surgical staff gives you.
If you have a question about any facet of cosmetic surgery or aftercare, the staff of Atlantic Coast Aesthetics is always pleased to talk with you about your interests. Follow us on Facebook, Instagram, Twitter and LinkedIn; call us at (561) 513-4763; or click here to contact us. Your question may be included as the focus of an upcoming Ask Dr. Pane segment, allowing us to inform and educate others while giving you the answers you need to make the best and most informed decisions about your cosmetic surgery needs and goals. Remember, at ACA we believe the only bad question is the one you DON’T ask!