Hi, I’m Dr. Frank Lista here at The Plastic
Surgery Clinic and we’ve just finished a day of surgery. Actually it’s our first day of
surgery in January in the new year, so Happy New Year to everyone. And one of our patients
asked a question. The question was: why do you use drains after breast augmentation when
other surgeons don’t? First of all, what’s a drain? A drain is a little tiny tube like
this, see it’s really small, it’s only a couple millimetres wide, it’s made out of silicone.
And at the end of surgery, while you’re still asleep, the drain is inserted around the implant.
It comes out through a little tiny opening just beside your incision, one on each side.
It’s invisible, it doesn’t bother you, it doesn’t hurt, you can’t feel it. One end of
the drain is attached to this little bulb, which is attached to the tube, and any blood
or fluid that collects around the implant comes out through this- through the drainage
tube, into the collection bulb, which collects any blood or fluid that collect. Now, why
do we use drains? Well, it’s all about a complication called capsular contracture. Capsular contracture
is a complication of breast augmentation where the body forms scar tissue around the implant
and makes the breasts feel hard. It’s not the implant going hard, and it’s not the breast
going hard, it’s the scar tissue around the implant that makes breasts feel hard. Now
capsular contracture is a big problem in breast augmentation surgery and studies over the
years have suggested that that incidence can be anywhere between 10% and 40% and it’s really
inconvenient because it feels terrible, it makes your breasts look not very good. One
of the things that we know causes capsular contracture is hematoma, or blood or fluid
collecting around the implant. And when that blood or fluid collects around the implant,
it can cause capsular contracture. So the idea of the drain is to drain that blood or
fluid so that it doesn’t collect and so it decreases the risk of capsular contracture.
The drains come out the next day, we see all of our patients the next day. The drains are
removed, it doesn’t hurt, it’s not a big deal, it doesn’t leave a mark, and our capsular
contracture rate is really low. How low? Well, first of all, there’s a study in the Journal
of- Canadian Journal of Plastic Surgery which has also suggested that drains reduce the
risk of capsular contracture. We’ve just finished reviewing 1300 of our patients who all had
breast augmentations with drains, and our rate of capsular contracture is 1.3% which
is the lowest published rate of capsular contracture in any study ever published. So clearly drains
help reduce the risk of capsular contracture. So why don’t all surgeons use it? Well first
of all, it’s expensive. The cost of the drain, the extra time to put the drain in, and the
nursing cost to see the patient the next day and take the drain out probably costs several
hundred dollars. The other reason why some surgeons don’t use it is because if you have
a drain, you have to see the patient the next day to take the drain out, and that’s inconvenient.
So cost and inconvenience. But here at The Plastic Surgery Clinic, that is never a concern.
Cost or inconvenience don’t matter if what we’re doing is better for the patient. And
clearly, using drains reduces the risk of capsular contracture, is better for the patient.
We don’t care what the cost is, we don’t care how inconvenient it is for us. What matters
is what’s best for you. So it’s not a big deal, it’s easy to use, it doesn’t hurt, you
don’t feel it, we take it out the next day, it’s no big deal. But it can lower your risk
of capsular contracture and in our study, 1.3%, pretty darn low. So it’s a great thing
to do and that’s why we use it. So thanks for visiting, follow us on Twitter or YouTube,
Facebook or on our website where we post commonly asked questions. I’m Dr. Frank Lista from
The Plastic Surgery Clinic. Thanks for visiting.