No, I never place drains for a breast reduction. Why not? I have been doing breast reductions without drains for over twenty years, so it is mostly just my personal experience.
What are drains for? A drain is a plastic tube that goes from inside the breast out through the skin into a plastic ball. When drains are placed, they suck out fluid from inside the breast, and then the patient has to empty and measure the fluid a few times a day. The problem with drains is that they create a separate scar, they are quite awkward and uncomfortable, and for the average person, it is pretty gross to see surgical fluid coming out of their body.
Well, you might wonder, what happens to the fluid if the drains aren’t removing it? Will you get a big pocket full of fluid in the breast? Your body has the natural ability to absorb quite a bit of fluid, so most of the time this is what happens.
What happens if your body doesn’t absorb the fluid? It is still possible to get what is called a seroma, or fluid pocket, after breast reduction surgery. However, the number of times that this happens is very low, so it doesn’t make sense to put drains in every patient. In the event that someone does get a fluid pocket after surgery, we can just place a tiny needle to drain it in the office. This usually takes care of the problem.
Interestingly, the American Society of Plastic Surgeons recommends against using drains after breast reduction surgery as studies have shown no benefit to doing so. There are certain other types of cases where using a drain is necessary, but drains are typically not needed for a breast reduction.