I am a firm believer in surgical drains after breast augmentation. So much so, that I brought my own drains to my breast augmentation surgery (“BYOD” = bring your own drains). 😉
During breast augmentation surgery, regardless of whether the implant is subglandular (on top of the muscle) or subpectoral/dual plane (completely or partially under the pectoralis major muscle), a pocket is created for the implant. The body secretes fluid from this raw surface, like when you deeply scrape your knee. In the instance of a wound outside the body, you first bleed, then your body secretes a clear yellow fluid known as wound fluid or “serous fluid”, then it dries and you form a scab.
Inside the body however, this wound fluid accumulates in a closed wound like the space around a breast implant or under the skin in an abdominoplasty (tummy tuck). This fluid is filled with proteins and sugars and is an excellent medium for bacterial growth. By whisking away this wound fluid using drains, there is very little swelling (your body does not need to absorb the fluid over weeks or months), you decrease the risk of infection and in turn capsular contracture, and you can appreciate your final results sooner (within weeks)!
I milked my drains several times daily and emptied them twice a day. As I didn’t have a great amount of breast tissue (more fat = more fluid) and my implants were not under the muscle, I didn’t drain a lot. “Your drains tell on you!” is what I warn my patients. I noticed that my right drain fluid was slightly bloodier and put out more fluid than the left. I’m right handed, and that was expected.
We walked around town for the next couple of days (Was anyone noticing my drains? NO!). I took prophylactic (preventative) antibiotics as prescribed, no more Ativan and only one narcotic pain pill. I was fine on extra strength Tylenol after that. Subglandular implants (not under the muscle) are not very painful, and I can testify to that!
I unwrapped and rewrapped my dressing and Mary helped me wash my hair in the tub on postop day 2. It felt good to get clean, as I normally wash my hair every day and I showered the bottom half of my body.
Drains go through a natural evolution in color and consistency. Being a bartender, I can’t help but describe them as the following:
- Bloody Mary
- Cabernet sauvignon
- Pinot noir
- Rose or Ice wine
- Pinot Grigio
The drain tubes can be a little irritating against the skin. Padding the skin underneath with a soft pad like a makeup remover pad or piece of a pantiliner is helpful, as shown in this video:
My drains were removed on postop day 3, as is common. They didn’t hurt when they came out, it just felt weird. I was happy to have passed this milestone and was excited to return home to my family!