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.
