I received an email the other day from a woman who had visited another surgeon regarding breast augmentation.  During her consultation he told her that he routinely uses drains during the procedure.  She wanted to know if I also use drains during breast augmentation. 

For those of you who may not understand what a drain is,  let me get this out of the way first.  A drain is a small tube that is placed into a space within your body that is designed to pull fluid away from this space and usually into a collection device.  By their nature there is a path through the skin that the drain will cross.  Drains are used frequently during any procedure that is prone to develop a fluid collection or “seroma.”  A common procedure within Plastic Surgery that usually requires drains would be an abdominoplasty where a large space is developed beneath the skin.  Here is a picture of a drain:

To answer her question about whether or not I use drains, the answer is:  Almost never during a primary breast augmentation.  There are few instances when I would consider one and this is usually during a revision case when extensive work is performed on a breast capsule.  The reason that I don’t use them is that I believe that they are not necessary and it has been  well demonstrated that drains increase the risk of surgery requiring complications and significant capsular contracture in patients who have them. 

Our websites www.beauty-surgeon.com and www.drmckane.com have additional information and before and after photographs of breast augmentation for review.  I invite you to schedule a consultation with me if you would like to learn more about breast augmentation or the use of drains during a procedure.  Please feel free to contact our office at (713) 661-5255 if you have any questions.

-Brice W. McKane, M.D.

© 2009, Dr. McKane. All rights reserved.

A patient in my clinic today asked an insightful question that I would like to share with you.  She noted that she understood that there is evidence supporting that there is a decreased risk of capsular contracture after breast augmentation if the implant is positioned behind the muscle.  She wondered, “Is there  an incision that is associated with less risk for capsular contracture ?”

A prospective study by Henriksen et al.  answered this very question.  The authors looked at the causative factors surrounding surgery requiring complications and significant capsular contracture in 2277 women undergoing breast augmentation.  The authors found that the “inframammary” or breast fold incision was associated with the least risk for complications requiring surgical intervention. Patients who elected to have this incision also experienced less risk of capsular contracture.  In fact, patients opting for periareolar or any other incision were 5.8 times more likely to develop capsular contracture than those who had inframammary incisions.  This evidence has led me to counsel my patients to strongly consider the inframammary incision for their approach to a breast augmentation.   

Here are the pre and postoperative photographs of a breast augmentation done through an inframammary incision.  This patient is very thin and had very little breast tissue.   Even in this patient, the incision is very well concealed and is barely visible on front view.  

Pre and Postoperative views

The postoperative photograph is taken at 1 month following surgery to show what an immature incision may look like when it is the most visible.  The incision will continue to fade with time.  This small investment in an easily concealable incision can have a significant impact on the need for additional surgery.

Our websites www.beauty-surgeon.com and www.drmckane.com have additional information and before and after photographs of breast augmentation for review.  I invite you to schedule a consultation with me if you would like to learn more about breast augmentation or the incisions involved in this procedure.  Please feel free to contact our office at (713) 661-5255 if you have any questions.

-Brice W. McKane, M.D.

© 2009, Dr. McKane. All rights reserved.