PURPOSE: Most surgeons in Europe continue to utilize drains after reduction mammaplasty, but the trend in North America has recently leaned heavily toward no drain utilization for reduction mammaplasty. The purpose of this study was to determine whether drain utilization after reduction mammaplasty decreases incidence of postoperative complications.
METHODS: Retrospective cohort study was conducted of all reduction mammaplasty procedures performed at our university medical center between 2010-2020.
RESULTS: This study included 944 female patients undergoing reduction mammaplasty. The majority of cases did not utilize postoperative drains (80.3%, n=763 of 944).
Drain utilization did not significantly reduce postoperative hematoma (p=.196), seroma (p=.185), dehiscence (p=.436), nipple necrosis (p=.511), or fat necrosis (p=.113), but drain use significantly increased postoperative infection (p=.011, 16.6% vs 10.0%).
Infections were more common in patients with older age (p=.015), higher BMI (p=.001), SNN (p=.048), and breast mass removed (p<.001). Wound dehiscence was more common in patients with higher BMI (p<.001), SNN (p=.013), and breast mass removed (p<.001). Nipple necrosis was more common in patients with older age (p=.021), higher BMI (p<.001), SNN (p=.003), IMFN (p=.029), and breast mass removed (p<.001). Fat necrosis was more common in patients with higher BMI (p=.005), SNN (p<.001, 37.8 vs 33.5 cm), IMFN (p=.005), and breast mass removed (p=.001).
CONCLUSION: Drain utilization does not reduce hematoma or seroma risk, but significantly increases risk of infection after reduction mammaplasty.
