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Should drain tubes always be used?

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Banobo

Should drain tubes always be used?
« on: March 14, 2009, 01:10:56 PM »
Hi i'm wondering if it's normal for a surgeon not to use some form of drainage after gland removal and lipo? If anyone could help me i'd be grateful. I had my surgery yesterday and all looks good but i can feel fluid under my nipples and surrounding area, it feels a bit like my nipples are floating. Hopefully that makes sense.

Linkback: https://www.gynecomastia.org/smf/index.php?topic=17138.0

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Offline Grandpa Bambu

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Re: Should drain tubes always be used?
« Reply #1 on: March 14, 2009, 01:29:19 PM »
Dude...

No, it's not a necessity for your surgeon to use drains.

If you have any fluid build-up it wil be absorbed by your body in a week or two...

GB
Surgery: February 16, 2005. - Toronto, Ontario Canada.
Surgeon: Dr. John Craig Fielding   M.D.   F.R.C.S. (C) (416.766.8890)
Pre-Op/Post-Op Pics

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Banobo

Re: Should drain tubes always be used?
« Reply #2 on: March 14, 2009, 03:08:40 PM »
Hi, with it only being done yesterday and nearing the end of today it's actually not so bad now, the fluid seems to be settling down and i'm really impressed with the overall shape.
I know i have a long way to go and a lot of changes to come but i am so relieved i got this done.

Thanks for the info bambu

Re: Should drain tubes always be used?
« Reply #3 on: March 14, 2009, 05:05:31 PM »
Drains can be thought of as a "safety valve" -- to drain off any potential fluid build-up after surgery.

I do about 150 cases of gyne per year -- and use drains in about 2-3 cases only.  But that is my technique and my bias -- other surgeons may differ.  Some surgeons use drains on every case; others on selected cases and others (such as myself) use them only rarely.

The decision to use a drain is based on the case itself, the surgeon's training and judgment.  There is no right or wrong -- what counts is the final result.

Dr Jacobs
Dr. Jacobs 
Certified: American Board of Plastic Surgery
Fellow: American College of Surgeons
Practice sub-specialty in Gynecomastia Surgery
815 Park Avenue
New York, New York 10021
Telephone:  (212) 570-6080
Email:  dr.j@elliotjacobsmd.com
Website:  http://www.gynecomastiasurgery.com
Website:  http://www.gynecomastianewyork.com/revi

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Banobo

Re: Should drain tubes always be used?
« Reply #4 on: March 14, 2009, 06:26:24 PM »
Hi there Dr. Elliot Jacobs and thank you for your input. I had a relatively mild case of gynaecomastia after which was mainly just the visual effect of puffy nipples due to the gland. It was far worse but over the years, weight training with plenty of cardio workouts i really reduced the overall horror. My surgeon said post op that it really was bonafide gyne and a lot of fibrious gland tissue was removed. Anyway fuild that i was worrying about seems to be dispersing quite well so my mind is at ease.  I have tight tape over the area but i'm sure things are going to look really good.
One little question you might be able to help me with, at this early stage should my nipple feel like it's a little floaty?  as if fluid is under it or should it be taught against my chest? It looks fine but to touch it's still soft.

Thanks for your help and i'll post some pics soon.

Re: Should drain tubes always be used?
« Reply #5 on: March 15, 2009, 08:54:25 AM »
More than likely, assuming there is no free fluid present beneath the nipple, then the softness that you feel of the nipple/areola itself is just swelling of the tissues themselves.  Think of a kitchen sponge filled with water -- it's a bit "squishy."  As the swelling is absorbed by your body, the tissues will resume their natural, pre-surgical feel.  This may take a few weeks or even longer.

Be patient!!

Dr Jacobs

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Banobo

Re: Should drain tubes always be used?
« Reply #6 on: March 15, 2009, 09:01:41 AM »
Thanks once again for your input, i know, i really have to be more patient it's just i get the impression with the tape off my nipples may take on the shape that they had before slightly. I really am worrying over nothing as you said the swelling is like a sponge and time can only tell. My doctor prescribed my diclofenic to take after op for the swelling would you recommend? or maybe arnica?

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DrBermant

Re: Should drain tubes always be used?
« Reply #7 on: March 15, 2009, 09:56:05 AM »
Hi i'm wondering if it's normal for a surgeon not to use some form of drainage after gland removal and lipo? If anyone could help me i'd be grateful. I had my surgery yesterday and all looks good but i can feel fluid under my nipples and surrounding area, it feels a bit like my nipples are floating. Hopefully that makes sense.

Here is an answer I posted before to a similar question with pictures from the poser:

updated pics

POST OP

this is 3 weeks post op this coming wednesday






i already had a hematoma drained 1 week post op, its pretty obvious i have another i think


should i be nervous? it definetly feels full of liquid, but it doesnt really hurt

Hematoma After Gynecomastia Surgery Complication means there is a collection of extra blood in the tissues.  Bleeding in tissues can expand, be tense, and cause discomfort.  Swelling from hematoma can be fresh blood, residual clotted blood, liquified blood, and injured tissues.  Clotted blood does not drain well.  Over time clotted blood liquifies permitting drainage.  Although the body will try to absorb the extra blood, it must break down the blood and then absorb the material. 

Although hematoma happen with any trauma, not having this complication and minimizing bruising and swelling with gynecomastia surgery are better solutions.  Early drainage, drains for hematoma, and helping the body deal with the extra fluid can help with healing. 
I rarely need drains for my gynecomastia patients.  Swelling after surgery tends to resorb over time, but patients do not typically describe such issues as "floating." 

Your questions are best directed to your surgeon who can with examination offer specific advice.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction

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Banobo

Re: Should drain tubes always be used?
« Reply #8 on: March 15, 2009, 10:33:31 AM »
My word that looks very drastic and painful. Drbermant thanks for commenting. I'l try to best describle my situation so here it goes. my chest is very flat now which i'm best pleased with, there has been sticky tape applied around the breast area with cutouts for my nipple with the under area of the nipple which has the half moon like cut covered. i cant stress enough that things look good but the part of my nipples which are exposed through the cutout are swollen outwards and although i think it's purely down to the healing i thought i'd just ask on this site to see if it was normal or to be expected. I thought maybe if i covered the nipple area with cotton and taped that down so my vest kept preasure on the nipple area also. Any fluid that i could feel which was minimal seems to have dispersed, just looking at other post op pics of people their nipples seems very flat to the chest.
I have appointment next week with my PS for checkup so i will bring all this to his attention, i just like to build a knowlege of these things before hand and i really value everyones input. Thanks you guys.

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Banobo

Re: Should drain tubes always be used?
« Reply #9 on: March 15, 2009, 12:15:19 PM »
Here is some pre op and post op pics. my consern is my nipples still seem strange after op. Please give me your opinion guys, overall i'm very pleased.

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Banobo

Re: Should drain tubes always be used?
« Reply #10 on: March 15, 2009, 12:17:26 PM »
And here is after pics just taken

Re: Should drain tubes always be used?
« Reply #11 on: March 15, 2009, 03:49:32 PM »
Obviously, you should check with your surgeon.  But from what you describe (a flat, symmetric chest), it sounds like there is just some swelling of the upper half of the areola.  When the adhesive dressings are removed, the swelling should go down and the areola should improve substantially.

Dr Jacobs

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Banobo

Re: Should drain tubes always be used?
« Reply #12 on: March 15, 2009, 04:27:28 PM »
Your words are reasuring Dr Jacobs. I was a little worried there might still have been some tissue still under the nipple area which was causing it to stick out. when i forst take off my compression garment they stay really flat but slowly start to form that shape you see in photos. I will be seeing him next thursday to remove dressings and for him to inspect things. My chest is in really good shape with very little swelling now, just hope my nipples are going to form (dare i say)  a normal shape? What would be your opinion in covering the nipples with a small cutout of cotton pad and to tape them over? it would maybe let the vest press on them, keep their shape. I notice on most peoples photo's they have covered the areola.

Re: Should drain tubes always be used?
« Reply #13 on: March 15, 2009, 09:09:05 PM »
Don't think that would do any harm -- but best to check with your own surgeon.

Dr Jacobs

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Banobo

Re: Should drain tubes always be used?
« Reply #14 on: March 16, 2009, 06:25:56 AM »
I'm going to call him today and see what he says. I have to say everyone on this site have been and continue to be very helpful, thank you all.


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