SP04. Are Drains Necessary for Reduction Mammoplasty? Findings From an Updated Large Cohort Study

PURPOSE: The use of closed-suction drainage for reduction mammoplasty cases currently varies in practice depending on the plastic surgeon. Whereas previous studies have analyzed the rate of complications directly associated with drain use in reduction mammoplasty, we present the largest cohort of patients who received this care to re-evaluate the necessity of drain use. METHODS: A retrospective study was conducted on patients who underwent bilateral reduction mammoplasty by a single surgeon from March 2015-February 2023. Patient demographics were collected from charts and summarized with descriptive statistics. Analysis was by breast, separated into those with closed-suction drains applied and those without. Breasts that had liposuction with the reduction or were missing data were excluded. Wilcoxon rank sum test for continuous variables and Fisher’s exact test for categorical variables were used to assess for significant differences between the cohorts. Univariate and multivariate logistic regression were performed to analyze the association of drain usage with post-reduction complications. RESULTS: Of 1015 breasts, 48.1% had drains placed, while 51.9% did not. Usage of drains was a significant predictor of decreased rates of seroma (adjusted OR = 0.09, 95% CI = 0.02 - 0.39, p = 0.001) and increased rates of infection (adjusted OR = 2.92, 95% CI = 1.08 - 7.91, p = 0.040) with and without adjustment for demographic or intra- and postoperative characteristics. None of the seromas or infections in this study warranted surgical intervention. Out of breasts that received drains, postoperative days to drain removal (average = 6.35 days, range = 1-19) were not a significant predictor of complications, even after adjustment for patient demographics. CONCLUSION: This study found that the use of closed-suction drains in reduction mammoplasty was associated with a decrease in seroma rates, but at the cost of an increased risk of infection. Our data suggests that in select patients, the usage of drains may be indicated; however, they are not without disadvantages.