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Closed-Suction Drains After Subcutaneous Mastectomy for Gynecomastia: Do They Reduce Complications?

  • Original Article
  • Breast Surgery
  • Published:
Aesthetic Plastic Surgery Aims and scope Submit manuscript

Abstract

Background

In cases of refractory gynecomastia, surgical excision of excess glandular breast tissue is often warranted. Closed-suction drain placement is commonplace; however, the effect of drains on preventing complications after male breast surgery has not been fully elucidated in the literature.

Objective

To investigate the effect of drains on reducing seroma and hematoma after subcutaneous mastectomy for gynecomastia.

Methods

Retrospective chart review of patients undergoing subcutaneous mastectomy for gynecomastia over a 10-year period. Charts were reviewed for demographics, BMI, comorbidities, type of local anesthesia, specimen weight, use of liposuction, and placement of drains. Outcomes were determined by seroma or hematoma in the 30-day postoperative period.

Results

A total of 163 breasts were studied (group I = no-drain, n = 46; group II = drain, n = 117). Group I had a higher rate of clinically significant seromas requiring needle aspiration than group II (6.5 vs 0%, p = 0.0214). There was no difference in rates of hematoma (group I vs II, 2.2 vs 6.0%, p = 0.443) and total fluid collections (group I vs II, 19.6 vs 16.2%, p = 0.647). BMI, use of local anesthesia, specimen weight, and use of liposuction were not significantly associated with postoperative complications.

Conclusions

Closed-suction drains may reduce rates of clinically significant seromas requiring needle aspiration. Though drains carry their own pertinent adverse effects (e.g., patient discomfort and anxiety, cost, and additional clinic visits), there remains no universal standard of care and surgeon practices vary widely. Given the potential to reduce seroma rates, we recommend that surgeons consider placing drains and discuss with patients the benefits and risks of drains after surgical treatment of gynecomastia.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to Table of Contents or the online Instructions to Authors www.springer.com/00266.

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Authors and Affiliations

  1. Division of Plastic and Reconstructive Surgery, Children’s National Medical Center, 111 Michigan Avenue, NW, Washington, DC, 20010, USA

    Jerry W. Chao, Gary Rogers, Michael Boyajian & Albert K. Oh

  2. School of Medicine and Health Sciences, The George Washington University, 2300 I Street NW, Washington, DC, 20052, USA

    Jerry W. Chao & Janani A. Raveendran

  3. School of Medicine, Georgetown University, 3900 Reservoir Rd NW, Washington, DC, 20007, USA

    Connor Maly

Authors
  1. Jerry W. Chao
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  2. Janani A. Raveendran
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  3. Connor Maly
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  4. Gary Rogers
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  5. Michael Boyajian
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  6. Albert K. Oh
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Correspondence to Jerry W. Chao.

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Chao, J.W., Raveendran, J.A., Maly, C. et al. Closed-Suction Drains After Subcutaneous Mastectomy for Gynecomastia: Do They Reduce Complications?. Aesth Plast Surg 41, 1291–1294 (2017). https://doi.org/10.1007/s00266-017-0959-z

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  • DOI: https://doi.org/10.1007/s00266-017-0959-z

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