Why Are Surgical Drains Placed During a Mastectomy?

If you are undergoing a mastectomy, you will probably have surgical drains placed.

A surgical drain is a plastic or rubber tube that comes out of your incision site. The tube is attached to a hollow rubber ball that collects draining fluid from the healing area. 

While you can expect to stay in the hospital for a night or two after your mastectomy, prior to leaving the hospital, your surgery team will give you instructions on how to care for your surgical site properly to prevent infection, as well as explain how to manage your drains until they are removed during a follow-up visit with your breast surgeon. 

Let's explore the basics of surgical drains after a mastectomy, including what they look like, how they stay in place, and what their purpose is. 

Surgical Drains During a Mastectomy

When you have a mastectomy, your surgeon may place drains in order to prevent the buildup of fluid and help speed up your healing. 

Prevention of a Seroma

This is because without drains, fluid may collect in the space where your breast or lymph nodes had been, and this can cause symptoms like pressure and pain. More seriously, when fluid collects without being drained, it may cause a seroma to develop. A seroma is a collection of clear fluid (called serous fluid) within the wound. Seromas can delay wound healing and result in infection and a poor cosmetic outcome. 

What a Surgical Drain Looks Like

When thinking of a surgical drain, it's easiest to picture a tube that on one end is attached to a bulb and on the other end, is extending inside your body into the surgical area. The drainage tube will be held in place with a suture so that it doesn't accidentally slip out.

Within your body, the tube collects blood and clear lymphatic fluid that then moves into the bulb, where it can be measured, recorded, and then removed. 

Fluid Within the Surgical Drain

You will use the drain to remove and measure the fluid multiple times a day and keep a record of how much blood and lymph is removed. Early on, the drainage is usually bright red, becoming thinner and changing to a straw-like color after the first few days.

As the volume of fluid decreases, swelling around your surgery site should decrease. When the fluid volume is 30 ml or less in a 24-hour period, you can have the drains removed. That said, even if you continue to have drainage greater than this, some surgeons still recommend removing the drains at around three weeks.

Mastectomy With Breast Reconstruction

This illustration shows the location of two surgical drains. This is because the woman had a mastectomy with immediate breast reconstruction, using a tissue expander.

With that, one surgical drain has been placed around the temporary breast implant to collect blood and lymph. 

In addition, the woman in the illustration has a sentinel node biopsy to check whether the breast cancer has spread to the lymph nodes, so there is a drain line close to her armpit. Depending on the results of your sentinel node biopsy your surgeon may also do a lymph node dissection removing further nodes.

Mastectomy Without Breast Reconstruction

For people who have a simple mastectomy without immediate reconstruction, there may be only one long incision that includes your lymph node biopsy as well as your mastectomy. Your surgeon may place surgical drains in your incision to help speed up your healing. Some people will have one drain and some will have more. If you have a bilateral mastectomy with lymph node biopsy you may have as many as five or six drains.

A Word From Verywell

The bottom line is that while tour surgeon may place a drain in a location somewhat different than those in the illustration here, the concept is the same—a surgical drain allowing excess fluid to be removed. This way you can heal well and rapidly and continue your on your road to recovering from breast cancer.

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