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Blog. Real Patient Question: Will I Need Drains?

It’s a question we field both online and in our in-office man boob consultations: will I need drains after surgery?

We understand the concern. To an active guy eagerly awaiting a much-improved torso, the thought of having drains passing through the skin after surgery can seem disconcerting. But we have good news and more good news. First, we almost never use drains when we perform gynecomastia surgery—our techniques avoid the need. But, on the rare occasions when drains are needed for man boob surgery, they are both useful and not as bothersome as you might think.

Here’s the scoop.

How We Avoid Drains in Man Boob Surgery

With more than three decades of experience performing gynecomastia surgery, our team works relatively quickly. A happy side effect of procedures of short duration is there’s less time for tissues to ooze. If we do notice vessels leaking, we stop them right on the table. Other ways we minimize fluid collection include:

  • Dilute Adrenaline:
    We use tumescent liposuction for male breast reduction, meaning we inject fluid containing dilute adrenaline into the area to be operated on. The medication helps minimize bleeding.
  • Firm Dressings:
    After our team is finished with the instruments, we apply compression dressings to the chest. These dressings press the skin down to the underlying muscle to minimize the possibility of fluid collecting between the layers.

Even when we perform top surgery for South Florida female to male patients, we often don’t need to place drains after the procedure. When there is a small to medium amount of tissue and skin to address and we elect incisions around the areolas, most often drains aren’t needed. We make an exception if a large area of undermining—meaning separation of layers of tissue—have been required. Then we may place drains to ensure fluid has an escape route.

When Drains Are Beneficial

If we should tell you drains may be a good idea for your top surgery or gynecomastia surgery, you needn’t be overly concerned. If you end up with drains, they will be needed for only a few days and they will be secured to your torso where they will not be unduly troublesome. We’ll also remind you that in certain cases, drains are a good thing! They can help keep swelling down and minimize the risk of post-op infection.

We may elect to use drains when operating on a guy with large man boobs and redundant skin. We often do when performing top surgery on a patient requiring a double mastectomy and nipple grafts. In these cases, there may be a large raw area that can “weep” fluid and possibly lymph to get rid of as well.

A Word About Hematomas

Hematomas, or blood collection under the skin, are rare in our practice. We make every effort to identify oozing vessels and stop any leakage prior to placing final sutures. Occasionally a blood vessel will open during the recovery phase—because the patient has not followed instructions or for no particular reason. We tell guys what to watch out for, and should a hematoma occur we attend to it immediately so no one can tell a difference after additional healing. Drains can help fluid and small amounts of blood exit the body, but when there’s a small but persistent blood vessel leak, a drain will not avoid a hematoma.

No Right or Wrong Answer

Whether or not a cosmetic surgeon chooses to use drains depends on many factors, not the least of which is training. If he or she was taught to use drains for male breast reduction, chances are they might continue the practice.

Since most experienced gynecomastia specialists do not use drains very often, however, one colleague suggests patients should avoid choosing a doctor who does. That’s a position worth considering. If a surgeon you’re consulting wants to use drains, it can’t hurt to ask why your case requires them and make sure you know the surgeon has treated at least hundreds of guys like you. Strictly speaking, though, there’s really no black and white answer about when to use drains.

For more on this and other questions about gynecomastia surgery, visit our extensive man boob FAQ here. To get your questions and concerns addressed in person, call us at 561-367-9101 for a consultation.


Dr. Elliot William Jacobs is a board-certified aesthetic plastic surgeon who specializes in FTM top surgery, gynecomastia surgery, revision gynecomastia surgery and male breast reduction. He is a native of New York and has over 40 years of experience in his field. Dr. Jacobs is a highly respected and sought-after surgeon who is known for his skill, experience, and compassion. Whether you are interested in gynecomastia for the first time, or are looking to correct a gynecomastia you aren’t happy with, Dr. Jacobs can deliver amazing results.


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