The Truth About Explant Breast Surgery Without Drain Tubes

Why does Dr. Whitfield not use drains? How can I get away with that? I get asked this all the time. It all goes back to one of my clients who came, who did not have breast implant illness symptoms, just simply wanted their old implants taken out and was begging me to do a fat transfer. And I did their fat transfer. I used drains on them. And that began my interest in providing more fat transfers simultaneously for patients experiencing breast implant illness and fast forward. Now, we do fat transfers all the time. We have a very specific program. Look at your genetic testing, your toxicity testing, gut microbiome, food sensitivity testing, hormone balance, and get you set up for success with both lowering inflammation pre op with our supplement package, our inflammation support bundle, and then doing phase one detox with our detox practitioner using cellcore products. So that helps get you prepared for fat transfer. Basically started really bothering me in the operating room was getting your liposuction garment on a patient who just had a fat transfer, wrapping them up with a gentle ACE wrap, and then having a drain tube sticking out. So it just was, oh, bothered me so much. And I worried about them getting infections because drain tubes ultimately leave your body through a, an opening. So by, you know, looking at that retrospectively, of course, more people will get infections who have drains because it's a tube sticking out of your body is not rocket science. So how do I not use drains in my cases? So for a long period of time, a tummy tuck has been done without a drain. It's called the drainless tummy tuck. And there's a particular suturing method you can use, and you can use like a internal surgical glue and you can help seal it and reduce the dead space, et cetera, et cetera, et cetera. So how do we do that when we're doing breast surgery? So we have the breast pocket where the implant sat, and typically it's behind the muscle. In the United States, some are above, but most, most of the patients are behind the muscle. So you have that opening of the breast pocket. You may not have that much breast tissue, you may not have that much fatty tissue, and then there's the skin. So this all once again came out of my patients who I did fat transfers for. So a fat transfer for me starts with the patient on their tummy. And we typically are taking love handle fats. And I prefer to take posterior inner thigh fat and outer thigh fat from the prone position using a small 3 millimeter opening under the butt cheek in the crease. Those are well hidden. It's very easy for me to take fat. It's very easy for me to get a nice result. If I want to provide skin tightening with body tight at the same time, I do that through those same incisions. We then will put some long acting local anesthetic in so patients have more comfort in those areas. And we'll flip over and then we'll either add fluid to the abdomen, take more fat, do more skin tightening, or if we're not using their abdomen, we'll go ahead and do their explant surgery. So once the explant's done, think of you're laying now, your patient's laying flat, they're on the operating room table. And I can see in the breast pocket, I can see in the armpit area, I can see down towards the tummy. You can almost imagine where I did the flank liposuction and, or the tummy liposuction or both. And then I will connect the breast pocket because a lot of times I'll do liposuction on the upper abdomen through the breast pocket, which is pretty common. That connects the spaces that I already created by doing fat retrieval liposuction on the flank area or the tummy area if I used it. And then so if I'm doing a lift and a fat transfer, or if I'm just doing a fat transfer, you know, I close the pocket through the incision that I made to get the implant out, and then I'll put the fat in. I prefer to put the fat in from the armpit approach because I like to have the ability to rebuild and rejuvenate the cleavage area, the upper two thirds, and I find it easier through the incision in the armpit. And then I'll gently wrap you up with an Ace wrap. We'll put your liposuction garment on, and then your body will drain the fluid downward through the breast pocket and underneath the skin in the fatty channels that I created. Doing liposuction of the abdomen and flank area, lower back area. You'll come to my office the following day, get out of your liposuction garment. Typically, do a lymphatic massage in our German device called Balancer Pro. And that day you may as well, or oftentimes will do a hyperbaric oxygen treatment, which I like to do for our clients. So if you just follow along, you're taking the body and its ability to collect fluid, put it in your lymphatic system and then get it out via urination. Basically, that's how I hack not using drain we create spaces so the fluid will drain down via gravity internally in the tissues, which is completely normal. We do it in liposuction all the time. I have never put a drain in anybody I've performed liposuction on for any circumstances because, as I mentioned already, it goes against philosophically what I would believe in and limiting the chance of an infection by using a foreign body. I just rely on your body to heal itself. So the fluid that we use, traditional liposuction has to be absorbed. We use compression in our office, we use lymphatic massage all the time. And that, I feel, is a safer, better way to get rid of the fluid than having to drain tube in. And that is how I do explants without drains.