Podcast episode (YouTube) featuring board-certified plastic surgeon Dr. Robert Whitfield explaining why he rarely uses surgical drains. He states that studies link drains with higher infection rates, describes when he will still use drains (e.g., extracapsular implant rupture or cases with uncontrolled bleeding/inflammation), and outlines alternatives and multimodal recovery strategies (progressive suturing, internal drainage, compression, high-protein diet, anti-inflammatories, ice, supplements). The conversation emphasizes patient responsibility in following recovery protocols. Closing includes promotional details and contact info for Dr. Whitfield in Austin, Texas.
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Welcome to the holistic and scientific podcast with board Certified plastic surgeon Dr. Robert Whitfield, Austin's natural choice for plastic surgery and the expert in smart laser and energy treatments.
And, you know, recovery was a little rough. I had, I got an infection from the drains.
All right, we're gonna have to talk about the drains.
Yeah, yeah. And that was one thing which, when you don't have all of the information, I was like, oh, and I know that the doctor has to do drains. If they don't do drains and there's something wrong, you gotta do drains. Well, I got drains. I had them for three days. Everything had been going fine. On the third day, went into the office, had them removed by the surgeon, and within 48 hours I had a fever. The area was red and very obviously infected.
So just so all the listeners understand, all of the studies suggest that the use of a drain ultimately is associated with a higher rate of infection. And so let's just talk about why we would use drains in the first place. And I've used drains for breast cancer reconstruction, for tummy tucks, for breast implant removals. So I, I will just give you my, my two cents on, on why you use them initially as a surgeon, because you don't want to leave a space that's open to fill just with fluid and develop what's called a ceramic cavity, because then you have this fluid buildup. And so I would argue it this way. I've gone to not using drains except for in really specific instances. So if I have a extra capsular rupture, which means your implant capsule, your scar has been compromised by the rupture, that usually means the gel or filler of the silicone device is now extravasated or leaked through your capsules in your breast tissue. That is a very unfortunate situation that I don't find very often anymore. But in that situation, I am very apt to use a drain because I cannot get the pocket devoid or cleared of materials easily. Because breast tissue is not something you can just magically clean and, oh, it's fine and be done with it. Now, the other time I've used the drain. Now, drains don't stop infections, they don't stop bleeding, they don't stop you from getting the seroma. Just so that everybody's clear, we hope that they do, but that's not ever been proven. So if you have a particularly problematic case and there's a propensity of bleeding for reasons beyond your control, maybe it's difficult to control their blood pressure. Maybe they just are somebody who has bled more during the case, maybe they're more inflamed. You never know the given situation. So I don't want to be throwing blanket statements here. So I will use them in those cases. But most of what I do is create an environment where I don't have to by lifting up the fold so that the fold will rise, disrupting that, that lower area so that internally it will drain. And that may sound like heresy, but I don't use drains and tummy tucks either. Haven't for a long time. So that you can do with a progressive suturing technique. And you can also do the same thing I just described, which is undermining and basically internally draining it, which is your body's gonna, if you will absorb the fluid and then eliminate the fluid provided several things are in order. Right. So I put patients on a particular diet that's higher in protein. I try to make sure the foods they eat don't create more inflammation or more edema or fluid. And we use supplements and we use anti inflammatories and we use ice. I mean we're doing all these things in conjunction with compression to help mitigate fluid production. Like if you have a multimodal approach, you'll do better. And some thin people, tiny little BMI patient will produce a lot of fluid and you'll be like, oh my gosh, how can this tiny person produce all this fluid? Well, if they don't compress, if they don't use ice, if they don't use their anti inflammatories, if they're not following the diet, they don't have enough protein in their diet. I mean there's, it's, it's pretty predictable who will do that. So as much as I can do to help, I need a patient who's really switched on to help themselves.
Yeah, yeah, definitely have to take responsibility. But the wonderful thing is that you offer all of these protocols and even just saying like, hey, if you up your protein and you reduce, you know, inflammatory foods, you're gonna have a better recovery. So I didn't, I had to research and try to figure all that stuff out on my own.
Take a screenshot of this podcast episode with your phone and show it at your consultation or appointment or mention the promo code podcast to receive $25 off any service or product of $50 or more. Dr. Robert Whitfield is a board certified plastic surgeon located in Austin, Texas, near 360 and Walsh Tarleton in Westlake. To learn more, go to drrobertwitfield.com or follow Dr. Rob on Instagram at doctorrobertwitfield. Links to learn more about Dr. Rob's smart procedures and anything else mentioned on today's show are available in the show Notes. The Holistic and Scientific Podcast is a production of the Axis the Axis IO.
