To Drain or not to Drain, That is the question.

[GnomeKid]

I definitely would go with drains.  They really weren't that big of a pain in the ass, and with all the vicoden its really not a bother.  I guess just seems a safer bet to me?  but I'm no medical expert

I agree though about the antibiotics.  Why do doctors love to give them out when there is no problem?!  We're creating super bacteria!!! I definitely did not take antibiotics after surgery.  (In fact I typically toss the prescription in the trash unfilled in almost any situation) 

[Kreuzfidel]

I'm in Australia, and I've not heard of anyone here NOT using drains.  I was given "prophylactic" antibiotics for only one day - that being said, Australia doesn't even have the antibiotic culture that America does - so considering I'm almost never given antibiotics here unless I'm seriously unwell, I took them as I figured they had a reason for wanting me to.

[Simon]

I put down my deposit and secured my surgery day today! Surgery is July 31st at 7am, I am sooo excited even if it seems a lifetime away at this point.

My pre op appointment is July 21st. I'm going to tell him I want drains for certain then. I think it would put my mind at ease. I'd rather deal with a little annoyance for a week then possibly effect my long term results.

[AdamMLP]

Jay, I think I possibly know who you're talking about with the haematoma, I think I remember him saying that Yelland told him that it happens in 1% of all operations, and his chest still looks amazing.  From the pictures I've seen you'd have never have guessed that there'd ever been any complications.

Doctors here hate giving out antibiotics unless there's a real reason to (in which case you should definitely take them) because the bacteria becomes more resistant to them.  We've had a couple of instances of really nasty MRSA here, which is why we're generally against them.  Prophylactic literally just means that they're given as prevention rather than cure.

[aleon515]

Jay, I think I possibly know who you're talking about with the haematoma, I think I remember him saying that Yelland told him that it happens in 1% of all operations, and his chest still looks amazing.  From the pictures I've seen you'd have never have guessed that there'd ever been any complications.

Doctors here hate giving out antibiotics unless there's a real reason to (in which case you should definitely take them) because the bacteria becomes more resistant to them.  We've had a couple of instances of really nasty MRSA here, which is why we're generally against them.  Prophylactic literally just means that they're given as prevention rather than cure.

Well I think that complication rate anyway is 1% (I am pretty sure you do know who I am talking about-- pretty well known older trans guy). I don't think you can make a case from one individual. Usually they don't end up making a chest look worse. I have only seen once where it absolutely did.

It's very very common to give prophylactic antibiotics for ANY kind of surgery here (including dental). But I don't go to a doctor, myself, who is very big on prescribing antibiotics, but many doctors here are more big on them.


--Jay

[Bimmer Guy]

I think the U.S. is finally starting to get the idea that we have been over prescribing anti-biotics.  It seems like docs are not handing them out as easily as in the past. 

However, yes I took them after surgery (Garramone), and since I very rarely take an antibiotic, I was fine with it.

[timbuck2]

I didn't have drains. No complcations and the recovery was relatively painless.
I can't find the article so I don't want to say it as fact, but I believe it's been proven that the drains don't make much of a difference in aiding recovery.

[Bimmer Guy]

I didn't have drains. No complcations and the recovery was relatively painless.
I can't find the article so I don't want to say it as fact, but I believe it's been proven that the drains don't make much of a difference in aiding recovery.

timbuck2, can you please remind us who your surgeon was?

[timbuck2]

timbuck2, can you please remind us who your surgeon was?

Ah, sorry! Curtis Crane in San Francisco, CA.

[Bimmer Guy]

Ah, sorry! Curtis Crane in San Francisco, CA.

No worries, it was my fault.  You have told us before.  I think it is helpful though, that people know who doesn't use drains if others are looking.  Do you happen to know if Brownstein used drains?  I know that he trained Crane. 

Did you have much liquid floating around in there?  I know FB and Nathan said their's felt kind of weird.

[Simon]

Ah, sorry! Curtis Crane in San Francisco, CA.

That's interesting, I didn't know Dr Crane did them without drains (I know Brownstein used to use them).

I know Dr Raphael and stopped using drains but he uses a technique where he "quilts" the skin to the muscle tissue so there is really no room for fluid to pool.

I'm still on the fence. I have a good while to think about it (pre op is July 21st) so between now and then I think I'm going to research to see who didn't have drains and what results they had.

[timbuck2]

I know Brownstein used them but I'm under the impression that Crane has only recently started doing them without drains. He may have started soon after he took over the practice, I can't quite remember.

For the first few days after the big reveal they did feel kind of weird...I'm not sure if I could say it was a feeling of liquid but it definitely was strange. If there was any extra fluid it was certainly reabsorbed by the body

And Simon, if you'd be interested in pictures of my chest for for comparison purposes I'd be happy to message them to you

[FlightyBrood]

FB's and Nathan's surgeon didn't do drains.  I think he has only done a handful of these surgeries, though.

To circle back to what I was saying Simon, is if it is that rare for surgeons not to use drains, than I would say yes to the drains.

You rang? Yeah, our surgeon doesnt use drains, he said theyre uncomfortable and not really needed. SOMETIMES seraomas can pop up but those are easily drained and can happen even WITH drains.

I also found out from a nurse that my surgeon, who is AMAZING in every way, has been doing gender reassignment surgeries since the 80s-He even used to do Phallo! But he stopped, knowing him its because he couldnt give patients a working penis, and that bothered him. But i cant say for sure.

Anyways, neither me nor my boyfriend had drains and everything is fine. no fluid build up and no uncomfy drains. it is a bit weird to feel fluid moving through your chest though. Nate HATED it.

I would say, go without them. The worst case scenario, you have a little build up that can be removed easily, and the little loose 'pocket' that people sometimes get tightens with time. No dog ears, either!

[Jack_M]

By the way, having drains or not has nothing to do with dog ears. Just thought that worth mentioning. Skin will tighten to where it's going to over time regardless of draining or even haemotomas or seromas as complications. I had one of the worst cases of fluid build up and don't have dog ears. The biggest factors with regards to whether or not you get dog ears are how good your surgeon is and your physique. If you're at a healthy weight with some pec development, assuming you have a good surgeon you have far less chance of dog ears than someone overweight with a less talented surgeon. Of course there will be lucky or unlucky cases; it's more a general norm.

[Bimmer Guy]

By the way, having drains or not has nothing to do with dog ears. Just thought that worth mentioning. Skin will tighten to where it's going to over time regardless of draining or even haemotomas or seromas as complications. I had one of the worst cases of fluid build up and don't have dog ears. The biggest factors with regards to whether or not you get dog ears are how good your surgeon is and your physique. If you're at a healthy weight with some pec development, assuming you have a good surgeon you have far less chance of dog ears than someone overweight with a less talented surgeon. Of course there will be lucky or unlucky cases; it's more a general norm.

It seems to me like there are either more skilled surgeons coming into the mix or surgeons are getting better.  I don't hear of many guys getting dog ears anymore. 

To follow up with what Jay said about heavier guys with less talented surgeons getting dog ears, the other thing is that sometimes it is back fat that the person is complaining about and not dog ears.  That is additional surgery.

[Simon]

On the dog ear subject, I'm not worried about it. My surgeon fixes those for free under local anesthetic if those happen.

[Berserk]

I didn't have drains for my surgery and didn't have any complications. My surgeons afaik never uses drains, he told me that the way he performs the surgery does a lot to reduce fluid build up and so drains aren't necessary. He's been performing top surgery since the 80s, and apparently performs 4-5 per week still. Personally, I'd say don't do the drains if your surgeon offers the option. A friend had bad complications with his chest (did his with another local surgeon), but they still managed to drain his chest as needed without them, and now he's fine.

[Bimmer Guy]

I didn't have drains for my surgery and didn't have any complications. My surgeons afaik never uses drains, he told me that the way he performs the surgery does a lot to reduce fluid build up and so drains aren't necessary. He's been performing top surgery since the 80s, and apparently performs 4-5 per week still. Personally, I'd say don't do the drains if your surgeon offers the option. A friend had bad complications with his chest (did his with another local surgeon), but they still managed to drain his chest as needed without them, and now he's fine.

Hi, Berseck.  Can I asked who your surgeon was?

[Berserk]

Hi, Berseck.  Can I asked who your surgeon was?

Dr. McLean at the McLean Clinic in Mississauga, Ontario. Both he and the staff were really amazing and I'd definitely recommend him. Total was 7,345 including taxes (Canadian Dollars) which also included revisions.

[Bimmer Guy]

Dr. McLean at the McLean Clinic in Mississauga, Ontario. Both he and the staff were really amazing and I'd definitely recommend him. Total was 7,345 including taxes (Canadian Dollars) which also included revisions.

Great.  Thanks for your response.