The table is only dropped and re-created in cases where that's the only way SQL Server's Management Studio has been programmed to know how to do it.
There are certainly cases where it will do that when it doesn't need to, but there will also be cases where edits you make in Management Studio will not drop and re-create because it doesn't have to.
The problem is that enumerating all of the cases and determining which side of the line they fall on will be quite tedious.
This is why I like to use ALTER TABLE
in a query window, instead of visual designers that hide what they're doing (and quite frankly have bugs) - I know exactly what is going to happen, and I can prepare for cases where the only possibility is to drop and re-create the table (which is some number less than how often SSMS will do that to you).