Will Massages in First 6 Months After Breast Implants Virtually Eliminate Risk of Future Capsular Contraction?

When I got 300cc sub-muscular silicone breast implants 7 months ago, my surgeon told me that if I performed the massages he taught me for the first 6 months there'd be no further risk of capsular contraction. I've had no problems, but I'm seeing stories on this website of capsular contraction happening years and decades post-op. Is what my surgeon told me true in my situation?

Doctor Answers (13)

VIDEO: Breast massage for breast implant augmentation surgery

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In my experience breast massages will help minimize the risk but not completely eliminate it. I have prepared a video on this subject and strongly encourage my patients to perform  them .  See VIDEO below.


Chicago Plastic Surgeon
5.0 out of 5 stars 41 reviews

Breast Massage Technique

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Thank you for your post. Unfortunately, capuslar contraction can happen at any time, even 10 years down the road.  Whether or not you have smooth or textured implants, however, you should follow some sort of massage technique. Massage is not a full proof prevention of capsular contracture, but it helps.
There are many reasons why one would want to do breast massage after surgery. These include,
1. to try to massage an implant into place that is assymetric with the other side,
2. to try to massage implants down that are too high,
3. to try to massage a constricted area of the breast to loosen up, as in tubular breasts, and finally
4. to try to prevent capsular contraction around the breasts.
As you probably have guessed, the type of massage for these different issues will be different as we are trying to accomplish different things. If the massage is done incorrectly, or past the point of symmetry when trying to lower an implant, then yes, it can cause bottoming out or widening. Follow these guidelines to avoid this. Your implants will get softer natually as the swelling goes down, so you should always follow your particular doctors recommendations regarding massage. These are the instructions I give my patients:

1. When the implants are assymetric, or appear to be at different levels or height, then the massage is different from side to side. This occurs sometimes if the implants are placed under the muscle and one muscle is released slightly different from the other side, or the muscle is naturally larger or different shape from the other side. Sometimes massage is performed to one breast only, and sometimes to both breasts but in different directions. You should ask your surgeon for specific instructions as every situation is different, but in general, think of the breast as a 'circle', and massage with significant breast on the opposite side of the circle that you want the implants to go. You have to feel an actual stretch in the tissues in the area that the implant need to go for this to be of benefit, otherwise you are not really accomplishing anything. If the massage is in the direction of the incision, I usually protect the incision with steri-strips in order to keep the scar from widening in the early first 3 months during the massage. The massage needs to be finished in the first three months and started early, otherwise it will have little to no benefit. Look at the breasts and analyze the symmetry and where the deficient areas are to make a nice smooth beautiful contour, and stop once that goal is achieved.

2. When the implants are high, and have not dropped, but are symmetric, some physicians use a tension band on top of the breasts, some ask the patient to go without a bra and allow gravity to slowly move the implants, some do a similar massage to the above but doing exactly the same thing on both sides. Consult with your physician on this.

3. When there is a constricted breast like tubular breasts, I sometimes have the patient massage as in #1, sometimes have them massage both sides of the 'circle' to loosen the constricted skin, and usually leave the patient out of a bra if both sides have tubular breasts or constriction at the bottom, or if only one side is constricted, have the patient wear a bra, but cutting out he cup on the side that is constricted, so that only the normal side is supported.

4. Finally, maintenance massage. I disagree with surgeons who want to keep the pocket or 'capsule' of the breast where the implant is contained larger than the implant. This aids in the implant becoming more and more displaced over time, with more separation at the cleavage point especially when you lay down, and can also cause sagging of the breasts. I actually use textured implants as a way to fight the implants moving inside the capsule of the breast so that they stay 'perky'. Natural 'perky' breasts stay in place when standing up or laying down, so 'perky' implants should do the same. I think the implant should fit in the capsule or breast pocket like a glove, and actually be adhesive to it. Thus there is a 'perfect' amount of massage that is necessary to keep this capsule flexible, but not wider than the actual implant and thus allow for movement of the implant and thus sag. I like grabbing the breast and pressing the opposite sides of the 'circle' toward the center, causing the central or nipple area to bulge out. I have my patients do this pushing the top and bottom together, the sides together, and then both diagonals together. This puts more pressure on the central portion of the implant, rather than the sides to allow the implant to continue to be adhesive, but the capsule to not widen. I ask my patients to develop a routine and do it in their morning shower, this way it becomes habitual and they won't forget, as this is a lifelong routine that should be performed.


Best Wishes,
Pablo Prichard, MD

Pablo Prichard, MD
Phoenix Plastic Surgeon
5.0 out of 5 stars 24 reviews

Massage Cannot Eliminate Risk of Capsular Contracture

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Since the rate of capsular contracture in my practice is low after breast augmentation, you do not need to do any massage unless I advise it. 99% of my patients are advised not to massage, a recommendation I have been giving for over eight years. If you are instructed to do massage exercises, it would be a little later on in your recovery so that things can get a chance to settle and tissues are allowed to strengthen a bit. I normally do not recommend breast massage for about a week to 10 days after surgery because your body is still recovering from the trauma of surgery. It is still "raw" inside, and massage may cause bleeding, increasing the risk of capsular contracture. It also hurts! However, please listen to your surgeon.

In my opinion, I do not think that massage can "virtually eliminate" the risk of capsular contracture. There is no guarantee this can happen, and I would ask the surgeon to provide you with proof if this is the case.

Jerome Edelstein, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 51 reviews

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Will Massages in First 6 Months After Breast Implants Virtually Eliminate Risk of Future Capsular Contraction?

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The answer to your question is no. Science does not understand capsular contracture at this time. We do have a number of theories as to why it occurs, the current one is inflammation caused by a subclinical infection around the implant. It is also true that capsular contracture occurs with the highest incidence in the first year after implantation; however, it can occur any time in the patients life after implantation without necessarily rhyme or reason. I also recommend massage, and I believe it does help in preventing capsular contracture but this is only anecdotal(25 years experience) and not based on science.

Paul Vitenas, Jr., MD
Houston Plastic Surgeon
5.0 out of 5 stars 37 reviews

Capsular Contracture

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"Massage in the first 6 months will eliminate the risk of capsular contracture"....Give me your doctor's name, I want to learn the same massage technique he uses!

Here's the Real Deal:

Capsular Contracture is still an enigma to us plastic surgeons; although we have some ideas on causes (hematoma, multiple surgeries, style of implant(?), etc.) we do not know for sure what causes it. We also know that over the life-time of your implants, the risk of developing capsular contracture increases steadily.

Recent studies also point to small infections around the implant called Biofilms that aggravate the scar tissue into "squeezing" down on implants. I have recently been using a Funnel device to place the silicone implant into the breast pocket....the Funnel allows me to do so without EVER touching and potentially contaminating the implants. I think it works great and current studies are looking at it's use with respect to prevention of capsular contractures.

Bottom line that I tell my patients, is massage is great to keep the implants soft and I have my patients start massage at 2 weeks after surgery and continue FOREVER. Certainly cannot hurt, but I do not think it COMPLETELY removes the risk.

Hope this helps!

Good luck!

Dr. C

johnconnorsmd.com

John Philip Connors III, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 14 reviews

Massage to minimize risk of capsular contracture

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The greatest risk for contracture Is within the first 6 months. Massaging the implants has shown to help minimize this risk but like many things in plastic surgery, there is not a great deal of science behind it. Your surgeon's experience and my own as well has shown this to be true in some cases. However, there is a small chance of contracture occurring at any time, one year later, two years later or even 20 years later. At the end of the  implants lifespan when implants fail, one of the first ways we know it is failing if by seeing contracture set in. This will not likely be an issue for you for 20 to 30 years. 

Andrew Kaczynski, MD
Sacramento Plastic Surgeon
5.0 out of 5 stars 55 reviews

Early massage after breast augmentation is no guarantee against capsular contracture!

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While early massage is very effective in softening the capsule around your implants, there is no guarantee that you will not develop capsular contracture down the road.  The thought is that by placing your implants under the muscle, the overlying muscle actually manipulates the capsule on the daily basis following your healing and so may lead to less issues with firmness.  But, this has never actually been proven. 

Your best bet for avoiding contracture is to be vigilant and see a local Plastic Surgeon if you develop any early signs or symptoms of contracture.  CC is very easily treated if caught early and surgery is not always necessary.

Gregory A. Buford, MD, FACS
Denver Plastic Surgeon
5.0 out of 5 stars 2 reviews

Massaging Augmented Breasts is NOT a Cure for Capsular Contracture (Scarring)

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Regarding: "Will Massages in First 6 Months After Breast Implants Virtually Eliminate Risk of Future Capsular Contraction?
When I got 300cc sub-muscular silicone breast implants 7 months ago, my surgeon told me that if I performed the massages he taught me for the first 6 months there'd be no further risk of capsular contraction. I've had no problems, but I'm seeing stories on this website of capsular contraction happening years and decades post-op. Is what my surgeon told me true in my situation?"

Your Plastic surgeon views on the topic of capsular contracture, if you correctly understood him, are in a distinct  minority. The vast majority of Plastic surgeons view capsular contracture as an overwhelming scarring in response to bleeding, foreign body reaction and especially infection. While breast massaging done right helps keep a pocket size as it was after surgery, there is NO evidence that it can prevent contracture.

Dr. Peter Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon
5.0 out of 5 stars 58 reviews

Massage and capsular contracture

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While I recommend massage because I think it can not hurt and may help, there are no scientific studies that support it one way or the other.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 15 reviews

No data

+1

There is no data to support that massaging will eliminate the risk of capsular contracture that I am aware of.

Samer W. Cabbabe, MD, FACS
Saint Louis Plastic Surgeon
3.0 out of 5 stars 2 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.