I'm asked to follow a generic massage routine (one fits all) involving pushing the implants in all directions as much & hard as possible despite of the fact that my implants have already sat low (or the right place) after the surgery and I'm not comfortable to push them hard downwards or outside (too much stretch on the skin there already).
Detailed Massage Technique for Post Breast Augmentation Surgery
Doctor Answers (3)
VIDEO: DETAILED BREAST MASSAGE TECHNIQUE: your wish is answered!
SEE ATTACHED VIDEO illustrating our recommendations for breast massage technique that we emploly in our office. First discuss with your surgeon prior to implementing this routine!
My Detailed Breast Massage Technique
Thank you for your post. Massage depends on what you are trying to achieve. In general, even if the implants are positioned perfectly, even if they are texture, even if they are anatomical, I still recommend light massage as in #4 as keeping the capsule that forms around the implant soft a pliable, I believe can help prevent capsular contraction. I included my massage techniques to show you what massage can and can't do. Certainly, as in your case, if the implants are already too low, then massaging them lower is not the answer.
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 naturally 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. If done indiscriminately then you can go too far and bottom out. Make sure you are paying close attention and stop once the desired contour or position is reached. Once this is reached, I recommend good support with an underwire bra that hits you precisely in the crease that was made while positioning the implant.
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.
Pablo Prichard, MD
Massage after Breast Augmentation
Thank you for the question.
Since you have had the procedure I would recommend that you follow your plastic surgeon's recommendations. Most likely he/she has recommended massage of the breast implants which is felt by many plastic surgeons to be helpful in keeping the breast implant soft. if you have questions about the specific technique your plastic surgeon recommends then address those with him/her during your next visit. Otherwise, I'm afraid you will be confused or overly anxious with online consultants' recommendations.
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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.