How Soon Should I Start Massaging After a Breast Augmentation?

I am at the end of my 2nd day of post op, I am 5'6 134lbs, and was given 600cc's high profile silicone under the muscle. I was very small, an AA cup pre-op and They are very tight and sitting high on my chest and also into my armpit area making it uncomfortable (not painful...just annoying) to just BE...I cannot help myself but to massage softly and try to move the implant down a little bit, but I don't want to damage anything, or massage prematurely. Is it safe to massage them so soon after op?

Doctor Answers 23

Timing of Breast Massage depends on purpose of Breast Massage.

Dear aura,
thank you for your post. 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.

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

Phoenix Plastic Surgeon
5.0 out of 5 stars 37 reviews

8900 Raintree
Scottsdale, AZ 85260

Massaging After Breast Augmentation

In general, one should begin breast massage after 3-5 days to allow for early movement and minimized scar formation. This has been shown to diminish the incidence of capsular contracture.

Rod J. Rohrich, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 30 reviews

9101 N. Central Expressway
Dallas, TX 75231

Is Post-Op Day 2 Too Soon To Massage Breast Implants?

Talk with your plastic surgeon about when he or she feels it is best to start massaging your implants. Often very soon after surgery the breasts are too swollen and bleeding may be a concern. (You should also be sure you have smooth breast implants, since textured ones shouldn't be massaged.)

To see a breast augmentation case after complete healing, click on the link below.

All the best.

Heather J. Furnas, MD
Santa Rosa Plastic Surgeon
5.0 out of 5 stars 26 reviews

4625 Quigg Drive
Santa Rosa, CA 95409

Timing of breast massage after implants

There is no fixed answer. You should be far enough out from surgery that you are not causing further swelling or pain by the massage. Only massage smooth implants and not textured implants. If in doubt, always check with your surgeon first. Best wishes. 
The video below explains the massage process. 

Francisco Canales, MD
Santa Rosa Plastic Surgeon
5.0 out of 5 stars 25 reviews

4625 Quigg Dr
Santa Rosa, CA 95409

Implant massage

I do not require my patients to massage their breasts, but I allow them to do so at two weeks. At two days you are likely to cause additional swelling leading to more discomfort and may place extra strain on your fresh incisions. I would recommend adding ice packs to the sides of your bra to help with the discomfort. Do not place ice directly on the skin - wrap it in towels or use prefabricated ice packs with the cloth toward your skin. Best of luck!

Grant Stevens, MD
Los Angeles Plastic Surgeon
4.5 out of 5 stars 94 reviews

4644 Lincoln Blvd
Marina Del Rey, CA 90292

Massage after Augmentation

Each surgeon has their own criteria.  Here is mine:

Breast Massage 
I am a big advocate of breast massage.  I like to wait until the first postoperative visit to begin massage for three reasons.  
1.  I do not want excess tension on the fresh incision, which can cause wound healing problems
2.  Massage will increase soreness and I want to get patients off pain medication as quickly and safely as possible.
3.  Early massage can increase the risk of bleeding, which is the number 1 cause of capsular contracture/scar formation.

For this reason, I begin massage therapy at the first visit, which is 4-7 days postop.  I then establish a regimine of 3 minutes of massage 3 times a day for 3 months.
I do prefer a bra, especially in physically active patients, as I find it helps prevent the implant from dropping too much and causing implant malposition.

Paul S. Gill, MD
Houston Plastic Surgeon
5.0 out of 5 stars 62 reviews

9200 Pinecroft
The Woodlands, TX 77380

When do I start massage after breast augmentation.

If you went from a double A to a 600 CC implant  you're already typing on the Internet it sounds like you're already pretty much a head of the game.

Each plastic surgeon will generally have his or her own regimen for when to massage and how to massage.

In my own practice we give instruction to begin a gentle massaging at the first postoperative visit one week after surgery.  I generally find a patients are quite sore right after surgery so I don't mind waiting about a week.

At the third week we give instructions for a more aggressive massage.  I also encourage my patients to wear an elastic Velcro strap that we provide that gives gentle compression to the upper portion of the implants heading them south in the same direction.  We usually begin this about a week after surgery.

I would suggest you check in with your plastic surgeon and see what his or her regimen is. 

Good luck for a quick in speedy recovery.

Adam Tattelbaum, MD
Washington DC Plastic Surgeon
5.0 out of 5 stars 68 reviews

3203 Tower Oaks Blvd
Rockville, MD 20852

Breast implant massage after breast augmentation

Breast implant massage is a common postoperative practice, but not universal. Different surgeons have different protocols - just check with yours. In my patients I usually have them start after their first postoperative appointment (usually around 1 week after surgery). There is no harm in starting earlier, you just need to be gentle.

I hope this helps!

Bryan Correa, MD
Houston Plastic Surgeon
5.0 out of 5 stars 8 reviews

4850 West Panther Creek Drive
The Woodlands, TX 77381

Implant Massage

 I often have patients start breast implant massage three days after surgery to prevent capsular contracture, but only for smooth surfaced implants. For patients with textured surfaced implants, whether round or tear-drop (anatomic) shaped, there is no need to massage, and in fact, may be detrimental.  

Nirav Savalia, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 31 reviews

180 Newport Center Dr.
Newport Beach, CA 92660

To massage or not to massage

Best to follow your surgeon's protocol and advice.  No one has really scientifically studied massage.  Surgeons do it but many do not.  I think it's more important what's done in surgery in terms of being precise, gentle and meticulous. 

Matthew H. Conrad, MD
Wichita Plastic Surgeon
5.0 out of 5 stars 11 reviews

1700 Waterfront Pkwy
Wichita, KS 67206

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.