Am I Doing the Correct Breast Augmentation Post-op Massage So As Not to Widen Pocket?

The displacement of breast implants is recommended to reduce the risk of capsular contracture. Perhaps that is unproven, but I have seen a few isolated cases where aggressive massage has helped to loosen a tight pocket that has begun to form when displacement was not being performed adequately.

Displacement of breast implants is done for smooth surfaced saline- and silicone gel-filled implants; it is not recommended for breast implants with a textured surface. Smooth breast implants will move freely within the pocket, while textured surface implants do not move -- either because of increased friction caused by the texturing, or capsular adherence to the textured surface.

Medial displacement of your implants is a normal part of the displacement exercise routine – but it will not allow them to move medially, since the medial border of the sub-pectoral pocket is defined (and limited) by the medial insertions of the pectoralis major muscle to the sternum. Nor, will the displacement exercises you have described cause widening of the pocket.

I have my patients begin implant displacement exercises one week following surgery. The acute pain of surgery has subsided by then so the displacement can be done a bit more comfortably.

Displacement Technique:

>> Place your hand flat over the central breast and press the implant inward towards the chest wall. Hold it there for a few seconds.

>> Lift each implant up; with your hand under the implant, slide it up the chest wall slowly, pushing it up towards the clavicle. Hold it there for a few seconds.

>> Push the implant medially; with your hand on the lateral part of the implant, slide it towards the sternum. Hold it there for a few seconds.

>> Push the implant laterally; with your hand over the medial breast, push the implant laterally. Hold it there for a few seconds.

The right implant can be displaced with the left hand, and vice versa. The displacement should be performed slowly and steadily with moderate force. Each displacement should be performed ten times.

Initially the displacement of the implant will be somewhat limited. But as swelling subsides, the tissues stretch, and the implant settles, the implants will move more easily in the pocket. Pain may somewhat limit your ability to move the implants initially, but as this subsides you will be able to displace the implants much more readily.

I only have patients push implants down if I feel they are not settling as intended.

Since there is a thought that these displacement exercises may reduce the risk of capsular contracture, I recommend the following frequency -- Perform these exercises three times daily for six months following surgery, then two times daily for the next six months, and then once daily thereafter. Prolonged use of displacement exercises may be more important for subglandular implants, as subpectoral implants seem to have a lower risk of capsular contracture.

Best wishes.
Kenneth Dembny

 

Thank you for your question.If you find that your breast is tight and particularly if you went up a few cup sizes, then breast massage will help your implants settle. I typically recommend waiting a week as it sooner may be too uncomfortable. However, if you can tolerate it earlier, then you can do so. I also recommend lymphatic massage as this helps to reduce swelling much faster in the breast.As far as how to massage, I recommend displacing the implant in all four directions (up, down, left and right). Example, pinch the breast on the top to displace the implant downwards. For the lymphatic massage, it is much more of a light gentle touch. We often recommend a massage therapist to help with this or we show patients how to do this at home.

Hello Jennylea,

Implant massage has no proven benefits, and I don't ever recommend it to my patients.  It will not prevent capsular contracture and it will not cure a tight or contracted capsule that has already formed.  Massage will not stop or prevent implant malposition toward the sides/armpits.  Saline implants have a propensity to drop with time, more than silicone gel implants, so there is no need to encourage them to drop either.  By this time, your breasts should be taking on a nice shape.  If this is the case, than don't be concerned about what might happen later. If you feel your implants are too far apart or too high, than discuss this with your plastic surgeon.

Best of luck!