Is 1 week post-op too soon to massage after Breast Augmentation?

Question

I am now 10 days post op. I have silicone implants under the muscle and was told to start massaging at my week 1 appt. I have done the massage for two days with only little soreness afterwards. I am a crossfitter and powerlifter, and was bench pressing at twice a week leading up to surgery, my muscles are still decently tight. I cannot find anyone who was given the permission this early. Is it too soon? Could it be because my muscles are tighter and they want to make sure they fall?

Sanjay Grover, MD, FACS · Answer

There is no good data or research to support the breast massage following breast augmentation.  There are surgeons that recommend breast massage and others that do not.  I have been performing breast augmentation for over twenty years and do not have my patients massage their breasts post op.  If an adequate pocket is created for a smooth, round implant, the implant will settle nicely over time as the tissues expand.  I have seen a very low rate of capsular contractures as well.

Martin Jugenburg, MD · Answer

Massage is not a one size fits all cookie cutter thing. Massage is or is not recommend to each patient based on the individual needs of the patient. You need to listen to your chosen surgeon he or she is the only one who can advise you on post op massage.  Regards,

Jerome Edelstein, MD · Answer

Hello,Not all Plastic Surgeons recommend massage or implant displacement. I recommend that you ask your Plastic Surgeon and follow their advice specifically for you.All the best

Jaime S. Schwartz, MD, FACS · Answer

I appreciate your question.

I would recommend that you discuss this question with your surgeon as every surgeon has their own respective post op protocol for his/her patients.  Your surgeon is your best resource as he/she is most familiar with your medical history and how you are healing at this time.

The best way to assess and give true advice would be an in-person exam.

Please see a board-certified plastic surgeon that specializes in aesthetic and restorative plastic surgery.

Best of luck!

Dr. Schwartz

Board Certified Plastic Surgeon

#RealSelf100Surgeon

Jeffrey G. Lind II, MD · Answer

Thanks for your question and congratulations on your surgery.  As others have mentioned, you should only be following the advice of your operating surgeon at this point.  If you ask 10 plastic surgeons their routine for post-operative massage you will get 10 different answers so its best to ask YOUR surgeon their rationale.  Best of luck to you.

Vishnu Rumalla, MD · Answer

Thanks for your inquiry, but frankly only your surgeon and his/her should answer questions about massage and activity at the less than 2 week mark.  Please ask your surgeon for his/her rationale and hope for a speedy recovery.

Jed H. Horowitz, MD, FACS · Answer

HEALING AFTER BREAST SURGERY, AUGMENTATION, LIFTS1.    pain is variable2.    it takes 2-3 months for implants to settle and muscles to relax3.    celebrex, motrin, and muscle relaxers can help4.    massage and stretching may help5.    everyone heals differently6.    4-7 days off from work is commonHEALING OF SENSORY NERVES: Tingling, burning or shooting pains, which will disappear with time and should not alarm you, indicate regeneration of the sensory nerves. If these sensations cause pain, repeated, local self-massage helps.ASYMMETRY: The two breasts commonly heal quite differently. One breast may swell more, feel more uncomfortable, or have a different initial shape. After complete healing, they will be more similar and natural. You must have patience, but if this causes concern, ask questions of the doctor or the nursing staff.SHAPE AND CONTOUR: The final shape of your breasts will start to look its best approximately three (3) months after surgery. It takes time for the skin and muscle to stretch and relax around the new implant. The breast will often look higher, firmer, and “less natural” in the first three (3) months. It can take up to a year to see your final result.FOLLOW-UP EXAMS: These are generally done in 1 week, 2 to 3 weeks, 3 to 6 weeks, 3 months, 6 months to 1 year, and 1-2 year intervals. In our office we include all of your follow up appointments in the initial surgical fee.While there may be a number of issues of concern following your procedure the best thing to do is visit your surgeon with any questions to make sure that healing is progressing as it should or if additional work will be needed. Best of luck to you.

Gary Lawton, MD, FACS · Answer

Implant massage is a critical part of the postoperative recovery from breast augmentation (like physical therapy is a critical part of the postoperative recovery from knee surgery).  The space for the implant is meticulously crafted at the time of augmentation surgery, especially when the operation is performed using the surgical endoscope through the transaxillary approach.  However, the distance from the nipple to the inframammary fold needs to stretch out to accommodate the implant (dropping) and the skin and muscle need to relax to give the desired shape (fluffing).  Implant massage allows you to manipulate the pocket from the inside to direct the forces in the appropriate directions to mold the breast shape to the desired outcome.  If the scar that is actively forming around the implant is allowed to heal without the influence of breast massage, the fold will not stretch appropriately (implant stays too high), the scar will attempt to contract in a linear way over the curved surface of the implant (breast shape will remain too flat), and the space will attempt to heal smaller and tighter than the implant (capsular contracture).  Implant massage influences the scar formation on the inside at the most critical phase of the healing, allowing the space to be larger than the implant (mobility which creates the natural feel and bounce).

Implant massage starts at one week at 5 times per day for one minute at a time and continues at this pace until one month.  I often see the patients weekly during this time to reinforce the technique and help the patients who need extra effort to soften the breasts. During this time period, the massage also breaks up the spasm, relieving the discomfort, particularly upon awakening from sleep (morning breast).  During the day, every time there is the sensation of tightness, implant massage breaks up the spasm and relieves the discomfort, minimizing the need for narcotics.  At one month, the force that can be exerted is increased but the frequency of massage decreases to 3 times per day.  As the wound matures, the massage can decrease to once per day forever as maintenance.  The patients integrate this into their shower routine.

Although some patients can get away with no massage, it is a common issue for those who stop the massage and make none of their follow up appointment to suddenly show up years after surgery claiming that they woke up one morning with a capsular contracture and implant malposition.  Of course this did not happen overnight, but was a slow process that could have been prevented with daily maintenance massage and regular routine follow appointments on a yearly basis (which we provide for free, forever). With this type of perpetual follow up, it is possible to identify a problem early that might need a modification in the massage technique.

Implant massage involves moving the device up against the wall of the pocket, holding pressure against the surface of the scar. The specifics are determined on an individual basis guided by what the patient needs. In some patients it is simple and of little significance.  In some patients it is a struggle to get the implants into the right position and to gain softness and mobility, but with the right technique and the appropriate dedication it is a huge success.  For the patients that do not participate in the massage in a meaningful way, some will get away with their lack of dedication because they were going to have soft breasts no matter what.  On the other hand, some patients will squander their opportunity to have an excellent result because they don't believe that the massage is necessary, or because they have been told by their friends or other doctors that they didn't need to perform massage.  Regardless, they often require surgery that could have been avoided by following the postoperative instructions of a surgeon that has performed nearly 10,000 breast implant operations and has seen the healing of each of those patients and integrated the successes and failures of each one into a postoperative plan that really works.

I find no use for bands, straps, bras or appliances after breast augmentation surgery.

Usha Rajagopal, MD · Answer

I usually have my patients wait about 2 weeks before starting the breast massage, obviously only if this is a smooth implant, not a textured implant. I would have you ask your surgeon what the best time for a massage is. Generally I would say about 2 weeks, and the massage to be done once a day, and the massage takes about a few minutes.

Scott E. Kasden, MD, FACS · Answer

Hi adangDo yourself a favor.  Don't listen to anyone but your surgeon.  Call him and ask him.  Although you sound healthy and you seem to be making a normal recovery, not all operations are the same.  Only your surgeon knows what was done, and what might be right for you.  Don't guess, know!  Call him.Regards.sek

Is 1 week post-op too soon to massage after Breast Augmentation?

Answers (11)

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