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

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.

Non-surgical management includes prophylactic massage to prevent it and if it occurs, the use of certain anti-asthma medications: Singulair and sometimes Acculate as off-label FDA usage to treat Capsular Contracture and in some cases of recurrence of capsular contracture in a preventative fashion. In my experience this works best for early diagnosed early contractures and used as a prophylactic, perioperatively when doing a capsular contracture surgery. The price for capsular contracture surgery varies greatly by geographical location, experience of the surgeon, whether in an outpatient surgery center vs hospital (hospital more expensive), type of breast implant, whether it is ruptured or not, estimated length of operating room time, and other factors.

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. You can repeat this several times a day.As far as capsular contracture, massage may help to keep the capsule nice and supple.  However, it will not provide a permanent risk reduction of developing a capsule in the future.

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. However, please listen to your surgeon. Ask them if you should be massaging your breasts.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.

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.

"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

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.

I personally don't think that implant massage does anything to prevent CC. This issue is related to low grade infection and inflammation around breast implants. External manipulation of the implats don't impact this process.

While capsular contracture is most likely to form soon after surgery, sometimes it develops months or even years later. I recommend that my patients get in the habit of massaging in their daily shower.I tell them I went them to retain their good results, like the one below (Click on link.)

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