I am 18 days post op BA. I got 300cc silicone unders. My PS doesn't start implant massaging until after my 1 month post op apt. I have read a lot of articles & posts that say early massaging will help soften the implants & relax the muscle allowing the implant to move like natural breast. My implants r soft but don't move much. Will starting massaging now help open the pocket so my breast r more movable? Or has the scar tissue already formed and it's too late? Any info is appreciated! Thx!
Will Massaging my Breast Implants Help to Soften Them?
Doctor Answers 15
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. 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. 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.
Pablo Prichard, MD
Massage after surgery
Contact your PS
An in-person exam with a board-certified plastic surgeon is the best way to assess your needs and provide true medical advice.
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Massage after breast augmentation
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 for the first several months.
Listen to your surgeon
Also, you should know that it takes about 3-4 months for your breasts to settle and appear more natural in contour. Until this time, they may look abnormally high, flattened and firmer.
Every surgeon has a bit different protocol. Just know that that there is no evidence to support or refute breast massage. Whichever method a plastic surgeon chooses is based in their experience. Speak with your plastic surgeon about your concerns.
Revisit the massage question with your Plastic Surgeon. I usually recommend massages at 10 days post op. This helps the implant to settle,as well as keep the pocket open. Also, this will depend on whether you have smooth or textured implants. Follow your Plastic Surgeon's post operative instructions for your best result.
Massaging breast implants
I believe massage helps. However...
1) How you massage matters (most women do not massage firmly enough)
2) How often and how consistently you massage matters
3) Massage will help with some softening if the capsule is not calcified, but it is a mild tool.
Consult with a board certified plastic surgeon prior to engaging in any massage protocol. There is also a company called Aspen which is located here in South Florida which is internationally known for its capsular contracture protocols.
If a capsule is too thick or there is some other reason that it has become thickened, you may have to either change the pocket or consider using an acellular dermal matrix product like Alloderm or Strattice to help prevent reformation of a hard capsule around the implant. It is the capsule (scar) around the implant which gets hard, not the implant itself.
I favor the use of implant message techniques to help keep the pocket bit more open. Also is serves a form of a breast self exam. I have my patients do these exercises for the life of the implant. I start these exercises around 10-14 days after the procedure. I think that even a month after the procedure would be helpful. Re-discuss this with your PS.