Massage for teardrop implants?

Question

During my last appointment (1 months op) I forgot to ask my doctor about massaging breasts. I don’t think he mentioned anything about that and I wonder if teardrop and smooth silicone implants require massaging. Some of the articles I came across state that teardrop implants don’t require massaging. Is it true?

Daniel Barrett, MD · Answer

Dear Aleksandrovna89,
I understand your concern. It is best that you consult your plastic surgeon regarding post operative care and management (i.e including massage techniques and timing) specific to your case. Your surgeon knows your condition well and has preferences on when and what to use for faster healing and recovery. Post operative care and management depends on the type of surgery performed and the technique used during surgery among other factors.It is best, however, that you follow your plastic surgeon's advice on post operative care management for a smooth and faster healing and recovery.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Gary Lawton, MD, FACS · Answer

Not only are your implants meant to stay in a specific orientation, but they are textured so the massage really would be a bad idea.For smooth implants, 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.

Ira H. Rex III, MD · Answer

In general, teardrop implants should not be massaged. In fact, this may cause them to move, and even tip over. You should talk to your plastic surgeon and get very clear instructions on how you should take care of these implants.

Kenneth Hughes, MD · Answer

Anatomic implants can rotate and shift, and I have had consultations for quite a few that have had that problem.  Unless your plastic surgeon cleared you to massage the implants, do not do so.Kenneth Hughes, MD, ABPS Board Certified Plastic SurgeonLos Angeles, CA

Aisha White, MD · Answer

This is a question that gets asked a lot by patients and the answer varies from surgeon to surgeon.  Some surgeons advise all of their augmentation patients to massage the implants, others specifically advise against it.  There is not necessarily one "right" way to do it.  I recommend you reach out to your surgeons office and see his or her preference.

James H. Rogers, MD · Answer

Teardrop, or anatomic implants have a three dimensional shape that requires precise placement to avoid asymmetry. While round (really hemispherical) implants can rotate without causing a deformity, teardrop cannot. For this reason, placement must be precise, and most teardrop implants have had a textured, or rough surface to prevent movement after placement.  It is generally recommended to not massage teardrop implants , at least initially, to prevent displacement. I always recommend, however, following your surgeons specific instructions for postop care for best results.

Emile Brown, MD · Answer

I would definitely not recommend massage of tear drop implants. These implants are textured so that your body will grip onto them and prevent them from rotating. Massage for smooth implants has never really shown any benefit either, and I think this is a bit of an "old school" teaching. I personally do not have any of my breast implant patients massage, regardless of whether they have smooth or textured implants.Emile Brown, MD
Board Certified Plastic Surgeon, Johns Hopkins & Harvard Trained

Nelson Castillo, MD · Answer

Thank you for sharing your excellent question.  Yes, teardrop implants do not require massaging as the motion could displace the implants into an incorrect position.  Hope this helps.

Chad Robbins, MD · Answer

Hello and thank you for your question .  There is no evidence that massaging helps soften or prevent capsular contracture .

Camille Cash, MD · Answer

Congratulations on your breast augmentation! Opinions vary by surgeon regarding massage of implants.  It is best to contact your surgeon and follow his advice for your best outcome.

Massage for teardrop implants?

Answers (13)

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