Should Sientra HSC textured implants be massaged?

I had a capsulectomy and implant exchange in January due to grade 4 bilateral CC. My surgeon didn't recommend massages or implant displacement. She said the textured implants should act like Velcro and " stick" to your own tissue. As a precaution to getting CC again I had ultrasound therapy. The nurse insists that the implants need to be massaged and moved. I am getting conflicting instructions. I have started to develop a hard capsule again and don't know whether or not to do the massages.

Doctor Answers 16

You do not need to massage textured implants

Sientra HSC round textured implants have a TRUE texture shell with a medium level of texturing. Clinical research on Sientra implants was recently published showing the lowest rate of capsular contracture ever published when their textured implants were placed under the muscle. For these reasons Sientra has a warrantee for capsular contracture that is automatic when you use one of their textured implants and it covers Baker grade 3 (visible) and grade 4 (painful) capsular contracture for patients undergoing first time breast augmentation.

Your plastic surgeon has given you the right advice. Texture is like a gentle form of velcro and your breast implant capsule needs to form and grow into the textured surface. This helps the collagen fibers in your capsule stay disorganized so that they stay soft and don't contract around the implant. If you massage the implants, you disrupt this process and lose the possible protective benefit of a textured implant. You should discuss this with your plastic surgeon so that you don't get these conflicting instructions.

There are other things that can minimize the risk of developing capsular contracture. Some plastic surgeons use a medication called Montelukast commonly known as Singulair to soften capsules around implants. It is a leukotriene inhibitor, and acts as an anti-inflammatory medication. It is used to treat asthma and seasonal allergies. Though not a lot of research has proven it, many plastic surgeons have a lot of experience using it to soften capsular contracture or to prevent it in patient who starts to feel some tightness. In appropriate candidates, I recommend patients who have capsular contracture take it before revisionary surgery and keep taking it for at least 6 months after surgery. This is an off label use of the medication, and should be used with caution in patients with liver disease. You should discuss with your plastic surgeon if you are a candidate.


Bay Area Plastic Surgeon
4.9 out of 5 stars 14 reviews

Sientra Breast Implants and Massage

Sientra implants do not need to be massaged and if you had textured Sientra implants they should not be massaged.  The reason is that the texture is designed to adhere or Velcro to your body so that have less risk capsule contracture over smooth implants.  Massage will hinder the adhering.
I hope that helps.
Best regards.

Brian Windle, MD
Kirkland Plastic Surgeon
4.9 out of 5 stars 56 reviews

Sientra Textured Implants and Massage

Your plastic surgeon is familiar with the recommendations of the particular breast implants she placed. She didn't recommend massage, and she explained that the textured implants stick to tissue like Velcro. Textured implants are designed not to be massaged. (You could call to confirm her instructions.)

Because the nurse is familiar with patients with encapsulated smooth breast implants, she knows that those implants need to be massaged. However, she is not a plastic surgeon and is apparently not aware of the no-massage recommendation for textured implants. Because Sientra textured implants have such a low capsular contracture rate, it isn't surprising that she doesn't have experience with this type of implant.

Unfortunately, no breast implant is associated with a zero risk of capsular contracture. Since you are developing another hard capsule, it would be a good idea to see your plastic surgeon again. 

Heather J. Furnas, MD
Santa Rosa Plastic Surgeon
4.9 out of 5 stars 29 reviews

Don't massage textured implants

You should talk to your plastic surgeon, but most plastic surgeons would not recommend massaging a textured implant.

Dennis Dass, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 139 reviews

Implant massage does not prevent capsular contracture

While smooth implants may need a little help settling into position, textured implants are not meant to move and should not be massaged. However, there is no good evidence that massage helps prevent capsular contracture anyway.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 47 reviews

Textured Implants

You should always follow the instructions of your plastic surgeon, if in doubt I would find another board certified plastic surgeon and get a second opinion.  Generally you do not massage a textured implant, it is possible the nurse performing the ultrasound therapy is not familiar with textured implants.

Kevin Rose, MD
Provo Plastic Surgeon
4.6 out of 5 stars 11 reviews

Massage not Recommended for Textured HSC Breast Implants

Thank you for your question.

No, we do not recommend massaging textured breast implants, including textured Sientra breast implants.

To be sure, ask your surgeon specifically.

I hope this helps.

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 150 reviews

Care for textured Sientra implants

Care for textured Sientra implants
Textured implants are generally not massaged.   they are meant to become part of the breast capsule and massaging will disrupt that

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 96 reviews

Do not "massage" textured implants.

Textured implants are designed to adhere to the tissues they touch. Any massage or displacement exercises that would be employed with smooth implants are NOT appropriate for textured ones. Your surgeon should always be considered the "final word" as far as advice, as it is s/he to whom you will go if there is another problem, not the nurse who gave you incorrect information.

The nurse was no doubt trying to help, but is either misinformed about "massage" and textured implants, or thought you had smooth implants, which would be the majority of implants in use.

If you are beginning to again develop capsular contracture, then you should talk to your surgeon, who may wish to consider Singulair or Accolate therapy (luekotriene inhibitors that may block inflammatory pathways that could be associated with your CC recurrence).

But NO massage or displacement! These maneuvers are simply mechanical movements designed to keep a surgically-larger pocket larger than the implant it encloses. Obviously, this is applicable only for smooth implants.

Let your surgeon know, but don't be too hard on the nurse who was simply trying to help, albeit in misguided fashion. Best wishes! Dr. Tholen

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 240 reviews

Massaging textured implants

I do not recommend massaging textured implants. There is little long term evidence of any significant decrease in capsular contracture with massage, while the texturing does help. I suggest seeing your surgeon though to make sure you are getting a recurrent contracture. A textured implant will not move around like a smooth one and it is important to let them examine you to make sure what is occurring.  If it is a recurrent capsule, then a site change will likely be a good idea.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.