Have I damaged my breast augmentation?

I had a breaks augmentation about 4 months ago and was massaging my breasts tonight when one of them felt as if the muscle was tearing at the top part of my breast. The pain is pretty sharp and I am concerned that the pectoral muscle is torn and the augmentation is damaged. I stopped massaging and still am having some pain. Should I be concerned?

Doctor Answers 8

Pain with massage

In the absence of swelling, bruising, and fluid collection. It is not likely that you tor the muscle through massage.  You should contact your plastic surgeon for an examination to confirm these impressions.

Implant massage

This sounds as if you were previously not doing the massage hard enough and you broke up some of the scar tissue.  Sounds positive to me.  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.

Pain 4 months after breast augmentation

I would recommend following up with your plastic surgeon for further evaluation.  Since there has been in a change in your breasts, it is best to get evaluated.  Best of luck to you and thank you for your question!

Chad Robbins, MD
Nashville Plastic Surgeon
5.0 out of 5 stars 35 reviews

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Thank you for your question.
In all likelihood, you have not damaged anything.  However, since there has been a change in your postoperative course, it's best to contact your surgeon to discuss the issue.

Best,
Dr. Dan Krochmal
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Thank you for your question.Since there has been a change in your recovery, I would contact your plastic surgeon to have a physical examination performed. It is hard to give you accurate advice without pictures or an examination. Your doctor is the best person to contact with any questions or concerns you may have. Best of luck in your recovery.
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Pain after massage

Thanks for your question. This early post-op it's more likely that a small tear has occurred in the capsule surrounding the implant. If no overt bleeding takes place, enlargement of the breast would be the tell tale sign, then it will resolve on its own. Follow up with your chosen plastic surgeon is recommended. Best of luck.

Marc J. Salzman, MD, FACS
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Pain after massaging implants

Hello.  It is more likely that you have caused some minor damage to the capsule that is forming around the implant. At 4 months, the capsule is fairly thin in most people and can sometimes be slightly torn.  In most cases, this resolves on it's own.  For peace of mind, it is best to follow up with your plastic surgeon.

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.