How Soon Should I Start Massaging After a Breast Augmentation?

I am at the end of my 2nd day of post op, I am 5'6 134lbs, and was given 600cc's high profile silicone under the muscle. I was very small, an AA cup pre-op and They are very tight and sitting high on my chest and also into my armpit area making it uncomfortable (not painful...just annoying) to just BE...I cannot help myself but to massage softly and try to move the implant down a little bit, but I don't want to damage anything, or massage prematurely. Is it safe to massage them so soon after op?

Doctor Answers 32

Timing of Breast Massage depends on purpose of Breast Massage.

Dear aura,
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.

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


Phoenix Plastic Surgeon
5.0 out of 5 stars 39 reviews

Implant massage

I do not require my patients to massage their breasts, but I allow them to do so at two weeks. At two days you are likely to cause additional swelling leading to more discomfort and may place extra strain on your fresh incisions. I would recommend adding ice packs to the sides of your bra to help with the discomfort. Do not place ice directly on the skin - wrap it in towels or use prefabricated ice packs with the cloth toward your skin. Best of luck!

Grant Stevens, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 116 reviews

Massaging After Breast Augmentation

In general, one should begin breast massage after 3-5 days to allow for early movement and minimized scar formation. This has been shown to diminish the incidence of capsular contracture.

Rod J. Rohrich, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 42 reviews

Massage

There is no need to massage Breast implants with modern Breast implants which have a much lower rate of capsule contracture

When should you start massaging after breast augmentation?

Implants sitting high immediately after surgery is not uncommon. Of course, much of what you would be experiencing only 2 days after surgery is swelling, and this can at times be quite alarming.
If you have significant concerns regarding potentially high riding implants and/or swelling then it is imperative you raise these issues with your surgeon immediately. They will know precisely what is normal for you and advise accordingly.
However, as a general guideline, it would NOT be recommended to commence downward breast implant massage so soon after surgery. For starters, it would be far too painful to even consider doing this. Most importantly, the wounds are far to fresh and "immature" to be subject to any excessive pressure beyond that which the implants themselves cause. I inform all my patients that surgical wounds need to be shown the appropriate "respect" to allow them to heal properly. 

Of course, the very concept of breast "massaging" is highly debatable.

As a general rule, once the breasts have fully softened and settled (3-6 months post-op), I do not recommend any formal breast massaging.

However, I do believe it provides a vital part in the recovery process.

Of course, "massaging" has several aspects to it and all patients in my clinic are provided the following general guidelines:
- Firstly, all patients are advised to "massage/moisturise" the breast skin commencing prior to surgery and continuing for 3 months after surgery.
- At 1 week post-op we advise all our patients to commence massaging down the cleavage line to help reduce the swelling and start to define the new cleavage.
- At the three week post-op stage you are then instructed on how to commence massaging your breasts. This might vary slightly between patients depending on how they are sitting. This is designed to help soften and settle your breasts.
- Also at the 3 week stage we advise all our patients to commence massaging the scar/incision which helps soften it release any tethering.

Does long-term ongoing massaging reduce the future risk of capsular contracture? The answer is "probably not".
However it does play a vital role in the initial softening and settling of the breasts and reminds patients that their new breasts are not "fragile" and that they can be handled normally.

Eddy Dona, MBBS, FRACS
Sydney Plastic Surgeon
5.0 out of 5 stars 48 reviews

Massage after Augmentation

Each surgeon has their own criteria.  Here is mine:

Breast Massage 
I am a big advocate of breast massage.  I like to wait until the first postoperative visit to begin massage for three reasons.  
1.  I do not want excess tension on the fresh incision, which can cause wound healing problems
2.  Massage will increase soreness and I want to get patients off pain medication as quickly and safely as possible.
3.  Early massage can increase the risk of bleeding, which is the number 1 cause of capsular contracture/scar formation.

For this reason, I begin massage therapy at the first visit, which is 4-7 days postop.  I then establish a regimine of 3 minutes of massage 3 times a day for 3 months.
I do prefer a bra, especially in physically active patients, as I find it helps prevent the implant from dropping too much and causing implant malposition.

Paul S. Gill, MD
Houston Plastic Surgeon
5.0 out of 5 stars 76 reviews

How Soon Should I Start Massaging After A Breast Augmentation?

Massaging your new breast implants helps a lot with pain and soreness. The breast skin is tight after breast augmentation, so massaging helps to alleviate the nerve ending pain. Massaging also helps to loosen the tight chest muscles so that the implants will drop into place. I tell my patients to start massaging 3-5 days after their surgery. Massaging also helps to prevent capsular contracture or hardening of the implants with scar tissue. 

Stanley Castor, MD
Tampa Plastic Surgeon
5.0 out of 5 stars 97 reviews

When do I start massage after breast augmentation.

If you went from a double A to a 600 CC implant  you're already typing on the Internet it sounds like you're already pretty much a head of the game.

Each plastic surgeon will generally have his or her own regimen for when to massage and how to massage.

In my own practice we give instruction to begin a gentle massaging at the first postoperative visit one week after surgery.  I generally find a patients are quite sore right after surgery so I don't mind waiting about a week.

At the third week we give instructions for a more aggressive massage.  I also encourage my patients to wear an elastic Velcro strap that we provide that gives gentle compression to the upper portion of the implants heading them south in the same direction.  We usually begin this about a week after surgery.

I would suggest you check in with your plastic surgeon and see what his or her regimen is. 

Good luck for a quick in speedy recovery.

Adam Tattelbaum, MD
Washington DC Plastic Surgeon
5.0 out of 5 stars 85 reviews

You should start....

Massaging your new breast implants helps a lot with pain and soreness. The breast skin is tight after breast augmentation, so massaging helps to stretch the skin and alleviate the nerve ending pain.

Massaging also helps to loosen the tight chest muscles so that the implants will ease into place for a natural look. Many plastic surgeons feel that it helps and it helps to prevent capsular contracture (scar tissue build up)..

Patients are usually asked to wait till their first post op visit before massaging their implants. Massaging too early can cause bleeding, loosen incisions, and increase swelling or bruising..

You're plastic surgeon is the best person to ask for this type of advice.

Massaging Breast

In my office we teach the first breast massage at their two week post operative appointment and then the second massage a month out from surgery.  I want my patinets to allow thier body to heal and allow swelling to go down.  

Mark W. Greene, MD
San Antonio Plastic Surgeon
4.5 out of 5 stars 24 reviews

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.