I had breast augmentation on the 14th of July so it has been a little over 2 weeks.
How May Times a Day Are You Supposed to Massage Your Breasts After Augmentation, and for How Long Each Time?
Doctor Answers 23
How May Times a Day Are You Supposed to Massage Your Breasts After Augmentation, and for How Long Each Time?
Great question and look at all the differing opinions, makes for an interactive venue. I'm more realistic as to implant massage or exercising. What do I mean? Well if you don't do them and get a capsular contracture or fibrosis, than you will be one of those - 'what if' patients. You know, what if I had done the massages would I be with this issue? Whether there is true science behind the concept of massaging or not, it seems to me after 34 years of implanting it is better to do than not. As for when - I start from 1 week following and recommend for 3 months. Just my way of practicing. Enjoyed this discussion.
Massage after Breast Augmentation
Here are my criteria for massage after breast augmentation:
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.
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Massaging their breasts
Massaging breast post a breast augmentation surgery is physician dependant. I prefer my patients start gently massaging their breast at 2 weeks post surgery for 2-3 minutes at a time, 2-3 times a day.
Displacement Exercises for Smooth Breast Implants
The displacement of breast implants is recommended to reduce the risk of capsular contracture. Displacement of breast implants is done for smooth surfaced saline- and silicone gel-filled implants; it is not recommended for breast implants with a textured surface. Smooth breast implants will move freely within the pocket, while textured surface implants do not move either because of increased friction caused by the texturing, or tissue in-growth into the textured surface.
I have my patients begin implant displacement exercises one week following surgery. The acute pain of surgery has subsided by then so the displacement can be done a bit more comfortably.
>> Place your hand flat over the central breast and press the implant inward towards the chest wall. Hold it there for a few seconds.
>> Lift each implant up; with your hand under the implant, slide it up the chest wall slowly, pushing it up towards the clavicle. Hold it there for a few seconds.
>> Push the implant medially; with your hand on the lateral part of the implant, slide it towards the sternum. Hold it there for a few seconds.
>> Push the implant laterally; with your hand over the medial breast, push the implant laterally. Hold it there for a few seconds.
The right implant can be displaced with the left hand, and vice versa. The displacement should be performed slowly and steadily with moderate force. Each displacement should be performed ten times.
Initially the displacement of the implant will be somewhat limited. But as swelling subsides, the tissues stretch, and the implant settles, the implants will move more easily in the pocket. Pain may limit your ability to move the implants initially, but as this subsides you will be able to displace the implants much more readily.
I only have patients push implants down if I feel they are not settling as intended.
Perform these exercises three times daily for six months following surgery, then two times daily for the next six months, and then once daily thereafter.
Massaging implants after surgery
In the past, it has always been recommended to massage your breasts after a breast augmentation. I do not recommend this to my patients. I tell my patients that you do not have to do anything to the breasts after surgery and to just let them heal.
There are more risks associated with massaging the breast that I believe that can hinder the healing process. When you massage the breasts, your are touching them and this allows bacteria from your hands to make it's way into the incision causing an infection. Also, by moving and touching the breasts, can start some bleeding and a hematoma can form. Lastly, you can move the implant and cause asymmetry of the breasts.
Don't need to massage your breasts
Massaging breasts is an old ritual that has never been proven scientifically to help. The concept was that it would somehow help to prevent capsular contracture (firm scar tissue squeezing the implants and making them feel hard). Capsular contractures were prevalent 30 years ago, but fortunately not quite as common today (possibly because of the use of saline implants, going under the muscle, and also better silicone implants that leak much less). I tell my own patients not to massage their breasts and our capsular contracture rate is low, certainly no higher than the norms. I am not completely convinced that breast massage is not counterproductive. I don't want the pocket stressed early in the healing process.
Breast Implant Massage
Not every plastic surgeon recommends implant massage following breast augmentation, but the vast majority of surgeons believe it's extremely important. Implant massage is also known as implant displacement and is designed to stretch the implant pocket to avoid the development of capsular contracture.
Implant massage is started one week following surgery and is typically performed approximately three times per day. Each session typically lasts about two to three minutes. The implant is displaced superiorly, inferiorly, medially and laterally. This is done for at least one year following surgery.
Variations in implant position, type of implant, and patient anatomy make every patient unique. For these reasons, implant massage isn't indicated for every breast augmentation patient. Before proceeding with implant massage, discuss this issue thoroughly with your plastic surgeon. He will teach you the proper technique for implant displacement and monitor your progress.
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. I generally recommend doing this a few times a day.
Different Types of Breast Massage for Different Purposes.
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.
Pablo Prichard, MD