Breast massage post op, good idea or not?

Question

I’m undergoing a breast lift with augmentation next week and I’m confused. Some say that massaging the breast post op can help prevent capsular contracture while others say it can increase the risk. Can anyone provide better insight? Thanks in advance

Gerald Minniti, MD, FACS · Answer

Hello,This is not 'specific to the patient and the doctor' as one respondent said, but this should be about evidence of efficacy, not doctor preference. Imagine if cancer doctors picked and choosed chemotherapy based on whether they liked it or not, and not on whether it was effective! That would be deadly decision making, wouldn't it? Well fortunately, capsular contracture isn't life threatening, but it is the most common complication that leads to reoperation.  So I think it's important to get the word out that you can reduce your risk tenfold by picking the right surgeon, than to rely on post operative implant massage that has been shown to be completely ineffective at preventing or treating capsular contracture. And yes, I've seen it all from overzealous massage: skin irritation, stimulation of lactation, bruising, and even hematoma. So not only is massage not helpful, it can be harmful. Surgeons who adhere to a 14 point plan to minimize implant contamination will reduce your risk from the average of 15% to 1.5%.  No massage necessary. BTW, augmentation mastopexy carries a higher risk of capsular contracture than augmentation alone. Why? Because surgeons don't adhere to strict techniques of placing the implant through an inframammary incision first, then closing the subpectoral pocket before performing the mastopexy. Instead, most put the implant through a very large incision that exposes the breast implant to the opened breast tissue, leading to implant contamination and capsular contracture. Choose your surgeon wisely and no massage necessary.

Kenneth Hughes, MD · Answer

In most cases, I do not recommend massage after breast augmentation; but plastic surgeons will have different post-op protocols. Recommend that you obtain guidance from your plastic surgeon.

Ronald J. Edelson, MD · Answer

Surgeons have been recommending breast massage after surgery to prevent capsular contracture.  I can think of one study that actually looked at whether it worked and the study showed that it did not make any difference.  Despite this many surgeons continue to recommend massage largely out of habit.  I also have heard that it may increase capsular contracture but there is no evidence of this.

Farbod Esmailian, MD · Answer

This is very specific to the patient and to the surgeon.  In some revision cases I don't have the patient massage, but in my primary breast augmentations I have my patients massage.I do not know if it helps, but I don't know of any drawbacks, therefore I recommend it.I would discuss this with your surgeon and see what your surgeon wants you to do and follow their recommendations.Hope that helps.

Daniel Barrett, MD · Answer

Dear innerbombshell,
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

Connie Hiers, MD, FACS · Answer

Whether to massage or not depends upon what type of implant is used. Massage is useful for smooth round implants, but not for textured.

David Nicholas Csikai, MD · Answer

Studies are conflicting concerning the importance of breast massage. I am not a firm believer in massage. I feel that it is more importance to begin stretching after early movement within rain. Massage of the upper muscle may help calm things down and make you feel better.

Shaun Parson, MD · Answer

Thanks so much for your question.  Early motion is an important component to breast augmentation surgery.  I always want my patients moving post-op.  I want them to lift their arms up over their heads and not be restricted with motion.  However, I do not have my patients massage.  There isn't any clear evidence that suggests massage reduces ones chance for contracture.  In fact, aggressive massage could potentially cause a hematoma and lead to a contracture.  So early movement is good but be careful about any type of aggressive massage.  Hope this helps.

Johnson C. Lee, MD · Answer

There is no scientific evidence that breast massage reduces capsular contracture. That being said, many surgeons still feel more comfortable if their patients continue the breast massages in the post-operative period. I find that at the very least, the massages allows the swelling to subside more quickly and softens the tissue at a faster rate. Johnson C. Lee, MD

Board-Certified Plastic Surgeon

Board-Certified Plastic Surgeon

Vincent D. Lepore, MD (retired) · Answer

Although, breast massage may help reduce the risk of capsular contracture, massaging the breasts cannot guarantee that a contracture can't happen.  Anti-inflammatory medications, such as Singulair, can also help reduce capsular contracture risks.  Check with your surgeon for their recommendations in your case.  Best wishes, Dr. Lepore.

Breast massage post op, good idea or not?

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