Why do you recommend people NOT massage?

oliveskinlover · 06-21-2008, 07:07 PM

I am fighting CC and have been told to rub vigorously. I was before and still got CC. It seems to me that maybe all of the rubbing/massaging may make the body shore up their defenses and close/squeeze around the implant? Just a layman's guess....

I know you don't recommend massage... Can you tell me why (briefly)? I'm curious to know your thoughts on it. Thank you!

Dr.Hueneke · 06-23-2008, 01:11 PM

First, I only tell MY patients that massage is optional. I do not advise other doctor's patients what to do. But I will share my opinion and hopefully it will be thorough enough.
The exact cause is unknown. The leading theory is contamination on the implant surface. Silicone implants have a higher rate of CC. This makes sense to me because the silicone implant literally is stuffed in the pocket. Saline implants are rolled up and filled when in place. You therefore have to handle "touch" the silicone implant much more. Another issue is the way the pocket is created. It seems that gentle dissection and controlling all bleeding is important. These are not new ideas for any of the fields of surgery.

OK. Now studies/data are out there to back up any side of this argument. I have seen data showing CC is not different in women who massage and those who don't. My rate is under 1% for a 3 year window. The national statistic is 9%. The issue is leading toward skin bacteria as the culprit, but it is not yet proven. The capsule is already forming at 1-2 weeks after surgery. Another observation I have made is most women are too sore to begin massage early when the formation of the capsule is happening. My concern is that the massage may stir up bleeding or enlarge the pocket so much that the implants then fall under the armpits when you lay down. If you do massage, then for how long. CC can happen at any time. So should women massage for the duration of their lives? I don't know if that is practical advice. Most CC's are occuring in the first 3-12 months anyway based on the data.

So, considering my individual technique and results I have not concluded any benefit to massage. If patients desire to do so, I show them how. Hopes this helps everyone.
Dr. H

Ina · 06-23-2008, 02:31 PM

That is a really interesting theory, thank you so much for sharing!

oliveskinlover · 06-23-2008, 07:32 PM

Very interesting Dr. Hueneke!

Don't worry, I am still following my PS' instructions for massage. And I see that the medical theory about massage does not bear any resemblance to my layperson's idea about it! LOL

Thanks again! I truly appreciate your time.

beckybee · 06-27-2008, 10:34 PM

Quote:

Originally Posted by Dr.Hueneke

Another issue is the way the pocket is created. It seems that gentle dissection and controlling all bleeding is important. These are not new ideas for any of the fields of surgery.

I'm glad you mentioned this. My PS mentioned this also, but I don't hear this very often on this site.

Dr.Hueneke · 06-28-2008, 11:33 AM

Your welcome. Another interesting observation is that women who experience a hematoma (bleeding around the implant after surgery) will most likely develop CC if untreated. Treatment does not ensure prevention of this problem but certainly lessens it. Any adjustments to the pocket, size changes, implant style changes, etc. can also increase risk for capsular contracture. I advise my patients to very carefully consider any unnecessary operations. Fortunately, I have not had much trouble at all with his problem and my re-operation rate is very low. It sounds like YOU have a good plastic surgeon. I hope you have not or do not experience any problems.
Dr. H

06-21-2008, 07:07 PM	#1
oliveskinlover Join Date: Nov 2007 Posts: 994 Thanks: 451 Thanked 427 Times in 371 Posts	Why do you recommend people NOT massage? I am fighting CC and have been told to rub vigorously. I was before and still got CC. It seems to me that maybe all of the rubbing/massaging may make the body shore up their defenses and close/squeeze around the implant? Just a layman's guess.... I know you don't recommend massage... Can you tell me why (briefly)? I'm curious to know your thoughts on it. Thank you!

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06-23-2008, 01:11 PM	#2
Dr.Hueneke Certified by the ABPS Join Date: Oct 2007 Location: Nashville, Tennessee Posts: 220 Thanks: 0 Thanked 159 Times in 93 Posts	First, I only tell MY patients that massage is optional. I do not advise other doctor's patients what to do. But I will share my opinion and hopefully it will be thorough enough. The exact cause is unknown. The leading theory is contamination on the implant surface. Silicone implants have a higher rate of CC. This makes sense to me because the silicone implant literally is stuffed in the pocket. Saline implants are rolled up and filled when in place. You therefore have to handle "touch" the silicone implant much more. Another issue is the way the pocket is created. It seems that gentle dissection and controlling all bleeding is important. These are not new ideas for any of the fields of surgery. OK. Now studies/data are out there to back up any side of this argument. I have seen data showing CC is not different in women who massage and those who don't. My rate is under 1% for a 3 year window. The national statistic is 9%. The issue is leading toward skin bacteria as the culprit, but it is not yet proven. The capsule is already forming at 1-2 weeks after surgery. Another observation I have made is most women are too sore to begin massage early when the formation of the capsule is happening. My concern is that the massage may stir up bleeding or enlarge the pocket so much that the implants then fall under the armpits when you lay down. If you do massage, then for how long. CC can happen at any time. So should women massage for the duration of their lives? I don't know if that is practical advice. Most CC's are occuring in the first 3-12 months anyway based on the data. So, considering my individual technique and results I have not concluded any benefit to massage. If patients desire to do so, I show them how. Hopes this helps everyone. Dr. H

06-23-2008, 02:31 PM	#3
Ina Join Date: Sep 2006 Posts: 1,930 Thanks: 544 Thanked 922 Times in 578 Posts	That is a really interesting theory, thank you so much for sharing!

06-23-2008, 07:32 PM	#4
oliveskinlover Join Date: Nov 2007 Posts: 994 Thanks: 451 Thanked 427 Times in 371 Posts	Very interesting Dr. Hueneke! Don't worry, I am still following my PS' instructions for massage. And I see that the medical theory about massage does not bear any resemblance to my layperson's idea about it! LOL Thanks again! I truly appreciate your time.

06-28-2008, 11:33 AM	#6
Dr.Hueneke Certified by the ABPS Join Date: Oct 2007 Location: Nashville, Tennessee Posts: 220 Thanks: 0 Thanked 159 Times in 93 Posts	Your welcome. Another interesting observation is that women who experience a hematoma (bleeding around the implant after surgery) will most likely develop CC if untreated. Treatment does not ensure prevention of this problem but certainly lessens it. Any adjustments to the pocket, size changes, implant style changes, etc. can also increase risk for capsular contracture. I advise my patients to very carefully consider any unnecessary operations. Fortunately, I have not had much trouble at all with his problem and my re-operation rate is very low. It sounds like YOU have a good plastic surgeon. I hope you have not or do not experience any problems. Dr. H