I’ve had my breast implants for about a year, and now I’ve noticed that my left breast dropped a little lower. After noticing such a drop, my doctor said to fix this he could go back in and close the pocket. This makes me wonder: why do some surgeons recommend massaging your boobs after surgery if it keeps the pocket open? It seems that would allow them to drop, and frankly I feel like that adds to the whole issue women have of no cleavage and/or sagging.
Massaging is recommended to keep too much scar tissue from forming and to help the implants drop into the lower pocket. Some patients who don't aggressively massage when it's recommended to do so can develop issues with the implants; they may never drop, leaving an empty pocket at the bottom of the breast. This can create a very unnatural looking breast that most women are unhappy with. At my practice, I gauge post-op bra and massage management case by case because not every woman heals the same.
Published on Jul 11, 2012
I totally agree with you. Massaging may cause micro-trauma, which may add to the capsular contracture. I have my patients sleep on their implanted breasts (not XL sizes) starting about 3 weeks after surgery. This is a gentle way of stretching the capsule!
Published on Jul 11, 2012
Whether you massage or not, it is not possible to push the implant any lower on the chest wall than the lower edge of the pocket that was created at the time of surgery. You, as a patient, could not possible push the implant so vigorously as to dissect the tissues of your chest wall. The pocket that is created at the time of surgery is what dictates the position of the implant.
Massage is intended to keep those dimensions open. It is not possible with massage to make the pocket any larger or lower. If your implant has dropped, your surgeon may have recognized that at the time of surgery and repaired the lower dimension. It is possible that those sutures have now torn, consequently leading to a lower position of your implant.
Published on Jul 11, 2012
There is currently no consensus on breast massage after implants. Some plastics surgeons recommend it, while others don't.
Certainly, overly-aggressive massage in the downward direction can contribute to the implants dropping lower than desired (though there are other factors not just the massage that can contribute to this). This also holds true for overly-forceful massaging in the lateral (or outward) direction, which can cause lateralization of the implant pocket.
Because of this uncertainty and variability in the force and direction of massage, many plastic surgeons simply ask their patient to not perform their own postoperative breast massage. But if they do, patients should be instructed to only massage very gently in the medial (inward) and upward direction to avoid downward and lateral malposition of the implant pocket (unless the patient's anatomy and implant location indicate otherwise, which would be determined by the plastic surgeon).
Published on Jul 11, 2012
The value of massage is debatable. It was initially believed to play a role in countering capsular contracture. However, it is now believed that contracture is more of an inflammatory process that is independent of massage.
Ultimately, pressure can alter the pocket. If the implants have settled in the appropriate place, then massage is not likely to help and may create space where there was none before. However, in the case of high-riding implants, downward pressure (i.e. a bandeau) may help.
As always, discuss your concerns with a board-certified plastic surgeon (ABPS).
Published on Jul 11, 2012