Massaging was initially believed to be important for preventing capsular contracture. However, the etiology appears to have more to do with biofilm and subacute inflammation over time. Ultimately, massage has very little effect on prevention.

In my practice, the implant pocket dissection is performed with the goal of optimal placement intraop. Massage runs the risk of stretching or distorting this pocket.

As always discuss your concerns with a board-certified plastic surgeon (ABPS).

Published on Jul 11, 2012

Implant massage can be a personal preference of the surgeon. Some believe that massage aids in preventing capsular contracture in certain types of implants. Textured implants are somewhat fixed in place and massage would not move them through the dimensions of the pocket, whereas smooth implants can be moved around the perimeter of the pocket by massage.

Published on Jul 11, 2012

Each surgeon has his/her preferences. Massaging the implants, in my opinion, keeps the pocket into which we place the implants larger and decreases the incidence of capsules. Please ask your surgeon, because it is he/she who is performing the surgery. Good luck.

Published on Jul 11, 2012

Massaging was recommended in the old days, when silicone implants were placed over the muscle. The incidence of capsular contraction approached 70% and it was thought massage would help--it didn't.

Published on Jul 11, 2012

My personal opinion is that if the patient is actively "doing something," they feel as though they are helping, even though studies have shown that massage does not necessarily impact the healing process. It doesn't hurt to massage, so either way, you'll be fine.

Published on Jul 11, 2012

The recommendation was a way to try and prevent capsular contracture or hardening from occurring. It really doesn't have any basis and, in my experience, I recommend that my patients lay on their breasts, which gives them at least one half hour of stretching the space rather than 5 minutes of massage.

Published on Jul 11, 2012

Massaging is a technique that allows the implant pocket to remain the same size as when your surgeon designed it- it is a well established technique that most surgeons advocate for smooth implants and I am a big believer in it. You should never massage textured implants.

I hope this helps

Published on Jul 11, 2012

This is a very good question. The best answer is personal preference in their practice. There have been numerous studies performed on the pros and cons of postoperative massage to reduce the incidence of capsular contracture after breast augmentation. The evidence supporting this practice is mixed, some showing a reduction in capsular contracture others showing no benefit. I personally advocate gentle massage of the implant with minimal displacement superiorly, inferiorly and medially. I recommend that it is performed 2 to 3 times daily for approximately one to two minutes for the first several weeks after the procedure beginning within the first week postoperatively. I don't advocate massage if the breasts are tender or painful, and never recommend massage when textured implants are utilized.

Published on Jul 11, 2012

There are three reasons some surgeons recommend massage, none of which is very satisfactory:

-They believe it will keep them soft. But this is demonstrably false: massage was not used in the articles showing the lowest rates of capsular contracture. Old habits die hard, even among surgeons.

-They believe in the old snarky doctor's adage, "Always have them do something they can't." No one can remember to massage their breast every day. So if you tell a patient to do it everyday and they get hard, they will blame themselves for the times they missed. I don't think that is good medicine.

-The surgeon creates so much pain and trauma that their patients' arms are frozen at their sides. They may make them wear tight bras or wraps. They may even tell them to keep their elbows at their sides. Their chest muscles tighten and the breasts may feel stiff. In that case massage may help to loosen the chest and allow the implant to move more normally within the breast. But the solution to this is to operate gently in the first place and allow patients to move their arms over their head in recovery so that this sort of massage is unnecessary.

A lot you will read on websites is a matter of opinion in which one surgeon's statements are as valid as any other. If someone does tell you that massage is necessary, please ask for a reference and forward it to me. I would want to read the paper and learn.

Published on Jul 11, 2012

Hello and thank you for your question. It is a personal preference with various surgeons and it also depends on what type of implants had been placed and were they have been placed. I would recommend that he discuss all of this with the board certified plastic surgeon in your area. Best of luck

Published on Jul 11, 2012

Implant massage has been a staple in the process of breast augmentation for decades. Based on the notion that moving the implant around after surgery would allow the capsule to become soft and expansive, and perhaps decrease your risk of capsular contracture. Most surgeons in practice today were taught that during their years of training and therefore adopted it as part of their practice. Many studies have been out now for some time that indicate that implant massage not only does not benefit normal healing, it does not prevent capsular contracture. Many surgeons like myself are eager to tailor their practice based on scientific evidence to provide the best service as we currently know it. In that effort, I stopped recommending implant massage for almost 10 years and have found that my patients are doing as well or better than ever before. Many like minded surgeons have had the same experience as well.

Published on Jul 11, 2012

I do believe in doing breast exercises to keep the internal scar big. If you don't do the exercises the space for the implant contracts down and increases the chance for capsular contracture. I would much rather keep the scar internally with a lot of volume so it has less chance of getting hard

Published on Jul 11, 2012

The theory behind massaging the implants is that it will help prevent the build up of scar tissue internally during the initial healing phase. This usually refers to the first three months post surgery. Some surgeons believe in this while others do not. However, if a patient has an anatomically shaped implant, then massage truly is contraindicated since it could shift the implant position and distort the aesthetic appearance.

Published on Jul 11, 2012

Massaging the implants after surgery was a method to reduce capsular contracture. Now that many preventative measures are done prior to surgery as far as how the skin is prepped and how the implant is placed and where it is placed, the postop massaging is not as crucial but still done by many.

Published on Jul 11, 2012

That is such a great question. I am not sure if I have a great answer. My best answer is how the breast augmentation is performed. if the breast implant pocket is made small then massage may be needed to relax the implant into its ideal position. if the great implant pocket is made the way it is intended to be, then massage really serves no purpose. Some plastic surgeons also believe that massage helps with capsule contracture while others do not. In the end, its not a matter of right or wrong its really what techniques and methods your plastic surgeon uses to achieve the best result for you.
All the best

Published on Jul 11, 2012

Thank you for your question. Every surgeon has his/her own recovery instructions for patients. Some suggest massage to help with the settling of the breast implants while others are concerned about scar tissue formation. My recommendation is to find a surgeon that you are comfortable with and who has lots of experience and listen to his/her advice regarding massage.
Best wishes.

Published on Jul 11, 2012

There is no hard scientific evidence that massaging implants is required for a good result. However, there are some studies and lots of experiential evidence to support this practice. The thought is it will keep your capsule soft and maintain enough space for the implant to move around in the pocket naturally. I recommend a massage starting around 3-4 weeks for most augmentation patients.

Published on Jul 11, 2012

Some implants have a fuzzy (textured) surface that is intended to promote tissue adherence. This is especially true for the anatomic shaped implants. In this instance massage is not recommended.

Published on Jul 11, 2012

Implant massage depends on the type of implant you have. Smooth round implants should be massaged, textured shaped silicone implants should not be massaged.

Published on Jul 11, 2012