Breast Augmentation: Cost, Reviews, Photos

Breast Implant Massage Protocol to Prevent Capsular Contracture

IMPLANT MASSAGE PROTOCOL I recommend the following protocol:

1) Push and hold implant for 10 seconds in the downward direction. Make sure you are displacing the implant so that it is pushing out and stretching the tissue in the desired location.
2) Push and hold implant for 10 seconds in the upward direction.
3) Push and hold implant for 10 seconds in the middle/medial direction.
4) Push and hold implant for 10 seconds in the lateral/side direction.
5) Apply firm pressure directly downward on the implant and hold for 10 seconds.
6) Forcefully squeeze the breast around the bottom/base so that you are squeezing the implant with circular force using both hands.
Do this exercise daily for the first three months and then three times per week. (Rodney A. Green, MD, Cleveland Plastic Surgeon)

Implant massaging after breast augmentation

Implant massaging is a important adjunct to getting a great result after breast augmentation, especially when the implants are under the muscle as I routinely do. Initially the implants appear high, firm, and tight. I usually begin massages at the third day after the surgery. The patient “presses” the breast in the upper pole and displaces or pushes the implant downward and holds that for 5 seconds to stretch the lower pole skin. Afterwards, the patient then “presses” the implant upward to ensure the implant is moving around “in the pocket”. This is started very gently at three days and gets progressively more vigorous when the discomfort has completely gone away at the end of the first week. This continues typically for 6 weeks after the procedure until the implants are in their final place. (Rodney A. Green, MD, Cleveland Plastic Surgeon)

How to massage breasts after augmentation to prevent capsular contracture

Every surgeon has a different opinion about the efficacy of massaging after breast augmentation; ask your surgeon for specific instructions about post-operative care.

For most patients I breast massage which is more of sustained pressure in each of 4 directions so that the pocket remains slightly larger than the implant.

I have them do this exercise whenever they are in the shower — if they link it to a daily activity they will not forget to do it.

For patients who have tight muscles or implants that need help settling, I recommend massaging 2-3 times a day for the first few weeks.

This helps keep the implant “pocket” soft and open, resulting in a more natural look. (Jimmy S. Firouz, MD, Beverly Hills Plastic Surgeon)

Massage after breast augmentation to prevent capsular contracture

Every surgeon is different when it comes to post breast augmentation massages. It depends on their preference as well as the placement of the implant. When consulting with a board certified plastic surgeon ask what their protocol is for massages post surgery. (Jimmy S. Firouz, MD, Beverly Hills Plastic Surgeon)

Does breast massage really work?

Other surgeons have adequately described the concept of breast massage after breast augmentation surgery. The real question is:

Does it work? No one really has the answer as I am aware of no good study that hows that massaging your breasts after implant surgery reduces the risk of capsular contracture. I DO know surgeons who will blame the patient for their contractures stating that they didn’t massage enough which is absurd.

Technically, when your implants are under the muscle, almost every time you move your arms your are functionally massaging your implants. If massaging makes you feel better, go for it. Otherwise, I think that it is a waste of time. (James McMahan, MD, Columbus Plastic Surgeon)

Another approach

I recommend a technique that does not displace the implant, because I don’t usually want to move it, because I have placed it where I want it. Rather, I have my Breast Augmentation patients compress the breast with a flat hand straight back against the chest for a count of 5, several times a day, starting after the first 3 to 5 days. This just stretches the early capsule and keeps the breast soft. There is no attempt to push the implant down etc, unless that is what is needed. (James McMahan, MD, Columbus Plastic Surgeon)

Massaging or displacement exercises after breast implants

We recommend displacement exercises for six weeks after surgery, followed by the more traditional kneading type of massage on an ongoing basis. This helps first to keep the pocket open as rapid healing is occurring, then to lessen the risk of contracture as time goes on. (Christian Prada, MD, FACS, Saint Louis Plastic Surgeon)

Breast “massaging” after augmentation

Breast “massaging” is more of displacement exercises of the implant. The theory behind which is to move the implant around the pocket created by your surgeon in order to keep the implant within the breast pocket soft and supple.

I typically recommend displacement of the implant, beginning a few weeks after you procedure, downwards, medially, and laterally.

Depending on the position of the implant as it settles determines the aggressiveness in that direction. Displacement of implants is thought to decrease the amount of capsular contracture (“scarring”) around your implant, as it keeps the pocket open versus right around the implant.

Certainly ask your surgeon his/her recommendation on this as each one will have their own recommendations regarding this, some who even do not believe in such measures. (Richard J. Bruneteau, MD, Omaha Plastic Surgeon)

Implant massaging

There are many opinions surrounding the need and manner with which patients should massaging implants following breast augmentation. In my practice, I tend to make the pocket larger than the implant to allow it to move more naturally, and I want that pocket to remain loose and large. This maneuver also helps with preventing capsular contracture as it keeps the pocket from getting too tight. I always personally review the implant motion exercises with my patients, and so despite my description, I recommend reviewing this with your surgeon. Placement of the bases of the index and middle fingers at the lower portion of the breast, below the nipple is followed by gentle pressure toward your rib cage. Ideally, you can feel your ribs as the implant is displaced upward. After you remove your hand, a gentle pressure on the upper breast should return the implant to a normal position. (Richard J. Bruneteau, MD, Omaha Plastic Surgeon)

Massaging implants after a BAM

I have every patient do breast massaging after augmentation starting at about 7 days after their surgery. Most patients are very sore after surgery and are resistant to the massaging. I have them concentrate on doing the massage especially lateral to medial and top to bottom.

Most implants are going to stretch the pocket laterally due to the curve of the chest and the implant under the muscle. I feel that when patients are given a complex set of maneuvers to do it is frustrating and they are not done correctly or at all. Keeping it simple is always the best. (Ashkan Ghavami, MD, Beverly Hills Plastic Surgeon)

Breast massaging

Your surgeon and/or nurse will demonstrate how to massaging the breasts post breast augmentation procedure.

This typically consists of pushing the implant up, down, and side to side, and is typically recommended a few weeks after surgery.

Massaging is designed to maintain the implant pocket created during surgery, maintain a softer appearance, and help minimize post surgical bleeding and pain. (Ashkan Ghavami, MD, Beverly Hills Plastic Surgeon)

Displacement Exercises Post Breast Augmentation

If you are performing displacement exercises to prevent capsular contracture, classically patients are encouraged to push towards the midline and upwards.

The theory is that performing this regularly, especially in the 1st year after your surgery, will help prevent a hard capsule from forming around your implant. As far as I am aware, there is no good evidence to support this. Nonetheless, many plastic surgeons do prescribe this practice. If, however, the displacement exercises are being done to promote the implants to “drop”, then you would push the implants down towards the ground. This is usually done with implants placed under the muscle, as they tend to ride high on the chest in the first few days/weeks after surgery. You should consult with your surgeon to determine the goal of the massaging/displacement exercises, and then perform the appropriate maneuver.  (Asif Pirani, MD, FRCS(C), Toronto Plastic Surgeon)

Massage of your breast implants after surgery is not necessary and if done incorrectly, potentially harmful.

There is no good data to support this practice and no evidence that it accomplishes any of the goals it purports to.

The pocket is developed properly at the time of implantation.

No amount of massage is going to fix an incorrectly placed implant, nor will it prevent capsular contracture. This has been studied. (Earl E. Ferguson III, MD, San Antonio Plastic Surgeon)

Moving The Implant Around The Space

We have the patients refrain from any massaging for the first week. At that time we show them the technique.

Essentially the concept is that you are moving the implant in the space to push against space that the implant sits, gently molding the scar as it forms around the implant. For smooth round implants, you want the space to be larger than the implant, which give the softness and mobility.

Using your fingertips, you hold the implant and move it down and then up, passing it back and forth between your left and right hand. This is done 5 times a day for 30 seconds to a minute per side.

After the implants are stable and soft, the message is performed once a day forever. Think of it like therapy. (Gary Lawton, MD, FACS, San Antonio Plastic Surgeon)

I don’t recommend massaging to my patients

Massaging after breast augmentation was advanced as a way to prevent capsular contracture. Capsular contracture is when the scar capsule around the implants thickens and tightens. Unfortunately, no good scientific trials ever showed a benefit to massage after augmentation. Recent advances in both implants and placement technique have proven to reduce capsular contracture. (Stephan Finical, MD, Charlotte Plastic Surgeon)

I have honestly seen gentle massaging of the implant, stretch the capsule and the early pocket nicely. I agree surgical precision to avoid a hematoma is essential. Careful postoperative massage can help patients recovery and tissues to relax quicker. I recommend side to side displacement early and circular massage after the first week for 3 weeks. I follow patients carefully each week to optimize care prior to resuming activities. (William C. Rigano, MD, Dayton Plastic Surgeon)

How Do You Massage Breasts After Breast Augmentation?

We recommend massaging 10 times in a circular motion clockwise around the breast. (starting at the top, 12:00 – 10 times, 1:00 – 10 times, 2:00 – 10 times. so on and so forth) We also teach how to lift and drop the breast in your hand. Remember that massaging is a very important part of your recovery. (Ahmad H. Ahmadi, MD, Sugar Land Plastic Surgeon)

Breast Augmentation Post Op

It is very important that you discuss specific follow up instructions with your plastic surgeon. If your plastic surgeon suggests massage therapy following breast augmentation you should ask for their advice on methods to use. Best of luck. (Christine Sullivan, MD, Columbus Plastic Surgeon)

Breast massaging

I like to ask my patients to allow the initial healing and swelling after breast augmentation to diminish before they begin to massage. The patients are instructed after two weeks then begin to massage the implants for several weeks to follow under my supervision. (Frank J. Ferraro, MD, Paramus Plastic Surgeon)

How do you massage breats after breast augmentation to prevent capsular contracture

In my practice I’m very selective on who I have massage their breasts after an augmentation. If a patient has thin and loose skin (common after pregnancy and breast feeding) I will not have them massage the breast. Their tissue is already very “lax” and I don’t want to cause an abnormally large pocket by having them move the implant. However, if the patient has very tight, thick skin (similar to a young female with no children) I will have them massage the implant to maintain a slightly larger capsule than the implant, and also to stretch the skin. I will never have a patient massage the implant if I have used a “form-stable” implant or “gummy bear” implant. (Robert Najera, MD, Frisco Plastic Surgeon)

There are many ways that surgeons will request that you do the massage. Some surgeons actually recommend you don’t even do it.

I would check with your surgeon as it will depend on the type of implant and the position of the implant and how the implant is sitting as to how they will want you to do the massage. (Lawrence Scott Ennis, MD, FACS, Pensacola Plastic Surgeon)

Breast Massage after Augmentation

Breast massage is utilized after augmentation to facilitate the movement of the implant within the surgically created pocket and maintain the pocket space.

This is typically only done for smooth implants, because textured implants are designed with a very tight pocket in order to prevent movement/motion.

This is often done for about 6 weeks after surgery, pushing the implants up, down, outward, and inward for about a minute in each direction, three times per day.

This subject is highly variable among surgeons – the best advice to follow is that of your personal surgeon! (Bryan Correa, MD, The Woodlands Plastic Surgeon)

The purpose of massage is for implant displacement.

Although plastic surgeons have mixed opinions on whether post-operative breast massage is beneficial after surgery, the main purpose of the massage is to displace the implant in a way that is supposed to prevent capsular contracture from forming.

This means pressing on the breast and implant (not just the skin) up, down, and to each side evenly for a few minutes, several times per day. Since there isn’t any clinical research proving or disproving the potential benefits of implant massage, most plastic surgeons will give varying advice on exactly in what way and how often massage should be performed. (Nirav Savalia, MD, Phoenix Plastic Surgeon)

Breast Massage after Augmentation

Massaging the breasts or more accurately, massaging the implants, is a carry-over from when most augmentations were done in the sub-glandular position with silicone implants that had a high rate of developing capsular contracture. Massaging helped (we thought!) to prevent contracture by preventing an organized capsule from forming around the implant. Now, with the majority of implants (saline and silicone) placed in the sub-muscular pocket and strictest attention to technique during placement, capsular contracture fortunately is very uncommon. The acts of brushing your hair or getting dressed contract the muscle over the implant, effectively “massaging” the implant. (Scott A. Brenman, MD, FACS, Toronto Plastic Surgeon)

Breast massage depends on the patient & implant type

As seen by the wide variation in responses by different surgeons, there is no consensus on this issue. I recommend only gentle massage for comfort rather than displacement-type massage, in which the implants are firmly moved into different positions. I have found that this works well for my patients. (William Andrade, MD)

I advise my patients to begin massage about 7 days after surgery for a submuscular augmentation. The motion is to massage inward and down. This is done 3 times per day until the breast look the way you want them to. This usually takes 3-4 weeks. At that point you can go in to an underwire. (A. Dean Jabs, MD, PhD, FACS, Bethesda Plastic Surgeon)

Post-Breast Augmentation Massage

While I generally recommend massage for my patients post-breast augmentation, it is important to follow your doctor’s instructions for breast massage. Your doctor will also know what kind of implants you have, as this affects massage instructions. The purpose of the massage is to manipulate the pocket so that the implant can assume the most desirable position for the patient’s body and proportions. (David Rapaport, MD, Manhattan Plastic Surgeon)

Breast massage/exercises post breast implants to prevent capsular contracture

We recommend breast displacement exercises when a smooth, round implant is selected for surgery.

This is important to discuss and confirm with your surgeon as you do not want to do these same displacement exercises for round or shaped textured implants. The exercises allow the pocket to stay open with intentions to decrease the chance of a capsule to form around the implant and therefore decrease capsular contraction and allowing for a soft breast.

We have a very low contracture rate and attribute this to the breast exercises. We have seen these displacement exercises done in many different ways and recommend discussing with your doctor exactly how he wants you to proceed as they seem to be very doctor specific and may depend on the surgical technique used. (Alan N. Larsen, MD, Atlanta Plastic Surgeon)