Breast Augmentation: Cost, Reviews, Photos

Massaging unlikely to change outcomes after augmentation

I agree with those who do not have their patient’s massage their implants after augmentation. Displacing the implant to keep a larger pocket would like require that the implant be pushed into a position for a significant amount of time to have an effect on the structure of the capsule.

More recently Grant Stevens and his co-authors published a study in Plastic and Reconstructive Surgery that six factors were independently associated with capsular contracture (i.e., implant placement above muscle, implant surface (smooth), incision site (periareolar incision) and hematoma or seroma development, device size (<350ccc), and use of a surgical bra.

However, as to the value of use of a surgical bra the authors caution that further study is needed. (David Mathes, MD, Aurora Plastic Surgeon)

Follow your surgeon’s protocol

I generally do not recommend breast massaging of incision after breast augmentation. This is because, using surgical technique, I develop a precise pocket for the breast implant where it will look and feel best. Breast implants do “drop” or settle over the course of several months – this is a normal part of the healing process. Some surgeons recommend incision massage as a technique to hasten this process.

Discuss incision massaging with your surgeon – plastic surgeons disagree about whether or not it should be done. Also remember that every patient is different, and sometimes techniques such as massaging or elastic band placement can help. (Lara Devgan, MD, MPH, New York Plastic Surgeon)

Breast incision massaging after surgery

I tell patients that have smooth round implants to move their implants up, down, to the middle and to the sides at least three times a day starting postoperative day 2-3. This makes sure that the pocket that was created during surgery is still as open and supple as it was the day it was created.

This helps with implant position and appearance and leads to a more natural result. I often find that the girls who are not massaging, see a big difference in the office when we show them how to perform the massaging. (Stephen J. Vega, MD, Rochester Plastic Surgeon)

Breast implant incision massaging

Breast massaging following augmentation actually refers to the process of implant displacement that is sometimes recommended for patients who have smooth-walled implants. This is a controversial topic as not all plastic surgeons feel that this is necessary. In theory, implant displacement exercises will expand the surrounding soft tissue pocket, minimizing the risk of capsular contracture to maintain a soft, supple breast.

I believe that careful surgical technique, accurate pocket dissection, and meticulous handling of the implant all play a much more important role in avoiding risk of capsular contracture than postoperative displacement exercises. The most common technique is to gently move the implant side-to-side, then up-and down.

Another option is to simply lie on your stomach to apply gentle pressure on the implant. I find this helpful for patients who’s implants are a bit slow to “settle” into place following surgery. Please consult your surgeon to be sure that he/she feels that such a technique is appropriate for you. (Scott D. Holley, MD, FACS, Portage Plastic Surgeon)

Importance of site massage while in the healing period after breast augmentation surgery

Regarding if you should massage after a breast augmentation surgery. I feel that focal massage of the operative areas is a vital part of achieving the optimal result after your procedure- period. Both myself, and my staff, spend a significant amount of time educating the patient on how to perform the massaging as the healing progresses. Depending on the patient’s native healing some require more deliberate, and prolonged, massage than others in order to achieve the most natural and symmetrical outcome. After all, for a breast augmentation to be successful – symmetry is a vital component of one’s result. As the surgical site(s) healing progresses over the initial several months the technique instruction can vary, and thus the importance of regular follow-up visits. (Sergio P. Maggi, MD, Austin Plastic Surgeon)

To massage or not to massage

No scientific studies support massage as beneficial or helpful after breast augmentation. The more science that is done indicates what’s done in surgery is far more important than what’s done after. Find a board certified plastic surgeon who is passionate about their technique and you will have the best chances of minimizing problems. (Matthew H. Conrad, MD, Wichita Plastic Surgeon)

Massaging after a breast augmentation

The technique I recommend to my patients is to push both breasts to sternum and hold for 5-10 seconds. Then, slowly relax to original position.

Do this direction 5 times. Now lift each breast up to your collar bone and hold for 5-10 seconds and relax. Repeat 5 times. I recommend the massage hourly for three months then daily after that time.

This is just my personal preference. Consult your doctor to see what technique they recommend. (Miguel Delgado, Jr., MD, San Francisco Plastic Surgeon)

No consensus about implant massaging

Opinions about the importance (and technique) of implant massage are highly variable, because there are no clinical studies documenting that it actually does anything to prevent capsular contracture.

I recommend it only for cases where the tissues are tight or the implants need some help settling for that same reason. In this case, it would only be for the first few weeks.

If your surgeon has recommended it, you should get advice from him or her on exactly what they want you to do. (Richard Baxter, MD, Seattle Plastic Surgeon)

Massaging is meant to maintain the pocket

Incision massage is a relatively individualized thing. Some surgeons recommend it and some don’t. The purpose of implant manipulation is to maintain the size of the pocket that houses the implant and theoretically keep the implant soft.

A discussion with your surgeon will provide you with specific instruction on how to perform the maneuver. (Kenneth R. Francis, MD, FACS, Manhattan Plastic Surgeon)

Implant massaging

Depending on the surgeon, it might be recommended that a patient perform incision massage beginning 1-2 weeks following breast augmentation with smooth, round implants. It is thought that displacement of the implant within the capsule of scar tissue formed around the implant may keep that scar tissue loose and help prevent thickening/hardening of it.

The implant is typically displaced in all four directions – up, down, left and right. Please see the link for an example of such instructions. Do not perform any such activity unless cleared by your surgeon. (Nicholas Tarola, MD, Nashville Plastic Surgeon)

How Do You Massage Breasts After Breast Augmentation?

Opinions on breast massage vary. It’s a question that’s best directed to your surgeon for specific recommendations. The more appropriate term is not really massage, but is implant displacement.

During a breast augmentation surgery a pocket is made beneath the breast to hold the implant. Some surgeons believe that pushing the implant up, down, left and right after the surgery helps keep the edges of the pocket open, so that they do not close down prematurely and deform the implant.

Implant displacement exercises are typically only recommended for smooth implants, not textured implants. A conversation with your plastic surgeon will help guide you on how best to care for your breasts after the procedure. (Austin Hayes, MD, Portland Plastic Surgeon)

Massage after Breast Augmentation, Connecticut

As you can see, by the number of different responses, there is no one answer. It will depend on what your specific surgeon wants you to do in his post-op routine and I would suggest following his guidelines. Breast massage or implant manipulation has been a popular recommendation from surgeons and has a few benefits but doesn’t mean it will prevent capsular contracture. The idea is to move the implant in the pocket that was surgically created to keep the pocket within it’s original form and reduce scar tissue from tightening around it. Not all patients may need or feel benefit from massage. In some cases women may feel a tightness and moving the breast and implant around helps alleviate that feeling. Suggested massage instructions consist of very gently moving your breast implants from side to side and up and down. (Alfred Sofer, MD, FACS, Fairfield Plastic Surgeon)

Massaging breast implants after breast augmentation surgery

After I perform Biplanar Augmentation Mammoplasty I instruct the patient in the recovery room to begin moving the implant superiorly towards the clavicle and hold for a few seconds then inferiorly for a few seconds followed by lateral and medial.

This keeps them soft and keeps the pockets open. This exercise is done twice an hour every day for the first six weeks.

I also have them raise their arms above their heads the night after surgery and they do not wear a bra for six weeks. (Paul Vitenas, Jr., MD, Houston Plastic Surgeon)

Massaging incision following breast augmentation

One of the nice things about putting implants under the chest muscle is that the chest muscle, as it loosens up, will do your massages for you as you go about your daily routine. It is constantly sliding over the incisions and massaging them.

I rarely see capsular contractures (thick scar formation around the implants that can make the breast firm or distort the way it looks) since I started putting implants under the muscle many years ago.

With implants above the muscle, you don’t get the massaging action of the chest muscle. In these patients I advise manual massages. Each doctor has his/her own protocol for this, but the basic idea is to move the implant around in the pocket in order to keep the pocket loose so the breast will stay soft.

The patient needs to be sure to move the implants from the base of the breast. If you massage from the top then you are simply moving your breast tissue over the implants and not accomplishing anything. Whether you use a circular motion or up and down, in and out, the whole idea is to move the implant.

I tell my patients that there is no magic number on how long or how often to do this. When they are in the shower or changing clothes, I tell them they might want to take a few minutes to do their massages. (Edwin C. Pound, III, MD, Atlanta Plastic Surgeon)

Displacement not Massaging breast implants!

Breast implants should be moved around within the “pocket”. This involves a series of stretching exercises that commonly push the implant down as well as towards the middle (sternum). Like any stretching exercises, the implants should be sequentially held in position for a short period of time and released, repeated 10 to 15 times and done at least three times per day.

These movements help mold the pockets and create the roundness that most patients seek and should be started as soon as the initial post-operative discomfort has subsided. (Eric Sadeh, MD, Manhattan Plastic Surgeon)

To massage breast implants or not…

As you have seen, there are many opinions on the importance, or lack of regarding massaging implants after augmentation surgery. And I believe everyone is in agreement that textured implants should not be massaged. That being said, no one really has any objective proof that supports their “opinion”. Since displacing the implant upwards and inwards does no harm, I’m a believer in “massage”. And all I have to support my opinion are the excellent results and cleavage my patients achieve. No one is claiming that massage will prevent a contracture, but it certainly cannot hurt. So I prefer to massage away and I also believe it helps the patient get accustomed to her new breast so that changes can be appreciated sooner, should they occur. (Curtis Wong, MD, Redding Plastic Surgeon)

Massage incision for breast implants

I recommend massage techniques after breast augmentation. The idea behind breast incision massage is not to massage the skin but to push the implant in all directions to displace it.

This way the space in which the implant sits doesn’t become tight. My patients displace the implants in a circular motion 2-3 times per day. I usually instruct them to start doing this at their first post operative appointment. (Jonathan Heistein, MD, Fort Worth Plastic Surgeon)

Incision Massage following breast augmentation…

In general I recommend my patients start breast massage at three to five days post-op. A printed instruction sheet that explains in detail the massage technique is given to the patient. Three times daily the patient presses the breast (implant) upward counting to ten and the inward counting to ten with each breast.

This is recommended for the first year following breast augmentation to help with keeping the implant “pocket” soft and open resulting in a natural looking breast(s). (Rod J. Rohrich, MD, Dallas Plastic Surgeon)

Breast implant massaging after augmentation

Capsular contracture is a complication that occurs when the scar tissue that forms around a breast implant hardens, causing deformity of the breast. Breast implant massage (displacement exercises) attempts to prevent capsular contracture. To perform, place your right hand on the lower portion of the left breast.

Your small finger should rest in the fold underneath your breast. Gently apply pressure towards your chest starting from the small finger, rolling your hand towards the index finger. This will allow the implant to displace upwards towards your collarbone. It is important to see the implant moving upwards, separate from the overlying skin.

Lastly, displacement exercises are only indicated in the presence of smooth shell implants. If you surgeon used textured implants, discuss with them before doing any exercises. (Kunaal Jindal, MD, Toronto Plastic Surgeon)

Incision Massage after Breast Augmentation

Accurate and proper “massage” can be the difference between a good and great result. It is not massage of the breasts, but rather moving the implant within the pocket and stretching the pocket and tissues to accommodate the implant and desired shape.

Implant displacement exercises can reduce capsular contracture, provide a slightly larger pocket so that the implant moves naturally within your body, and improve breast tissue shape in patients where there was some deficiency and/or tightness preoperatively.

In my practice “massage” is used judiciously and specifically, based on the individual patient. I give each patient unique instructions at three weeks. I typically have them perform the exercises twice a day for a minute or two. (Brian Reedy, MD, Reading Plastic Surgeon)

Method of Breast Implant “Massage”

In order to keep the breasts as soft and natural as possible, it is important to “massage” the implants starting about 10 days after the procedure. This is done by firmly squeezing the bottom of the breast so that the implant momentarily bulges upwards; when the squeeze is released, the implant falls back into the normal lower position.

Three squeezes right in a row on each breast, held for ten seconds for a total of thirty seconds a day, should do the trick. Woman often incorporate this into their morning shower routine. (Richard Restifo, MD, New Haven Plastic Surgeon)

How Do You Massage Breasts After Breast Augmentation?

There is confusion about incision massaging versus implant displacement. They are different processes with different purposes. Here is the break down: Massage is moderate pressure circular motion rubbing of your breasts and stroking motions towards your armpits aimed at speeding resolution of swelling after breast augmentation. Also, it helps with resolution of any weird nerve sensations (tingling, electrical sensations) and hypersensitivity.

This is most useful in the first 4-6 weeks and can be performed about 3 times a day. Stop this once implants are settled and swelling is resolved. Displacement exercises are performed by pushing the implants up, down, and towards the middle in order to stretch the capsule as it forms. This is thought to reduce your risk of capsular contracture. This is generally started within a week of surgery and is performed daily in the long term. Every plastic surgeon has their own protocol for this. Be sure to follow your plastic surgeons instructions. (Michael Vennemeyer, MD, Southlake Plastic Surgeon)

Massaging breast after augmentation

I do not personally recommend massaging the breasts after augmentation – there is a risk that the scar capsule will rupture if it is performed too vigorously, and this can cause the body to create more scar tissue in response to the injury. (Alfred C. Speirs, MD (retired), Colorado Springs Plastic Surgeon)

How do you massage breasts after breast augmentation?

Massaging therapy after breast augmentation can help reduce firmness and capsular contracture. I usually have my patients at 3 weeks post-operatively start massaging by placing the hands on the outer aspect of the breasts and pressing the implants towards the midline and holding this for 20 seconds. I usually have them do this several times a day. (Robert Heck, MD, Columbus Plastic Surgeon)

Breast incision “massaging” after augmentation

When you “massage” your breasts after an augmentation, the goal is to actually “displace” the implant, not just massaging the breast tissue.

You are looking to keep the pocket around the implant larger than the implant itself.

By displacing the implant you are stretching the pocket. There are 2 key things to remember because not all implants should be displaced.

If you have a smooth, round implant your surgeon may have you displace the implant to keep the pocket that the implant sits in larger than the implant.

You should press the implant up until it is uncomfortable; hold it for a few seconds and then release.

Do this in each direction a few times a day for the first 3-6 weeks.Textured implants should not be displaced. The texturing of the implant encourages the capsule attach to it and therefore each time you displace it while you are recovering you are separating the tissue from the outside of the implant. Make sure you know what type of implant you have before you start displacing it. (Christopher T. Maloney Jr., MD, Sarasota Plastic Surgeon)

How to massage after breast augmentation

This is a perfect example of “ask ten surgeons” get ten differnet answers! There are more than one way to skin a cat, and same applies to getting great results from a surgical procedure. The important thing here is to do what YOUR surgeon tells you, because one surgeons instructions may not only not work, but be detrimental for another surgeon’s patient.

When I perform breast augmentation surgery using the “One Day Recovery: technique, I make the pocket to fit the implant. I haven’t asked or required my patients to massage their breasts after surgery in as long as I can remember. And my capsule contracture rate is well under 1% at five years. (Mark D. Epstein, MD, Wayne Plastic Surgeon)

Stretching Implant Pocket (not massaging) May Be Helpful

The incision massage is not a massage. It is actually a process to stretch the pocket or internal scar tissue that forms around the implant. This is supposed to reduce the chance of this internal scar tissue from tightening and causing a capsular contracture.

There is no definite science that says implant massaging prevents capsular contracture. However, many surgeons suggest this be done as there are few other options to help reduce the risk of capsular contracture. I would definitely avoid massaging/displacing the implant in the first few weeks after surgery. First of all, this is extremely painful. Second, there is no capsule/scar yet so there is nothing to stretch! Third, this can cause increased breast augmentation swelling, bruising and even outright bleeding. In fact, it has been argued that bruising/bleeding caused by over-aggressive or early massage can itself lead to capsular contracture. In the end, this is an area that is still open to investigation. Speak with your surgeon and follow his instructions. (Parham Ganchi, PhD, MD, New York Plastic Surgeon)

I do not recommend massaging of incision after breast augmentation

I am personally not a fan of breast implant massages. I believe that good surgical technique and using the most advanced high quality implants gives you the best chance of preventing capsular contracture.

I find that some surgeons rely on breast incision massaging to overcome poor technique and poor results. This is something to discuss with your specific surgeon before your surgery. (Matthew Schulman, MD, )