Breast Massage After Augmentation

Any surgical procedure carries a certain risk of complications, and with breast implants, one of the complications most on women's minds is the risk of the scar tissue surrounding an implant to thicken and harden following surgery, a condition known as capsular contracture. There are two schools of thought regarding this complication: some believe a patient can help to prevent the complication while others claim that formation of capsular contracture is largely dictated by the way the surgery is performed and other factors outside of a patient's control. Those who agree that patients can play a role in prevention of capsular contracture believe that using specific breast massage techniques will help displace the implant, allowing the surrounding tissue of the breast pocket to remain soft and unrestricting.

I recommend that my breast augmentation patients in New Jersey perform soft tissue breast massage following surgery in order to keep their breasts feeling and looking soft. To better understand why breast massage can benefit breast implant patients, an understanding of capsular contracture is critical.

What Is Capsular Contracture?

Capsular contracture occurs when the surrounding tissue of a breast implant hardens. While this can happen at any time after breast augmentation, it is more common in the first few months following the procedure. A capsule is made up of tissue that naturally forms in the pocket where the implant is placed. In most cases, this tissue cannot be seen or felt, but if the tissue hardens, in can tighten around the breast implant, creating an unnatural appearance and potentially even causing discomfort.

Under the Baker Grading System, there are four grades of capsular contracture. Grade I capsular contracture is when the breast feels and looks soft. In essence, Grade I is case in which no capsular contracture has occurred and the implant appears natural. In Grade II capsular contracture, the breast feels slightly firm, but still appears normal overall. Grade III occurs when the breast feels firm and also looks abnormal. The squeezing of the implant by the capsular tissue generally results in a ball-like appearance. Grade IV means that the breast implant is hard and painful, and appears abnormal. Depending on the case, secondary breast surgery may be performed for patients between Grades II and IV.

What Causes Capsular Contracture?

Although the exact cause of capsular contracture is unclear, certain risk factors are thought to increase the likelihood of a patient developing this complication. These factors include bacterial infection during or after surgery, presence of hematoma (a collection of blood in the surgical area), presence of a seroma (a collection of serous fluid in the surgical area), history of radiation, trauma to the breast, and existence of an autoimmune disorder. Smoking is also believed to increase the risk of capsular contracture. While proper surgical technique can reduce the risk of certain factors like germ infection or formation of a hematoma or seroma, and patient behaviors such as breast implant massage and avoiding smoking can further reduce risk, capsular contracture may still develop with no known cause.

Breast Implant Massage Technique

I advise my breast enhancement patients from Philadelphia and New Jersey to give themselves daily soft tissue breast massages, generally starting 10 days after their procedure. Manipulation of the implants is recommended 5 to 6 times daily for a full 3 months after surgery. The massage is performed by the patient placing their hand under the inframammary fold using the opposite arm as the breast, with the palm facing upward. The patient then rotates the hand upward and pushes the implant toward the top of the breast, displacing the implant. This process is repeated on both breasts. I further recommend rolling the implant back and forth, and squeezing and compressing the implants repeatedly by hand. Ongoing massage is also indicated for at least a minute twice daily after the initial 3 month period.

Some amount of scar tissue will naturally form around any implant or foreign material placed in the body, but the goal of massage is to ensure that this scar tissue does not become excessive or hardened. All women considering breast augmentation should learn more from their surgeon about capsular contracture, including the likelihood of this complication, what techniques the surgeon uses to prevent hardened scar tissue from forming, and what recommendations (such as breast implant massage) they should follow postoperatively to minimize their risk.

Frequently Asked Questions

QUESTION:
can swelling after breast augmentation occur again after the swelling had gone down?
I had a breast augmentation almost 4 weeks ago and everything was fine post op. After the third week, I noticed that my swelling had gone down a bit. Although my right breast was slightly bigger than my left, but I knew that it was normal until about several days later, I woke up and noticed that my left breast had now gotten slightly bigger than my right. It just felt a lil bit heavier. The next morning, I was doing my routine massages and felt pain on the side of my left breast but it only hurts when I touched it. I called my PA and told me it was normal and said for me to take any anti-inflammatory drugs (advil, motrin etc.) i haven't taken it yet because the pain has subsided and I am concern that I might have hematoma and don't want to take advil etc for it will worsen it. Do you think I have some kind of a complication or is this a normal healing process? it's just strange to me that I have swelling again after it's gone down a lil bit.
- ANSWER:
  You are right to be concerned, I mean, after the swelling starts getting down it should improve, but taking in count that this process usually takes about 6 weeks. I think your surgeon should evaluate you, ask for an appointment, anyhow he or she should reevaluate you after the procedure periodically for some time. Here you can read a bit more about complications in breast augmentation and try to compare if have any alarm sign http://www.aestheticandplastic.com/procedures/augmentation-mammoplasty.html
  
  Best luck
QUESTION:
how soon breasts become soft after breast augmentation???
HI! I HAD A BREAST AUGMENTATION 10 DAYS AGO. I DO MASSAGES BUT MY BREASTS DONT LOOK ALIKE. ONE IMPLANT MOVED DOWN AND THE OTHER IS STILL UP, IS IT OK? WHEN WILL THE BREASTS BECOME SOFT?
- ANSWER:
  It will take up to 3 months, give or take depending on your muscle, tissue, overs or unders, etc.
  
  My surgery is in 2 weeks. But I have also started to post on this breast implant message forum:
  
  http://www.justbreastimplants.com/forum/
  
  The women here are incredibly supportive and knowledgeable about augmentation, pre/post-op issues, sharing stories and experiences. I know if you read a little, and post your question there, someone will give you great advice!
  
  Good luck to you for a speedy recovery!
QUESTION:
I don't have pain but discomfort in my right breast after my breast augmentation 10 days ago. Is this normal?
My implant was 400 cc. My recovery has been incredibly easy and hardly painful at all. At first my right breast was harder and swollen more but the doctor said that was normal. I've been massaging but that also makes my right breast more sore. It's still harder than the left and I almost feel like the implant is pushing down as opposed to my left breast where it seems to be staying in the middle of my breast.
- ANSWER:
QUESTION:
How can I regain sensitivity after breast augmentation (read details below)?
I had breast augmentation surgery a little over a year ago. I went from being between an AA and A in size to a full B. They were inframammary (at breast crease) and subpectoral (beneath the muscle) saline implants. Although my nipples themselves now have normal sensitivity, some areas of my areolas are numb as well as some of the skin on the lower portion of my breasts. When I pinch the skin, I do feel pain; but when I gently touch the skin, there is a definite loss of sensitivity.

Is it likely that this partial numbness is permanent, or is there still time for it to return? How would you suggest I facilitate the healing process if there is still time? For the past week or so, I've been taking Vitamin B complex vitamins and massaging my breasts twice daily. Is there anything else you would suggest I do?
- ANSWER:
  You should talk to your doctor. I think most likely permanent.
QUESTION:
Breast Augmentation, after surgery?
I just had implants put in 2 days ago (So they are still VERY FRESH). I'm taking pain medications as well as antibiotics. I also have sleeping pills in case I have trouble falling or staying asleep.

But for those of you out there (doctors, or prior patients, etc) - are there other things I can do to make myself feel better? Can I massage the top of my breasts with lotion? Should I "sorta stretch"? (even my triceps feel really tight)...

Thanks for your help.

EG
- ANSWER:
  You need to follow what your doctor told you to do. My PS had be do a series of massage exercises twice a day starting about a week after surgery. I was not able to push myself up out of bed or really do much in the way of using my arms a few days after my surgery.
  
  Your skin will stretch on its own and I would ask your doctor if massaging with lotion is ok before I did it. It is going to take some time for your body to conform to your implants. You are more than likely still pretty swollen especially under your arms and around your stomach. Once the swelling goes down the tightness will gradually go away and your breasts will drop.
  
  It was hard for me to fall and stay asleep in the beginning. You might ask your doctor about this and see if he can prescribe something more affective.
  
  Good luck with your new look. I couldn't be happier with my surgery and the outcome.
QUESTION:
Women: Have you ever had a Therapeutic Breast Massage?
I was given four steps on how to do it yourself. You can look it up online also if you ever wanted to try it. It helps for people who had breast augmentation, adhesion after implant surgery, lactating mothers. Lymphatic massage to treat Lymphedema. I like it because of course helps prevent Breast Cancer. I've few family who have had breast cancer.
Here's in article

http://www.massagetherapy.com/articles/index.php/article_id/115/Breast-Massage
lmao Ant, this is serious. Guys don't get "nut sac cancer".
- ANSWER:
  I'd love to give you a therapeutic breast massage.
QUESTION:
exercises after breast augmentation?
I had a BA a few weeks ago and I try to do the massages the dr. told me to do, but they are so hard and hurt when i try to push on them. i have heard horror stories about the implants not moving if you dont do the massages right and they will not fall, is this correct!!!!
- ANSWER:
  Breast implants for cosmetic purposes is dumb.
QUESTION:
i am 6 months post breast augmentation and my right breast is still hard?
I had a breast augmentation back in febuary, after the procedure both breasts were hard and sore within a week the pain had eased and within 5-6 weeks the left breast was perfect as if nothing had been done, couldnt even feel the implant but the right breast never settled, cant press in on it and cant really squeeze to far, its as if theres a small brick in there, iv tried massaging regularly even vigorously and still no change my surgeon just told me keep massaging and come back to him when im a year over it, by that stage my year aftercare cost will be up and it will start costing me every time i have a concern. anyone elso have the same problem or can shed a bit of light id be grateful its starting to worry me now as it was 5 yrs savings went on this and to think this is the end result
- ANSWER:
  it sounds like you have some scar tissue, the same this happened to my friend, they had to go back in and remove the scar tissue.
QUESTION:
BREAST CELLULITIS/BREAST IMPLANT INFECTION?
I had breast augmentation done in March 2008. Almost right after I started to bruise at the incision site on my left breast. The bruises faded. But then my sutures(spelling?) 5 months later started to poke out of my skin. Like a hard zit that felt like a staple. He did not want to remove them for fear of disrupting the implant. I was told to lightly massage them until they were gone. I thought they were. About 1 month ago I started to get pain behind that implant. I was put on antibiotics and they thought I was having capsular contractor. It seemed to clear up and I was taken off antibiotics. Soo then about 1 week later it came back times two. Swollen and painful. I was hospitalized and eventually told I had breast cellulitis. I am still battling this and will have to have my implant removed. What I would like to know is am I the only one going through this and if anyone else may think it has to do with the stitches that did not dissolve?
Thank you!
- ANSWER:
  you certainly are not alone,
  your symptoms were just due to infection of your implant - which overall will happen in about 2% of these surgeries.
  
  once there is infection - you will get capsular contraction , chronic pain, and waxing and waning signs of infection.
  
  no amount of antibiotics can cure these infections - the implant must be removed in order for the infection to be cured. The sooner the implant is taken out, the sooner you can start your progress -- glad you have made the right move. Taking an antibiotic while the implant is still in - is just a waste of time.
  
  good luck to you --
QUESTION:
I'm literally so worried right now. My husband is deployed. At first the deployment was going fine.?
We talked everyday on the computer. He called me about every 2 weeks or so. When he came for R&R we went to visit family instead of going somewhere with just me, him and our daughter. About a month after he gets back to deployed location, he says he doesn't deserve me. he doesn't know why I love him. He says he is not happy, not with ME but with life in general. He feels life has let him down. He said he just doesn't know about us. He later wrote me an email, saying let's work it out. I'm sorry for everything I've done, I know I've let you down and I'm sorry it will never happen again etc. About a week after that he says we should look into getting a divorce, that he is not in love with me anymore. Well it's been 4 months since that happened, everything was going ok. Still weren't talking NEARLY as much as we used to. But out of the blue a couple weeks ago he ims me and flips out. Telling me I never listen to him, all this mess. He said I have medication for when I get home. I then told him that I had already got on Zoloft. He got mad, asked me why I was sad, I have nothing to be sad about, I'm able to buy whatever I want (I had breast augmentation). I told him I got on it when he told me he wanted a divorce. He said well you know we're still going to talk and see how things go when I get home. Now he only has 2 weeks until he gets home. He isn't talking to me at all when I email him, he doesn't answer my emails. I can call his phone though, and he always picks up, and if he doesn't he calls me back within the hour. So technically I can't say he is ignoring me. I'm worried. I guess my question is how common is this? Could a male veteran tell me what is going on? This is his 3rd deployment. I'm just so worried. A little more to the story I know this is long. But I do everything, I massage his feet every night when he is home, I work full time and still do all the duties of a stay at home mom or housewife. I never refuse sex. His first wife cheated on him multiple times while he was deployed, she also told him she wanted a divorce while he was deployed. I haven't even looked at another man. I couldn't conceive of it. He has been let down by every woman in his life, his bio mom, his adoptive mom. I'm wondering if he feels I am going to let him down? He told me before his first wife said she would never hurt me, and look what she did. That I was telling him the same thing and what happens if I let him down to? I feel like I am a good wife. I'm just confused. I'm scared, worried. I want so much for things to work out and my heart is telling me it will but how do I help HIM when he gets home? And what could be making him do this? I don't think people understand the stress a lot of wives go through with deployments. I know that sounds so selfish of me, I don't intend for it to sound that way, he is under way more stress than I am. I am just so upset by this whole situation. I've been ALONE completely for an entire year. Just me and my baby and the people I work with. It's just so hard. He was supposed to be there for me and for the last 4 months he he's not. The thing is he says that he is not over what the ex wife did to him, stabbing him in the back when he needed her, he doesn't want her, he is over HER, just not what she did. Yet he is doing the same to me. Thanks to anyone who reads and responds.
- ANSWER:
  Does he have PTSD? My husband did the last time he came home from Iraq. I know it can feel so overwhelmingly lonely when you're dealing with a deployment but the fact is you just have to try and make the best of it. They are so busy and so stressed they just do not have the time to make us top priority while they're gone. My husband can be the same way sometimes, the last thing he wants to hear when he's a million miles away is me crying. Guys in the military have to KNOW that their woman can be self sufficent. They also have to know nothing gonna happen while they're away. All you can do is reassure him and be strong. When my husbands away I catch up on housework,make packages for him and watch all my favorite movies and shows. You guys will make it through.
QUESTION:
What are the top ten questions i need to talk to my doctor about before labor?
Im 31 weeks and am trying to make an extensive list to give to ask my doc about labor and whats going on. Ive made a Birth Plan and me and my hubby have asked some questions but i want to make sure that we hit the nail on the head with things we should be worried about. heres my birth plan. (still in work because idk if im hep positive)

Birth Plan
Full Name: Pauve
Partners Full Name: Robert
Todays Date:
Due Date: Saturday, August 14, 2009
Doctors Name: Dr. Bidisha Ray
Hospital Name:Flagstaff Medical Center

I would like...
- My partner: Robert
- My mother: Cynthia
Kailee----Friend
-Mother in Law- Victoria
-My Grandparents: Don and Sandy
.....present before AND/OR during labor

During labor I would like:
- Music played (I will provide)
- Lights dimmed
- The room to be kept quiet
- As few interruptions as possible

- Hospital staff limited to my own doctor and nurses. NO STUDENTS or INTERNS PRESENT

I would like to spend the first stage of labor:
- walking around when I feel and am able
-I would like to eat whenever possible
I am not interested in:
- An IV, unless I'm dehydrated, give extra fluids (heparin or saline lock IS ok)

I would like fetal monitoring to be:
-Intermittent

I'd like labor augmentation:
- Preformed ONLY if baby or myself is in great distress
- First attempted by natural methods such as nipple stimulation, ankle rubbing, walking around
- Preformed with Pitocin

For pain relief, I would like to use:
- Breathing techniques
- Distraction
- Hot therapy
- Massage

During delivery, I would like to:
-Semi recline
-change positions if I need to (laying on side, try squatting)

As the baby is delivered, I would like to:
- Push as directed and as I feel I need to
- Avoid forceps usage
- Avoid vacuum extraction
- Use whatever methods the doctor deems necessary

I would prefer to tear naturally,
- Unless I am at risk of tearing into anus or clitoris
- Followed by local anesthesia for the repair

Immediatley after delivery, I would like:
- My partner to cut the umbilical cord

If a C-section is necessary, I would like:
- To make sure all other options have been exhausted
- To stay conscious
- My partner to remain with me the entire time

I would like to hold the baby:
-As soon as it comes out and again after,
- After suctioning
- After weighing
- After being wiped cleaned

My partner and I would like to swaddle the baby for the first time.

I would like my family members (NAMES):
- To join me and the baby in the room later after my partner and I have had time to bond with baby.
- Please do not allow anyone besides my partner in the room during delivery, unless I say otherwise.

I would like baby's medical exams and procedures:
- Given in my presence
- Given in my partners presence
- To include a hearing screening test
- To include a Hep B vaccine

I would like baby's first bath given:
-In mine and my partners presence

I would like to feed baby:
-By breast feeding and as soon as possible after the birth

I would like baby to stay in my room:
- All the time, given that its healthy

I would like my partner:
- To have unlimited visiting
- To sleep in my room

After birth, I'd like to stay in the hospital:
- As long as directed by doctor

If baby is not well, I'd like:
- My partner and I to accompany baby to the NICU or another facility and to hold baby whenever possible
and ive already talked to several hospital staff members and my lamaze coach (who is a prenatal nurse at the hospital) and i know the hospital protocal.
i talked to her today and will go friday to show her the birth plan. we are allowed to eat. the hospital does not have ANY water births and no hot tubs but i can go into a hot shower or bathtub. which my doctor has okayed as well. and as for the spelling i got the base from another person and havent checked for spelling yet (its only a rough draft so dont be cheeky).
once again. have already gone over the hospital procedures with my doc and hospital staff. we dont have visiting hours because its basically locked down. we just have to say who is ok to come in and out. and yes. its ok to have hubby sleep in there. they even advised us to have hubby bring a sleeping bag. i really wish you people would read the whole thing before answering. and yes. i can eat. already talked to them about it grrrrr.
- ANSWER:
  I hope you have checked with the hospital about their policies. Some of these they may absolutely not be able to allow, such as having your partner sleep in your room, some hospitals just do not let it happen. When I was in hospital I heard the lady in the next room arguing with a nurse because she wanted her husband to stay they night and they would not allow it. Also if you give birth in the early hours of the morning, once you are taken to your room all visitors will probably be told to leave. Most hospitals have set visiting hours and outside these hours they do not allow ANYONE including your partner to visit. Also, if you live in the US I believe most hospitals do not allow you to eat during labour. If you live in Australia, they do.
  You have to remember that your hospital will probably not bend their policies and procedures for you, yes it is nice to want all of these things but I think some of them are a bit unrealistic. You are absolutely entitled to say what you want during your labour and delivery but outside of that you may not get what you want if their rules do not allow it.
  
  ETA: Sorry, when I typed up my answer you hadn't added that you had already spoken to them yet.
QUESTION:
Women: Have you ever had a Therapeutic Breast Massage?
(I asked this before) I was given four steps on how to do it yourself. You can look it up online also if you ever wanted to try it. It helps for people who had breast augmentation, adhesion after implant surgery, lactating mothers. Lymphatic massage to treat Lymphedema. I like it because of course helps prevent Breast Cancer. I've few family who have had breast cancer.
Here's an article

http://www.massagetherapy.com/articles/index.php/article_id/115/Breast-Massage
lol Ant
lol Jaysunproxie, I didn't go yet. I leave the 15th. lol there is a video that I wanted to show but I think it'll violate the terms here.
- ANSWER:
  My sister got breast implants.....she was supposed to massage them for an hour a day (at least) for the fist year or they wouldn't be as natural feeling.....
  
  I go back and forth as to whether I want them or not (I'm a full 38 c....but want double D's)......I remember my sister's popped (one of them), and had to pay a lot of $$ to get it fixed because the doctor she used went out of business....
  
  Of course, this topic is not all about breast implants, right? I'm babbling.....**slowly tiptoes away** LOL
QUESTION:
BREAST CELLULITIS/BREAST IMPLANT INFECTION?

I had breast augmentation done in March 2008. Almost right after I started to bruise at the incision site on my left breast. The bruises faded. But then my sutures(spelling?) 5 months later started to poke out of my skin. Like a hard zit that felt like a staple. He did not want to remove them for fear of disrupting the implant. I was told to lightly massage them until they were gone. I thought they were. About 1 month ago I started to get pain behind that implant. I was put on antibiotics and they thought I was having capsular contractor. It seemed to clear up and I was taken off antibiotics. Soo then about 1 week later it came back times two. Swollen and painful. I was hospitalized and eventually told I had breast cellulitis. I am still battling this and will have to have my implant removed. What I would like to know is am I the only one going through this and if anyone else may think it has to do with the stitches that did not dissolve?
Thank you!
- ANSWER:
  Oh no, that sounds quite bad. I was an intern at a cosmetic surgery office, I've heard such incidents where the surgical suture failed to go away and these patients had to return for a follow-up. In most cases, three weeks is sufficient for the wound to close firmly. The suture is not needed any more, and the fact that it disappears is an advantage, as there is no foreign material left inside the body and no need for the patient to have the sutures removed.
  
  In your case, it seems that your body has failed to break down the stitches. It could be due to your wrong choice of sutures for your body. Occasionally, absorbable sutures can cause inflammation and be rejected by the body rather than absorbed. So i think you should visit your doctor.