Massaging Breast Implants After Surgery

The theory behind massaging your breasts after breast augmentation surgery is to try and reduce the risk of capsular contracture; a condition that was once the biggest concern with breast augmentation surgery, which can cause the breast to be hard, painful and misshapen.  It is believed by some plastic surgeons that if the implant pocket is kept larger than the implant by frequently moving the implant around inside of the pocket, the scar capsule will not shrink and compress the implant, which is what a capsular contracture is.

No Conclusive Evidence

To my knowledge, no reliable medical study has ever been published in the plastic surgery literature that proves that massaging your breasts after surgery reduces the risk of capsular contracture.  Despite this, many surgeons still recommend breast massage to their patients.  It is truly unfortunate that some surgeons actually blame their patients for getting a capsular contracture by claiming that they didn’t massage their breasts enough after surgery. 

Unknown Cause

The honest truth is that capsular contracture is an enigma in plastic surgery of the breast.  It is generally accepted that excess bleeding leaving blood in the pocket around the implant can increase capsule formation.  For this reason as well as to reduce the risk of bleeding during and after surgery, it is strongly recommended to avoid any medication that can thin you blood for two weeks before surgery.  This includes aspirin, Vitamin E, ibuprofen, Advil and other anti-inflammatory medications as well as many herbal medications. 

Biofilms

Other theories include the idea that capsule formation has to do with biofilms created by microorganisms.  This is a relatively new concept in medicine and surgery.  Bacteria can attach to an implanted prosthesis and form a film on the surface of the implant, which allows them to live and multiply without being attacked by the body’s immune system.  The concentration of bacteria is not enough to cause an actual infection, but is enough to stimulate the formation of a firm capsule and, hence, a capsular contracture. For this reason and to avoid the risk of infection of breast implants, most surgeons recommend the use of antibiotics for at least a few doses around the time of surgery and it is becoming more common practice to irrigate the implant pocket with a dilute solution of antibiotics to not only reduce the risk of clinical infection but also to reduce biofilm formation and, hopefully, reduce the development of a biofilm. 

Antibiotics

If your surgeon recommends that you take antibiotics around the time of surgery, you are encouraged to follow those instructions; not only to reduce your risk of implant infection but also to potentially decrease capsule formation.

One of the most confusing things about capsular contracture is that it frequently occurs only on one side.  It is hard to imagine why one breast stays soft and the other gets hard when they were put in the same patient, at the same time, by the same surgeon and identical implants were used on both sides.  

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