There is no clear-cut answer to the question of postoperative massage. Ask 10 plastic surgeons what they recommend, and you will likely get 10 slightly different answers! This is probably because there is just no clear evidence that implant massage works to decrease the risk of capsular contracture, and too much massage early on may increase the risk of bleeding (or hematoma).
Many surgeons will advise patients to massage smooth-shelled implants postoperatively in order to keep the implant pocket open. In theory, this reduces the risk of capsular contracture, which is the scar tissue that normally forms around an implant. It only becomes a problem when it tightens and puts pressure on the implant. Textured-shelled implants are meant to allow very fine tissue ingrowth into the shell, which reduces the risk of capsular contracture. Therefore, many surgeons will not have patients perform implant massage after placement of textured implants.
If implant massage is advised, this involves moving the implant up, down, and side to side at least a few times a day to keep the pocket slightly larger than the implant. This usually starts a week or two after surgery and may continue for a couple months. The decision to perform implant massage exercises should be done with your plastic surgeon’s advice. Some breast shapes may respond better to pushing the implants down along with wearing a breast strap, and other cases this may cause too much bottoming out or settling of the implants. Sometimes it is recommend just to go bra-less and move around normally to create micro-movement of the implants and allow them to settle naturally. In revision cases it is imperative to talk to your surgeon about postoperative instructions.
The bottom line is that if you are unsure what to do – ask your plastic surgeon. Being too aggressive moving implants around early after surgery can cause problems, and there is no clear evidence that implant massage works to help prevent capsular contracture in all situations. Every patient is unique and I prefer an individualized approach.
– Dr. Michelle Spring