Introduction
Breast augmentation procedures are usually carried out for cosmetic purposes, correction of breast asymmetry, to overcome postpartum (after pregnancy) breast involution, and in cases of breast aplasia ( congenital absence of breast mainly due to some syndromes).
But breast implantation has a lot of associated complications like hematoma (collection of blood outside a blood vessel), seroma (collection of serous fluid), infection, absence of nipple sensation, capsular contracture, etc. Capsular contracture is a common complication seen in about 20 % of cases. Post-operative care and post-operative instructions suggested by surgeons are said to play a vital role in reducing the progression of capsular contracture.
What Are the Benefits of Breast Implant Massaging and Displacement Techniques?
The following are said to be the uses of breast implant massaging techniques:
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Some studies show that breast implant massaging and implant displacement techniques reduce the risk of capsular contracture. Capsular contracture is one of the most common complications following a breast implant. A capsule is a form of fibrous tissue (scar tissue) formed as a result of an inflammatory reaction (normal immune response of the body). There are different grades of capsules ranging from mild to severe cases. In severe cases, the breast becomes firm, abnormal, and painful. In such severe cases, implant removal is the only option.
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But more research is needed on whether massaging techniques really prevent capsular contracture. Some studies suggest that massaging techniques do not prevent capsular contracture but reduce the progression of the condition by making the breast pocket open and by moving the implant.
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Gives the breast a natural appearance and makes it soft and flexible.
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These massaging techniques also improve the blood flow to the area.
What Are the Different Massaging Techniques?
Breast implant massage is started one week after surgery, which helps in making the breast softer, thus giving it a natural appearance. Dr. Rolando Morales suggested the following technique as described:
The following technique is performed for the submuscular implants (implant placed below pectoralis major muscle). It should not be performed for sub-glandular implants (implant placed above pectoralis muscle and below mammary gland) as it may push the implant towards the center and result in symmastia (uni-boob). The direction for massage is- up, down, to the midline, and to the side. One push in each direction completes one cycle of massage.
Implant Roll:
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First, stand in front of a mirror with the bra off. Keep the palm open and rolled upward, with which press against the breast directly under the nipple.
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The palm should be rolled upward against the chest wall, which causes the implant to rise upwards. This is called rolling upward movement.
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As one looks in the mirror, one can see the fullness in the upper portion of the breast and can feel tightness. Initially, one may hear the implant slide against the chest wall.
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Then the implant should be displaced downward for about ten seconds. The downward massage can be reduced in frequency as weeks pass by after surgery.
Midline Massage:
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This technique is used for refining the sides of one’s implant. In the case of submuscular implants, this massage help in the relaxation of the chest muscle and helps in developing better cleavage.
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Palms are pressed against the breast and compressed towards the center, making the implants move toward each other.
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The massaging techniques should be followed for one year following surgery.
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For the first six months, two cycles should be done thrice daily. After six months, two cycles should be done twice daily for the next six months.
What Are Implant Displacement Techniques?
Implant displacement exercises help in keeping the breast pocket open and keep the implant moving thus reducing the risk of capsular contracture. One need not fear pushing the implant firmly, as it is not painful.
1. Upward and Downward Squeeze:
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Upward- Gently but firmly using an open hand, cup the bottom of the breast so that implant is pushed upwards. Hold it in such a position for five to ten seconds.
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Downward- Put the hands on top of the breast and push down so that implant gets seated on lowered breast fold. Hold in such a position for five to ten seconds. Repeat both exercises ten times each on both breasts.
2. Up, Down, In, and Out:
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Up - Place the opposite hand under the breast and lift the breast up, and hold for ten seconds.
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Down - Place the hand on top of the breast and push it downwards. Again, hold for ten seconds. Repeat both up and down exercises ten times each on both breasts.
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In - Also called cleavage movements. Using one hand, cup the outer breast, feel for the implant, and push the breasts toward the midline.
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Out - Using one hand, cup the inner breast, feel for the implant, and push outward.
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Each exercise should be performed five times a day. After two months, exercises are done once daily. After three to four months, it needs to be done only once weekly.
What Are Other Ways to Reduce Capsular Contracture Risk?
Other ways, other than massaging techniques, that reduce the risk of capsular contracture are as follows:
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Making modifications in implant manufacture, like incorporating drugs in shell, filler, and mesh.
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Administration of oral antibiotics preoperatively, use of intravenous antibiotics, and presoaking of implants in antibiotic solutions are pre-operative steps that can be taken to reduce the risk of capsular contracture.
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During the surgical procedure, irrigation of the breast pocket with antibiotics and proper cleansing of the surrounding incision with irrigation solution can reduce the risk of capsular contracture.
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Oral administration of antibiotics and anti-inflammatory or anti-fibrotic drugs can reduce the risk of capsular contracture.
Conclusion
More standardized studies are needed to study the impact of massaging and implant displacement techniques on capsular contracture. Some studies show that it does not prevent capsular contracture but reduces its progression and gives the breast a soft natural appearance. But it is always advisable to follow such massaging and implant displacement techniques only under the guidance of a board-certified experienced plastic surgeon.
