After breast augmentation surgery, your immune system will respond to the foreign materials inserted into your chest. Your body builds a “capsule” around each breast implant. The capsule is made from interwoven collagen fibers, or scar tissue.
In some cases, the capsule tightens over time. This is called capsular contracture.
When this happens, the collagen “fabric” around the implant shrinks due to a buildup in fibers. This tightening can squeeze the implant, making it feel hard and painful to touch.
To help prevent this from happening, your plastic surgeon will likely recommend that you perform a daily breast massage in the first few months after your surgery. There are benefits to learning how to properly massage the area, but it isn’t guaranteed to eliminate your risk of capsular contracture entirely.
The exact cause of capsular contracture isn’t fully understood. Massage can help prevent the capsule from hardening, but it may not stop the process completely.
After your surgery, your surgeon will advise you on how to massage the area. They may also refer you to instructional videos describing the proper technique.
In most cases, you should be doing your own breast massage. Your doctor can teach you the correct way to do it, but given the sensitive nature of this massage, they shouldn’t offer to do it for you. If your doctor does perform your breast massage, they could lose their medical license.
Talk to your doctor about when you should start your massage therapy. This can vary depending on your individual surgery. Some practitioners recommend that you start a daily routine a week or so after surgery.
Make sure you talk to your doctor about how to safely massage the area. If they’re unable to provide verbal guidance, they should be able to provide you with instructional materials, such as a pamphlet or video.
Here are some general techniques that you may find beneficial:
- Cup your hands over the top of your breasts, either one or both on each breast at a time. Push downwards for a few seconds, release and repeat. Do the same maneuver, but this time push the breast upward.
- Push your breasts toward the middle of your chest by placing your hands on each side. Hold for a few seconds and repeat.
- Push your breasts toward the middle of your chest, this time with the opposite hand (crisscross them below your breasts). Hold and repeat.
- Place both of your hands vertically on each side of a breast and squeeze. The squeeze should be firm enough but not painful. Repeat on your other breast.
- Grab your shoulder with your opposite hand so that your elbow will press over your breast.
Some practitioners recommend that you vigorously massage your breasts:
- three times a day in the first month post-surgery
- twice a day in the second month
- once a day throughout the rest of the lifespan of your implants
A good rule of thumb is to massage for at least 5 minutes at a time.
Although the recommendations for how often and how long to massage can vary, doctors typically agree that regular breast massage is one of the best ways to prevent capsular contracture.
There aren’t any risks associated with breast massage. To ensure that you’re using the appropriate techniques, go through the moves with your doctor before you leave your appointment.
Ideally, you will watch an instructional video during your appointment to help guide you or receive an instructional diagram before you leave. You may want to do the massage in front of a mirror for the first few times so that you can ensure you’re doing it correctly.
Once capsular contracture starts developing, massage may help reverse some of the hardening.
Anti-asthma medications may help soften the capsule. This is thought to work because of the medications’ anti-inflammatory properties. Vitamin E may also be beneficial. Talk with your doctor before you take any medications or supplements. They can walk you through your options and discuss any potential benefits or risks.
In some cases, surgery may be an option. Talk to your doctor about whether this is the best route for you. With capsulotomy, the implant is “freed” from the capsule but will still remain inside your breast. With capsulectomy, the entire capsule is removed and the implant is replaced.
Although everyone who undergoes breast augmentation will develop a capsule — which is how your body naturally responds to having an implant — not everyone will develop capsular contracture.
Research on capsular contracture is limited, so it isn’t clear how common this complication is. Researchers in one 2008 meta-analysis estimated that capsular contracture affects between 15 to 45 percent of women who undergo breast augmentation.
It isn’t clear why some people develop capsular contracture and others don’t.
It’s thought that the following factors may play a role:
- blood accumulation in the area
- bacterial contamination
- placement of the implant in regards to the pectoral muscle
- presence of various substances either on the implant or introduced during surgery
The type of implant used may also be a factor. Smooth implants may have slightly higher risk for capsular contracture than textured implants do. Saline implants may carry a lower risk than silicone implants.
More research is needed to determine why capsular contracture develops and how common it is.
One of the most efficient ways to help reduce your risk and possibly even reverse capsular contracture is daily breast massage. You should massage your breasts for 5 minutes two to three times a day during the first two months after surgery. Afterward, you should massage for 5 minutes at least once a day or as often as recommended by your doctor.