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My thoughts on the value of massaging breast implants.
There is a controversy following breast surgery as to should breast implants be massaged or not, and in order to answer this question we need to go into just what happens during a breast augmentation.
A breast augmentation typically done below the pectoral muscle (submuscular) is one in which a pocket is developed beneath the breast, above the thorax (chest cage), and in between the midline (the sternum), and the lateral border of the pectoral muscle just before the armpit (axilla). This pocket needs to be large enough to accept and contain a breast implant. We need to remember that a breast implant is typically an envelope filled with saline solution or an envelope filled with silicone gel.
In my Champaign cosmetic surgery practices, typically we use saline prostheses; however, these thoughts are applicable to both silicone and saline prostheses. Neither saline solution or silicone gel can get hard; however, certain implants (breasts) become firm or hard. So, how does this happen? In order for an implant to feel firm or hard your body needs to make a capsule, that is, a cover over the implant that is tight. This can happen even if it is not very thick. We actually can make a good example by putting a piece of Kleenex on top of an implant and putting some pressure with that Kleenex over the implant, this will make the implant feel pretty hard. So, it is not difficult to make an implant feel firm or hard if even a thin capsule becomes snug or tight over an implant.
Massaging will prevent this capsule over the implant from becoming “tight” over the implant. This is done by moving the prosthesis up, down, towards the sternum and towards the axilla. When one does this, there is more room inside of the pocket for the implant to fit in. This keeps the implant feeling soft. This is important not only because implant will feel soft but it is also important in the sense that an implant which moves freely inside of the pocket is one that allows the breast to move normally and behave as a natural breast. A natural breast moves with normal chest movements so we could even say that there is a certain wiggle of the breast when one moves. This is desirable and relates to the normality of a breast as compared to a breast that is fixed to the chest wall and it looks fake or unnatural which is typically the case when a prosthesis feels firm.
While we don’t know why some implants become firm in some people and do not in others, we do know that through massage, we can create a wide pocket for the implant to “live” in. This allows the implant to feel softer than it would if the pocket was tighter. It is this simple reasoning that is the answer as to why it is not only desirable but also necessary to massage an implant after breast augmentation surgery. There really are no drawbacks to massaging an implant.
We also need to remember that in order for an implant to be able to be massaged, it needs to be a prosthesis that is smooth. Textured prostheses do not lend themselves to movement and so they should not be massaged. By in large most Breast enhancement surgeries today in the United States are carried out with smooth prostheses, so the argument that all prostheses should be massaged is a good one.
G. D. Castillo, M.D.
COSMETIC PLASTIC SURGERY
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