Breast Massaging

In other words, the common belief that breast massage is necessary after augmentation is based on recommendations, not proven benefits. It is something that has been passed down and followed without scientific evidence. Scientists and academics know that proving a fact requires research; we cannot rely solely on personal experiences. Therefore, it cannot be concluded that massage is necessary.

Just because many people do something doesn't mean it's correct. For example, seeing motorcycles driving on sidewalks or against traffic doesn't mean it's right. Similarly, widespread corruption doesn't mean it should be followed. The same applies to breast massage.

From what I've heard and seen, those who recommend it give various reasons. Some say it helps maintain breast shape, prevents future problems, makes breasts firm and natural, reduces or prevents fibrosis, prevents hardness, helps breasts expand, prevents wrinkles, reduces breast cancer risk, and improves blood circulation, benefiting the heart and lungs, leading to better overall health (which is exaggerated). We won't discuss these unproven claims. Some believe vigorous massage moves the silicone implant, maintaining the implant pocket created during surgery. Let's see how true this is.

I once experimented by making an incision under the breast, creating a pocket for the implant, and placing the implant without closing the incision, allowing visibility of the implant. I then used my hand to vigorously massage the breast. The implant did not move at all, whether it was a smooth surface or textured surface implant. What moved was the patient's breast tissue. So how can we believe that breast massage can move the implant?

Fibrosis is the process of formation of fibrous tissue. This new connective tissue is created by the body at the site of injury as part of the normal healing process. The main component of fibrosis is collagen, a type of protein found throughout the body, such as in tendons, dermis, blood vessel walls, and cartilage. The purpose of fibrosis is to hold torn tissue together, preventing separation. The more the tissue is pulled apart, the more fibrosis is created, as seen in hypertrophic scars and keloids.

Whether it's skin, internal organs (like liver, kidneys, heart), or bones, if there is a tear or fracture that is surgically repaired or reattached, we must keep it still to heal quickly. In medicine, we aim to minimize fibrous tissue at the repair site once healing is complete. However, fibrous tissue remains without any benefit to the body and can cause stiffness and block blood flow.

Another cause of fibrosis is inflammation. Inflammation can be caused by various factors. In breast augmentation, residual blood in the implant pocket causes inflammation and fibrosis. If bacteria contaminate the implant pocket, chronic inflammation and increased fibrosis occur, especially in non-sterile operating environments or with unclean surgical instruments.

In addition to creating fibrous tissue in response to injury and inflammation, the body also forms fibrous tissue to isolate foreign objects. In this case, the foreign object is the breast implant. The implant, made of silicone, is surrounded by fibrous tissue that separates it from other body tissues. This surrounding layer of fibrous tissue is called a fibrous capsule.

When breast tissue is surgically altered to place an implant, there is injury, inflammation from the silicone, residual blood causing fibrosis, and potential bacterial contamination. How can massage eliminate the causes of fibrosis which is followed by fibrous capsule? Massage only causes internal wounds to move, preventing healing, tearing further, and stimulating continuous healing, leading to more fibrosis/fibrous capsule. The more vigorous the massage, the more inflammation and fibrosis/fibrous capsule occur.

After breast augmentation surgery, many people say it feels like being run over by a truck. I heard this when I started working in 1999, using methods learned from old teachers, making an incision in the armpit and using a large metal instrument to create a pocket in the breast. If being run over by a truck wasn't enough, vigorous massage would cause even more pain and suffering.

From what I've heard from patients who received massages, all said it was very painful and vigorous, with clinic or hospital staff or massage therapists even climbing on their chests. It wasn't just a one-time thing; they had to repeat it several times a week for weeks. It became a business, with patients paying for massages.

As people age, their skin sags partly because it loses its firm attachment to deeper structures, such as breast skin and tissue detaching from the pectoralis major muscle. Facial skin and muscles detach from facial bones. If any part of the body is vigorously moved daily for months or years, it will sag and detach from deeper structures. Vigorous breast massage, pushing and pulling in all directions daily for months or years, will cause sagging. No need to buy a bra; sagging is inevitable.

If massage could prevent breast hardness or lumps caused by fibrous capsule (so called capsular contracture), there wouldn't be patients needing surgery to fix these issues, as all clinics recommend massage. From my experience, patients needing surgery for hardness or lumps all said they received or were taught to massage their breasts. In contrast, my hundreds of breast augmentation patients who didn't massage never returned with hardness or lumps.