Breast Augmentation Creating Challenges for Breastfeeding Moms

For better or for worse, breast augmentation surgery remains at the top of the most requested cosmetic surgeries list. According to top plastic surgeons, it’s because this surgery has a reputation for enhancing self-confidence by improving body proportions and increasing the fullness of one’s breasts.

However - as any good plastic surgeon should tell you in consult - there are risks involved with getting this surgery, many of which can have irreversible consequences when it comes to breastfeeding and milk supply. If you’ve been considering getting breast augmentation, there are several things you should be aware of before you commit. As always, an informed decision is the best one you can make.

How can augmentation surgery cause breastfeeding challenges?

It should be noted that many women are able to breastfeed with breast implants. Even so, Nadine Rosenblum - a nurse and lactation consultant with The Johns Hopkins Hospital prenatal lactation program - explains that having breast surgery means there is no guarantee that a mother will have a full supply of milk. A review and meta-analysis published in the International Breastfeeding Journal found that, when compared to women without breast implants, women who have had augmentation surgery were less likely to exclusively feed their infants with breast milk.

Why does breast augmentation affect milk supply?

The Centers for Disease Control and Prevention says that breast augmentation, lift, and reduction procedures can affect the breast’s nerves and ducts, which impacts lactation directly. Various factors influence whether and to what extent a woman is able to breastfeed following augmentation surgery, such as the number of connected ducts and the functionality of the nerves that enable lactation.

The following factors play a significant role in a woman’s milk supply after she’s had implants:

• Whether the implants are placed under the chest muscle, or on top of it. 
  • If they are placed under the chest muscle, and therefore far enough from the glandular tissue of your breasts, there is less chance that they will interfere with the production of milk.
• The type of incision that was made to insert the implant. 
  • If the surgery succeeds in keeping the areola intact, or if the incision is made under the breast, through the armpit, or the belly button, the woman’s chances of breastfeeding with minimal challenges are higher. However, if the incision goes across the areolae or nipples, it’s likely that some of the milk ducts and nerves have been cut, and the woman might have significant trouble producing milk.
• What measure of feeling is left in the nipples following the surgery. 
  • If the nerves around the nipples were damaged, it reduces the sensation that is necessary to trigger the levels of the hormones prolactin and oxytocin, which in turn triggers the production of breast milk and the letdown of milk, respectively.

How safe is it to breastfeed with implants?

Most experts agree that it is relatively safe to breastfeed your baby with implants. The Centers for Disease Control and Prevention report no clinical evidence of problems in babies of mothers with silicone implants. Moreover, one study measuring silicone levels didn’t find higher levels of silicon in mothers with silicone implants than those without implants.

However, breastfeeding mothers with breast implants should keep in mind that they are at a higher risk for complications to their implants should they develop mastitis. This is a type of breast infection that sometimes happens when a woman is lactating. According to John Semple, head of plastic surgery at Women’s College Hospital in Toronto, mastitis can increase your risk for capsular contracture. This happens when the scar tissue that often forms around an implant starts to tighten. Capsular contracture has the potential to be very painful, and if it is a severe case, can result in the woman’s implants being removed.

The verdict: Are breast implants and breastfeeding compatible?

While it’s very possible to breastfeed with implants, most experts encourage their patients to wait until they’ve had all their children before getting breast augmentation surgery. This is not only due to the potential challenges to their milk supply, but also because of possible complications, further adjustments, and revisions that may be necessary following pregnancy and lactation.

It is an unfortunate fact that breastfeeding tends to result in some sagging of the breasts, and if a woman gets pregnant after her augmentation, there is the possibility that some of the changes made during her surgery may be reversed. Furthermore, women who aim to breastfeed exclusively might struggle to do so if they have implants, and may be required to top up with formula.

The CDC explains that mothers who have had breast surgery may need support to increase milk production. Breastfeeding is always the number 1 source of nutrients for your baby, and experts will recommend that you take the necessary steps to ensure your baby gets all he can.

To meet your breastfeeding goals - especially if you’ve had breast surgery and are struggling - you can follow CDC recommendations and consider taking certain supplements to increase your milk supply.

References:

Schiff, M., Algert, C.S., Ampt, A., et al. The impact of cosmetic breast implants on breastfeeding: a systematic review and meta-analysis. Int Breastfeed J 9, 17 (2014). https://doi.org/10.1186/1746-4358-9-17

Walker, M. (2016). Breastfeeding Management for the Clinician: Using the Evidence, 4th Edition.

Lawrence RA, Lawrence R. (2016). Breastfeeding: A guide for the medical profession, 8th Edition.

Gagne, C.  2019.  Can you breastfeed after a breast augmentation? Today’s Parent. https://www.todaysparent.com/baby/breastfeeding/can-you-breastfeed-with-implants/