Timing is everything. Ideally, you’d opt to have breast augmentation or reduction after you’re done having children. But life throws us curve balls and surprises, and plans often change. If you’ve had breast reduction or augmentation, you might be surprised to learn that breastfeeding may still be a possibility. Since the American Academy of Pediatrics recommends breast feeding exclusively for six months, and continued breastfeeding through one year (or more), that’s a good thing.
Breast Reduction and Breast Feeding
Whether or not you can breastfeed after breast reduction depends on the type of breast reduction technique your surgeon uses. Pedicle techniques give you the greatest chance for future breastfeeding. Pedicle techniques involve raising the nipple and areola to a higher position on the breast, but still leaving them attaching to some breast tissue (so that the nerves and milk ducts stay in tact). Although it takes longer and is more complicated, surgeons like this technique because it usually offers good results; however, it doesn’t always work for very large-breasted women (E-cup or larger) because it can cause problems with nipple circulation or nipple loss. The other approach, the free nipple graft technique, removes the nipple and areola from the breast completely, and then reattaches it as a skin graft after breast tissue is removed. Because the nipple/areola is completely removed, you won’t be able to produce breast milk after the surgery. If breast-feeding is a future goal, make sure you talk to your surgeon about it and see if the pedicle technique is right for you.
Implants and Breast Feeding
Women with implants can breastfeed in theory, but you may not know if you’re able to until you try. It depends on the type of incision your surgeon used. If your incision is under the fold of your breast, or through your armpit, you have a much better chance. But the “smile” incision around the areola makes it less likely, especially if the nerves around the areola were damaged or cut. Without the nerves, your brain can’t release prolactin and oxytocin, the two hormones that make breastfeeding possible. It’s important to make sure your doctor and pediatrician knows about your implants. You may have more severe engorgement, and your baby may need some supplementation (formula); your pediatrician will keep an eye on the baby’s growth to see. If you want to nurse in the future, definitely talk to your surgeon about using techniques and incisions that are least likely to disturb the nerves and milk ducts in the breast.