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Breastfeeding after Breast Surgery

 

                               Breastfeeding After Breast Augmentation

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Breastfeeding is possible for most patients who elect to have breast augmentation surgery and is no more difficult with implants than without. Women who have experienced breastfeeding without implants seem to experience no problems when attempting to do this with implants.  The question has become not if such a patient can lactate, but rather how much milk she is able to produce.   Any surgery to the breast can reduce lactation functionality, and there are many factors that affect the final outcome. 

The most important thing to remember with lactating is the condition of the nerves so trying to preserve the fourth inter-costal nerve is paramount.  Be sure you tell your surgeon your desires of whether or not you want to breastfeed in the future, as having the areola incision might not be your best choice.  Injuries to the fourth inter-costal nerve are more likely to happen with the areola incision than any other incision placement.  The fourth inter-costal nerve is extremely important in lactating because of its function of triggering the release of oxytocin, which in turn triggers the milk ejection reflex.

The inframammary incision definitely makes less of an impact on the milk supply because neither the glandular tissue nor nerves are affected.  It has been stated, that sometimes implants placed on sub-glandular can apply pressure on the lactiferous ducts and glands, which will reduce lactation.  However, I have known several women including myself that had no problem with breastfeeding with implants placed sub-glandular.  Breast implants that are placed below sub-pectoral tend to have least amount of impact on lactation because the glandular tissue and nerves are untouched.

Regeneration of nerves is called “reinnervation”.  When the nerves in the nipple/areola complex regenerate, mothers produce a much greater supply of milk.  When the patient’s nipples regain a normal response to touch and temperature, this indicates that the nerve infrastructure is functioning well and henceforth can conduct the sensations that are necessary to the pituitary gland for production of the hormones prolactin and oxytocin, which are essential for lactation.  The ability of the mammary system to fulfill the demand of lactation is dependent on the state of the glands and ducts. The more time has passed since the actual procedure of breast surgery, the greater the chances that the nerves significant to lactation will have regenerated.

It has also been concluded that women with breast implants do not risk exposing their breastfed children to excessive amount of silicone. The Institute of Medicine concluded, “No evidence of elevated silicone in breast milk or any other substance that would be harmful to infants was found in women with silicone gel-filled breast implants".

There are a lot of factors that play into successful breastfeeding experience for the new mother.  Not only any prior breast surgeries, but also the mother’s attitude towards the breastfeeding experience is an important influence on her breastfeeding success.  You can get more information on breastfeeding with implants from the La Leche League.

 

 

                                      Breastfeeding after breast reduction surgery

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Of all the different breast reduction surgical techniques, almost all patients are likely to have their lactation ability reduced.  The actual procedures that are done in breast reduction that have resulted in the greatest preservation of lactation potential are those in which the areola and the nipples are not completely detached.  The nipple/areola complex can be moved as long as the lower portion of the nipple/areola complex remains intact. The inferior pedicle technique is one where the areola and the nipple are moved while attached to a mound of tissue called a pedicle.  This pedicle contains the connected lactiferous ducts and nerves.   Any damage to this system is a direct result of deep severed tissue where the glands are removed and the ducts and nerves are detached.

Even in the procedure of the free nipple graft technique”, where the nipples are completely detached, women have in the past regained nipple sensitivity and also some lactation capability.  Since 1990, most all breast reduction surgeries in the United States involve the inferior pedicle technique, since this procedure preserves the ducts and the nerves needed for breastfeeding and sensitivity.  Since breast reduction surgery is removing the excess breast tissue to make the woman more comfortable, it is very important to make sure you tell your surgeon your plans on whether or not you are finished with having children.  Breast milk and pregnancy will make the breasts grow larger again, as well as weight fluctuations.

With breast reduction and augmentation surgeries there is a possibility of having a successful lactation experience with being a new mother.  The milk supply could be somewhat reduced with your first baby after the surgery, but there are ways of increasing lactation by many other avenues.  Psychological, mechanical and chemical methods or devices can greatly increase your production of breast milk, as long as the milk ducts are functioning normally.  There are also ways of supplementing the breast milk supply so that the patient can experience the breastfeeding relationship and bonding that takes place between mother and child.

 

 

 

 

If breast implants are placed to rebuild the contour of the breast following breast removal with mastectomy; then the chances of breastfeeding is not possible.  Women who have breast reconstruction due to breast cancer - often have the nipple/areola complex re-grafted on the breast.  Because of the fact that the glands and milk ducts are removed from surgery, this does not make these patients a good candidate for breastfeeding.


 

 

 

 

 

 

 

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