Breast augmentation surgery is very common throughout the Western world, with the US being the pioneer in this technique that began in the sixties. Since then, both surgical techniques and the quality and performance of the prosthesis have evolved considerably into a very safe procedure. It is in demand by women who have small, asymmetrical breasts or women who have lost breast volume after pregnancy or have lost weight significantly.
One of the most frequently asked questions posed by women who choose this intervention is whether they can breastfeed after breast augmentation surgery. The answer is yes, because the techniques used today in breast increase take this into account and the glandular tissue is not affected so the woman can breastfeed.
In support of this response it is necessary to analyze in detail some aspects of this intervention because, depending on the technique chosen to introduce the implants, different results can be achieved when breastfeeding with breast implants:
Placement of the breast implant
There are different areas of the breast in which you can place the prosthesis, which is usually behind the gland but with the option of placing it over or behind the chest muscle. The final decision about where to place the implant is up to the surgeon after analyzing the current structure of patient’s breast and the size and type or model of prosthesis to be introduced.
Technique of implant placement
It may vary depending on the anatomy of the current breast and the volume of the rib cage of the patient. The most usual ways of insertion of the prosthesis is by a small incision either in the areola or under the breast. The resulting scar is almost invisible because in the area of the areola there are important changes in tones and textures of the skin that hide the scar, and under the breast it is hidden by the breast itself. Also, the chosen type of prosthesis influences the process, which can be smooth or rough, round or anatomic.
Choosing a good plastic surgeon with years of experience, there is no reason why in the future you would not be able to breastfeed after breast augmentation surgery, as with the previously mentioned techniques any glandular tissue damage is avoided and the prosthesis is placed behind the pectoral muscle. Besides, the incision or scar is made in the fold beneath the breast so the nipple is not altered or modified at any time.
In cases where the surgeon decides to introduce the breast implant by the areola of the nipple should take extra care not to damage any milk duct or the mammary gland, since, although neither the ducts nor the glands seem to be affected, in some cases small scars inside the breast may make breastfeeding difficult but not stop it if a duct is damaged. If the patient warns the surgeon that she is planning to be a mother in the future, the specialist extremes care to avoid any damage to the mammary glands, ducts through which milk flows or nerves.
If a nerve is damaged, the future mother can lose or decrease sensitivity in the nipple area, which ultimately may end up affecting future milk let-down. If the milk ducts are damaged during surgery, in the future, when she is a mother, the patient may produce less milk but she will still be able to breastfeed after breast augmentation with more difficulties.
In some very rare cases, what can happen is that the implant has not damaged ducts but that it compresses them a little, which reduces the passage of milk or even gets to block them entirely, which usually causes breast inflammation.
Which technique is safer for breastfeeding?
The surgeon should always try to prevent from any damage in the area of the nipple, where milk ducts and various nerves responsible for sensitivity in female breasts are. These nerves and sensitivity that they cause in the nipple are responsible to alert the brain to release oxytocin and prolactin, hormones necessary for milk production.
With the introduction of the prosthesis by the nipple areola these risks are increased, therefore surgeons often choose the area of inframammary line to enter it when the patient has informed them of her desire to be a mother in the future. From that area under the breast, any possibility of damage to the nerves of the nipple is reduced. The surgeon will choose the most appropriate technique for each patient once the anatomy of her breast is analyzed, so that the future mother can breastfeed with breast implants or prostheses without any problems.
How to detect if breasts are damaged after surgery?
Unfortunately, the patient cannot detect if there is any damage to her breast before the time she starts breastfeeding, until breastfeeding after breast augmentation surgery. If the nerves or milk ducts have been affected, there are no symptoms or consequence in the aesthetics of the breast. Therefore, until the time comes to produce milk to feed the baby, there are no signs that manifest damage. It is important to warn the pediatrician who is taking control of the baby that the mother has undergone breast augmentation so your pediatrician can pay special attention to adequate food and, if necessary, advise a milk supplement with formula, which she finds appropriate.
Can I get mastitis if I have breast implants?
Some gynecologists warn of an increased incidence of this disease during lactation in women who have been implanted prostheses placed behind the mammary gland and offer several recommendations to reduce this increases risk. Firstly, it is recommended to the mother to make sure that the baby is fed fully from each breast so that the breast is completely empty as that is the way to decrease the risk of mastitis. They also advise that the feeds should not be too long and that if they observe some small swelling in the chest or any symptoms of milk retention, they should come to see the doctor as soon as possible. The occurrence of mastitis is also very common in mothers who are breastfeeding and do not have breast implants so that other gynecologists do not associate it with breast augmentation. Acute mastitis increases the risk of capsular contracture so all the necessary precautions which reduce their possible occurrence should be taken.
Will the silicone affect my baby?
It is one of the fears of many mothers who have implants and with given the materials which current implants are made of, it is totally unfounded. There are no data demonstrating the existence of this risk for the baby, since the content of the implant does not come into contact with mother’s milk. With current cohesive silicone gel prostheses there is no possibility of gel leakage inside the chest, so any potential risk is eliminated.
A few years ago, in case of filled gel implants which could cause leakage, it still did not pose a high risk, and even if a minimum dose ingested by the baby, the effects on the baby’s health would be virtually nil because it is a material easily digested by children (some medicines, cosmetics and even foods are made of silicone as it perfectly absorbs).
Some studies have measured the level of the elemental silicon (silicone component) in breast milk and compared levels between women with breast implants filled with silicone gel and women without any breast implants and the result did not indicate higher levels in women with breast implants. Something curious is that cow milk has higher levels of elemental silicon when compared to human milk.
If I have breast implants, will my baby be fed well? Will she/he take enough milk?
The existence of breast prosthesis is not an issue for feeding the baby, but as in all cases of breastfeeding, mother should monitor the reactions of her little one. The signs that the baby is feeding properly are a continuous weight gain, the number of wet nappies each day, at least five or six times, and how many times he/she poops, which should be at least three times a day. If these signs are normal, they reflect adequate food so there should not be any cause for concern. If the mother observes or detects some different behavior of the baby during breastfeeding with breast prostheses or breast implants after breast augmentation, she should refer to the pediatrician in case a supplement or food reinforcement is necessary.
Will my chest deform during breastfeeding if I have breast implants?
Throughout pregnancy due to future breastfeeding, there are various changes in the breasts affecting their appearance and these changes happen regardless of the existence of breast implants. Changes such as sagging or stretch marks also occur in women who have lost a lot of weight. Breast augmentation does not imply greater intensity changes or modifications that breasts suffer during pregnancy.
How long should I wait to get pregnant?
There is unanimity among physicians about the need to wait a reasonable time from breast augmentation to future pregnancy, because pregnancy brings great hormonal changes in women with significant physical changes such as breast augmentation and tension of their tissues. These changes within the breast are not recommended during the period of adaptation to the breast prosthesis since they can affect the process, especially internal and external scarring. Other changes are also produced, which may affect the woman, such as increased water retention. Although there is no process same for all women, experts recommend a wait of at least eight months after the intervention to avoid unnecessary risks.
I have just become a mother, when can I undergo breast augmentation surgery?
As we have discussed, all mothers suffer various changes in their breasts during pregnancy, of greater or lesser intensity, which all affect various tissues of the breast. To this must be added the various hormonal changes that have taken place and should get back to their normal levels. The body should regain its normality and for this reason it is recommended to wait at least six months if a woman does not breastfeed and another six months after you are done with nursing. After this deadline the surgeon will discuss the state of the chest and decide whether it is the right time to perform surgery or to wait some time.
Although most experts do not pose problems to breastfeed with breast augmentation, there are some experts who do not advise it, since they consider that the occurrence of mastitis is higher in case of breast prostheses.
How to choose a good plastic surgeon?
To avoid any complications arising from the intervention, it is essential to choose a good plastic surgeon, such as those offered by BonoMédico, with years of experience and at a price without competition. Cosmetic surgery is a very complex branch of surgery since it must take into account solving problems or conditions of the patient and also achieving an impeccable appearance, which in some cases is extremely difficult, as in breast reconstructions after cancer, large burns or major trauma. An intervention may be needed in any part of the human anatomy so they must have a great knowledge of the body and learn many different surgical techniques depending on the tissues they will operate.
Before any surgery, the surgeon must have a direct and honest communication with the patient to get to know her expectations of the operation, what her desires and goals are and inform her on the predictable results, which do not always coincide with those desired by the patient . You must inform the patient of the various surgical techniques applicable in her case, potential risks and issues, the advantages and disadvantages of various options. When a patient comes to see a surgeon, in most cases there is a problem or a real deformation that requires a surgical solution, but in some cases the concern of the patient is excessive or disproportionate and her problem or does not exist as such, or it does not require surgery. The surgeon should advised against an intervention in these cases.
Consultations with the surgeon prior to any intervention are essential to properly analyze the patient’s expectations regarding the solution to her problem or physical abnormality. The surgeon will analyze the current breast and guide the patient regarding the outcome that offers the best possible result. Both physical examination and analysis of the medical history of the patient are essential to make the most appropriate decisions in each case and to highlight any pathology that may advise against the intervention. Preoperative tests are essential in cases where anesthesia and hospitalization of the patient are required.
Analysis of the photos before and after breast augmentation surgery is recommended to compare the results obtained. Finally, the more information the patient is offered during the consultations, through lectures, brochures or publications which describe all steps, the better she can make her decision about breast augmentation.