All women are different, some of them may have small or slightly flabby breasts and others, due to pregnancy or to loosing considerable weight, may lose their consistency. Breast augmentation can help improve the aesthetics by placing breast prostheses that increase the volume giving it a more attractive look. However, one of the most common question women have in regards this type of surgery is whether it will affect breastfeeding in the future. But, before answering that question, it is necessary to explain the different types of surgery that exist today and, depending on the selected technique, different effects on lactation may appear:
Where the prosthesis is placed
The prosthesis or breast implant can be placed in different areas of the chest either behind the gland but before the muscle or behind the pectoral muscle. The surgeon will select the place of installation depending on patient anatomy and the model and size of the prosthesis that will be implanted.
How the prosthesis is introduced
The introduction of the prosthesis is performed through an incision that is usually done in the areola around the nipple or just under the breast. The scar that remains after the procedure is virtually invisible. The choice of an appropriate prosthesis for each patient is a fundamental decision that requires proper assessment of surgeon based on patient’s breast anatomy and their thoracic capacity. This decision should be taken by analyzing various aspects such as size, shape of the prosthesis (anatomical or round), smooth or rough, etc.
These are several questions that women frequently ask before undergoing surgery:
Will it affect future breastfeeding? Can I breastfeed if I get a breast augmentation with prostheses?
In principle, there should be no problem due to the fact that current surgical techniques do not cause any damage to the glandular tissue. The prostheses can be placed behind the pectoral muscle and place the scar under the breast in order to leave the nipple free of any alteration.
In some cases, complications may arise when the implant is inserted through the areola of the nipple and placed behind the mammary gland leaving behind a small scar on the inside that does not usually stop breastfeeding although it may hinder it if the ducts are damaged. The surgeon must take special care to avoid damaging the nerves, breast milk ducts and mammary glands while performing the implant. If any damage occurs in a nerve during surgery, it may reduce sensitivity which could cause some trouble when delivering breastmilk to the infants. If the milk ducts are affected, breast will produce less. Lastly, sometimes the breast prosthesis compress the ducts to the point of blocking them causing inflammation.
What kind of breast augmentation surgery has fewer risks for future breastfeeding?
When the implant is inserted through the nipple areola there is a greater risk of damaging nerves causing a loss of sensation in the nipple area. These nerves are very important during lactation as they emit warning signals to the brain to free two hormones, oxytocin and prolactin, fundamental in the production of milk. Surgeon’s ability and experience are very important here to prevent such damage and the patient must inform the surgeon to use extreme caution if she’s planning on breastfeeding her future children.
When the prosthesis is inserted through the armpit or under the breast, the risk of damaging breastmilk ducts or the glands increase.
It is almost impossible to know whether an operation has damaged the nerves or ducts of the breasts before you start breastfeeding. These damages don’t affect the form or aesthetic of breasts, making it almost impossible to detect before the baby needs feeding, and only at that point, any incidents can be detected. It is recommended to inform the pediatrician of the existence of breast prosthesis to carry out a closer monitoring of the developing infant and thus dispel any doubts about proper nutrition. In some cases, it will be necessary to complement breastfeeding with formula milk.
Do breast implants increase the risk of mastitis?
There are studies that show the existence of a more or less direct link between breast implants behind the mammary gland and an increased risk for mastitis during lactation. An acute mastitis can cause a capsular contracture of the prosthesis and all the complications that this entails. To reduce this risk, the baby should empty the breasts and the ducts should not dilate too much, if any symptoms of inflammation in the chest or even retention of milk are presented, it would be better to run to the doctor. The occurrence of mastitis is common among mothers with infants who don’t have breast augmentation so it should not be associated solely to the existence of the prosthesis.
Could silicone prosthesis affect lactation?
There are no studies proving any harm to the baby’s health. The material that prostheses are made of don’t interfere in any way with the breastmilk and therefore do not reach the baby. Specialists maintain absolute calm in this regard. There is no evidence that leakage of the silicone implant can reach breast milk. Even if it were to happen, the effects on the baby would be practically nil since that silicone is formed by a perfectly digestible material for the baby. There are medicines, cosmetics and even some food products containing small amounts of silicone that human body is capable of tolerate it with no problems.
What are the precautions to take into account when breastfeeding with a breast prosthesis? Will the baby be able to drink enough breastmilk?
If you have a breast prosthesis and want to breastfeed your baby, you should look for the signs that well-fed child presents. If the baby is gaining weight regularly, wets the diaper more than 6 times a day and expels from 3 to 5 stools daily you will be seeing signs of a proper diet through lactation. If these signs are not observed, then you should go to the pediatrician to ensure that the infant feeding is being sufficient or if any kind of additional support will be needed.
Could breastfeeding deform the implant?
Pregnancy and subsequent breastfeeding always affect breast appearance, with or without breast implants, and, just like the sudden changes in weight could cause stretch marks, sagging and alterations could appear and affect breast shape. However, these alterations do not seem to have greater intensity in breasts with implants.
How long is it recommended to wait before having a baby after breast augmentation?
This is a very important question because expectant mothers suffer many hormonal changes with obvious physical consequences. Pregnancy carries an augmentation of breast size by itself and, in some cases, quite substantial, and stress / strain of some of the internal tissues of the chest. It also changes blood flow and fluid retention in various parts of the body may be presented as well. If all these changes come to the woman who is newly operated, it can affect the normal healing process, both internal and external.
There is not an exact timeframe for all, since all patients are different, but surgeons recommend a period of at least eight to ten months to avoid the appearance of possible complications. If the mother has taken the decision to have several children, it is ideal to wait for the last child to have the operation.
And how long is it recommended to wait for a breast augmentation after having children?
All women experience changes in their bodies during pregnancy, and lactation can affect the internal tissue of breasts. Hormone levels could take months to go back to normal. We must identify two possible scenarios:
- The mother chooses not to breastfeed the baby: in this case, 6 months should pass to have the surgery.
- The mother decides to breastfeed the baby: in this case, the mother would need at least 6 months after the child has stopped breastfeeding.
In both cases, the surgeon will discuss the status with the mother and will decide the best time to do the procedure.
Opinions against breastfeeding after breast augmentation
There are breast specialists that don’t allow breastfeeding after breast augmentation since, although less than the natural, artificial feeding is sufficient to feed any baby appropriately. And they do not allow it because they consider that the risk of mastitis increases with the existence of breast implants introduced via areola. Prostheses implanted with this technique can affect some breastmilk ducts and, in those cases, acute mastitis could appear which may cause the removal of the implants.
Moreover, there are several general risks in this kind of surgery that may affect future breastfeeding. Some of these risks are:
- Alteration of nipple sensation: in cases where nipple sensitivity is altered after breast augmentation, the ability of the mother to breastfeed their babies is reduced. Lactation is not inhibited, but it becomes more difficult since nipple sensitivity it’s very important to identify the babies’ needs.
- Breast pain: any major surgery will cause some pain days after it’s completed. Normally, this pain disappears gradually as time goes by, but in some cases it remains for months with low intensity. This pain can harm future breastfeeding due to the inconvenience of the mother.
- Risks associated with the prosthesis: the main risks of breast implants are associated with a possible rupture, implant displacement or falls and capsular contracture. Among these risks, capsular contracture should be noted, and it has its origin in the scar formed around the breast. This scar can get to shrink and compress the implant causing deformation or a rupture. Depending on the intensity of the contracture, it may become necessary to replace the prosthesis. They are usually very painful thus preventing breast feeding.
In conclusion, we can say that breast augmentation with implants or prostheses may not directly affect future breastfeeding although there are some risks that could block this important maternal role.