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.
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 breastreconstruction
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.
