Breastfeeding With Implants: An Explanation
Breast augmentation continues to be one of the most popular plastic surgeries in my own practice, and furthermore across the entirety of the United States. In fact, data from The Aesthetic Society shows there are more than 360,000 breast augmentation procedures every year. Undoubtedly, that number will continue to grow in the future.
A portion of these procedures will be on patients who have already had children and are unlikely to have more in the future. Anecdotally speaking, about half of the women I operate on are in this situation.
However, there are a large number of patients who consider breast augmentation before childbearing. And one of their main concerns is whether they’ll be able to breastfeed in the future. It’s one of the most common questions I receive during a consultation.
Can You Breastfeed With Implants?
The quick answer is that the overwhelming majority of people who have breast implants will be able to breastfeed, but it is not guaranteed. There are several factors involved, including incision points, implant placement, and a woman’s natural ability to breastfeed.
Breastfeeding is a complex series of events, starting with hormonal changes during pregnancy that allow the breast ducts to enlarge and produce milk. Implants can affect the ducts, in some cases.
There are also sensory nerves in the nipple that tell the brain to let milk flow. Implants can affect these nerves, reducing or limiting flow.
But despite these risks, most patients can breastfeed.
It’s difficult to give a risk number because some women may have difficulty breastfeeding with or without implants. Therefore, it’s vital to discuss any breastfeeding concerns during the pre-surgery consultation phase.
I always recommend that my patients ask themselves, “If I couldn’t breastfeed following implant surgery, am I comfortable with the alternatives?”.
While most patients will be able to breastfeed successfully, this is the safest way to think about it, just in case.
Factors That Can Affect Breastfeeding With Breast Implants
There are two several factors that can affect breastfeeding after a woman has implant surgery.
The first is the breast ducts, which make and express the milk. To insert the implants, a surgeon will need to make incisions. There are multiple areas where incisions can be made, offering various pros and cons.
With respect to breastfeeding, an incision around the areola may cut or damage the breast ducts, which will then impact their ability to create and transfer milk. We can avoid this risk by instead making an incision under the fold of the breast, which largely avoids these ducts and may be more appealing to patients who have not yet had children.
An incision underneath the breast is essentially underneath the ducts, and there is less damage to the breast tissue too.
Another factor is the placement of the implant. This is less of an issue than the incision point, and the system is very redundant so any approach still gives the opportunity to breastfeed, but I favor placing most of my implants underneath the chest wall muscle, which is even further away from the ducts. Placement under the muscle may also diminish the risk of implants becoming infected in the future. It’s like an additional barrier.
The second factor is milk “let down” or flow rate. When the nipple is stimulated signals go to the brain and milk is released. If nipple sensation is lost, flow can be limited.
During breast implant surgery, the sensory nerve to the nipple that allows milk to flow can be injured. It’s a nerve that can’t be seen during surgery and it comes up through the rib cage. As a general rule, larger implants may put more stress on that nerve or make it more likely the nerve is injured.
Using another incision site or a more sensibly-sized implant lowers these risks, although as long as one side maintains sensation, milk flow will usually occur.
With or without implants, sometimes the ducts that produce milk can become infected with breastfeeding. It is rare, but possible, that such an infection could also infect the implants. This is one of a variety of reasons why I prefer to insert breast implants under the muscle. Doing so adds a layer of protection separating the implant from the ducts in case an infection happens.
Impact On Children
For those who are able, breastfeeding with implants proceeds as in the natural breast. There is no evidence that breastfeeding causes any harm to children when implants have been placed. The outer shell of the implant is made of silicone, which is found in a variety of other areas in our lives – from the sand on the beach to the mold release on milk cartons. It is inert.
Does Breastfeeding Affect The Look Of Implants?
Breastfeeding can affect the look of implants, but not (usually) because of any impact on the implant itself.
Once a set of breast implants has dropped and settled into position after surgery, they usually stay there. And while implants can rupture and will certainly need maintenance over time, it is actually the natural breast that is equally likely to need treatment in the future.
Especially after pregnancy and breastfeeding, the breast tissue will swell and then shrink. Some women will shrink back to where they were, which is no problem. Others may shrink back and have a little bit of droop but still look fine (in fact, a little droop can look more natural).
A good number of patients, though, will shrink and gain so much droop after childbearing that they may need a breast lift, also known as mastopexy. Mastopexy is a common element of a mommy makeover, which typically involves tightening both the breasts and the tummy after childbearing is complete.
While I have never had a patient complain of breastfeeding issues after childbearing, I suspect it does happen. The key is to ensure patients understand the possibility and embrace it. I think it is important that plastic surgeons, like myself, provide a window into the future about what patients can expect with breastfeeding following a breast procedure, and the changes to come in the future.
Hopefully, you’ve found this explanation of breastfeeding with implants useful. And, if nothing else, be sure to discuss your goals for breastfeeding with your surgeon prior to finalising your plan for implants.