Sunday, December 4, 2011

Breast Feeding After Breast Implants

Breast Feeding After Breast Augmentation

   There are two main types of implants being used for breast augmentationsilicone gel and saline implants.  Neither silicone gel nor saline implants interfere with breast-feeding.  Although there have been concerns about passing the silicone into breast milk during breast feeding if the implants were to rupture, studies have shown that silicone molecules are too large to pass into the milk ducts and breast gland tissue. Surprisingly, silicone levels were found to be higher in commercially available infant formulas (4402.5 ng/mL)  than those found in women with silicone breast implants (55 ng/mL).

Photograph from Alliedhealthblog

     Although there are no guarantees that one would be able to breast-feed whether you undergo breast augmentation or not, the type of incision may affect one's ability to breast-feed.  There are few choices for incision location for breast augmentation:  periareaolar incision (around the edge of the nipple), inframammary incision (incision underneath the breast), axillary incision (along the arm pit), and periumbilical (around the belly button). 
     A periareolar incision may interrupt or disturb the lactiferous/milk ducts of the breast. Previous clinical studies have shown that women who had breast surgery through a periareolar incision were five times more likely, when compared to women without breast surgery, to have insufficient milk during breast feeding.  A periareolar incision may still be used with minimal damage to the lactiferous/milk ducts depending on the technique used by your surgeon to place the breast implant.  A recent study showed that there was no difference (p>0.05) found in the breastfeeding experience between periareolar and inframammary approaches in women with hypoplastic breasts (small breasts) who underwent a breast augmentation.  This study, however, showed that the success rate of breast feeding decreases by 25% in women with hypoplastic breast who previously underwent breast augmentation. According to the study, the need to supplement breastfeeding increases by 19% in these women.

Fast Facts on Breast Feeding and Breast Surgery
  • A Brazilian study has recently shown that the probability that a woman will be able to breastfeed exclusively after breast reduction was 29%; after breast augmentation was 54%; and in women who had no breast surgery was 80%.
  • The risk of not being able to breast feed in women who had breast reduction is 5 times greater than in women who had no surgery (p=0.002).
  • The risk of not being able to breast feed in women who had breast augmentation is 2.6 times greater than in women who had no breast surgery (p=0.075).

Although the clinical evidence is not as strong for a physician analyzing this data (not a Level I evidence), there is indeed data to suggest that breast surgery, such as a breast augmentation, may affect one's ability to breastfeed.  I recommend discussing your concern and your plans to breast-feed with one of your Houston cosmetic surgeons when you decide to have a breast augmentation procedure (breast implant placement.)  The type of incision that your plastic surgeon uses may vary based on individual considerations. 

Reference:
Andrade RA, et al. Breastfeeding pattern in the first month of life in women submitted to breast reduction and augmentation. Jornal de Pediatria. 2010 May-Jun;86(3):239-44
Cruz NI and Korchin. Breastfeeding after augmentation mammaplasty with saline implants. Annals of Plastic Surgery. 2010 May; 64(5):530-3
Hurst N.  Breastfeeding after breast augmentation. Journal of Human Lactation. 2003 Feb;19(1):70-1
Semple JL, Lugowski SJ, Baines CJ, et al. Breast milk contamination and silicone implants: preliminary results using silicon as a proxy measurement for silicone. Plast Reconstr Surg. 1998 Aug;102(2):528-533.


Date Article Updated: 6/1/2011

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Silicone Gel Breast Implant or Saline Breast Implant?