The Pros & Cons of Breastfeeding vs. Pumping
The things you should know to help you make your decision.
With breast augmentation being one of the most popular plastic surgery, women commonly ask if it’s possible to breastfeed with implants.
The short answer is YES! The more accurate answer is, it depends.
Dr. Michael L. Workman, MD, Portland Plastic Surgeon estimates that there is roughly a 90% chance an expectant mother will be able to breastfeed after getting breast implants, given that the mother-to-be was able to breastfeed before the surgery.
In other words, if you are able to breastfeed before getting implants, then you will most likely be able to breastfeed with implants.
Consensus by lactation specialists and plastic surgeons nationwide indicate that, generally, breast implants do not interfere with breastfeeding. “If a woman was able to breastfeed prior to having implants, then there is no reason why she should expect to have any difficulty after the implants are placed,” Matthew Schulman, MD, a board certified plastic surgeon in New York City advises.
While there are no scientific or conclusive studies to show that breast implants have any effect on breastfeeding, there are a variety of factors from the breast surgery itself that may possibly affect a woman’s ability to breastfeed after getting implants:
According to Irene Zoppi, a clinical education specialist at Medela, “many mothers with breast implants are able to breastfeed with little difficulty, but the surgical procedure has the potential to damage some of the milk-making tissue, milk ducts and nerves in the breast.”
Breast implants can be placed under or above the breast muscle, with the majority of doctors opting to place implants under the muscle.
Scott C. Sattler MD FACS explains that “when an implant is placed behind the muscle, there is very little surgical trauma to breast tissue. Less breast tissue trauma results in less breast scar tissue. Less breast scar tissue means more healthy breast tissue available for milk production.”
Dr. Miriam Labbok, a physician and director for the Carolina Global Breastfeeding Institute, also explains that placement of the implant behind the muscle puts less pressure on a woman’s mammary glands as opposed to placing the implant above the muscle.
“The mammary gland, like any other gland, performs normally when it has blood supply and space to grow,” said Labbok. “But when you put pressure on any gland in the body you risk it malfunctioning and compromising lactation.”
Therefore, the less pressure a woman puts on their mammary gland, the higher her chances are at producing milk.
Already placed an implant above your breast muscle? No worries!
Rest assured that placing breast implants above the muscle generally does not disrupt the flow of milk from the milk ducts to the nipple.
So breastfeeding is still very possible for mothers with implants above the muscle. However, if given the choice of placing an implant behind or above the muscle, barring all other medical and health issues, placement of the implant behind the muscle seems to be the superior choice.
Perhaps more important than the placement of the breast implant is the incision site during surgery.
Modern technology offers a variety of placement techniques when it comes to breast surgery:
Inframammary (an incision made in the fold where the lower breast meets the chest wall), transaxillary (an incision in the armpit), or periareolar (an incision on the areola, usually on the lower semi-circle of the areola).
The most popular approach for breast augmentation is periareolar, which yields the most accurate results with a discrete scar because the incision is made at the pigmented area around the nipple. Although this method yields the most aesthetically pleasing results, it can decrease a woman’s ability to breastfeed.
Dr. Marianne Neifert, a pediatrician and author of “Great Expectations: The Essential Guide to Breastfeeding,” explains that nipple incisions for implants should be avoided if breastfeeding is important to the patient [because] all the milk ducts that drain the different lobes or sections of the breast kind of convene there [and] it’s possible to accidentally cut milk ducts or the nerve that sends the signal to your brain to release more hormones that then helps you to produce more milk.”
Neifert also adds that cutting a nerve during breast surgery could result in over- or de-sensitivity in the nipple, both of which affects breastfeeding because it interferes with nipple sensation, which is vital to the production of breast milk.
Therefore, “to optimize the preservation of breastfeeding ability, the incision should be placed in the fold under the breast,” Louis DeLuca, MD advises.
It is worth noting that complications with breastfeeding in breast surgery patients arise more often with extensive surgery, such as a breast lift with implants or breast reconstruction surgeries.
The goal for breastfeeding success post-op is to minimize the interference with the breast tissue and milk ducts during surgery.
Studies show that simple cosmetic breast augmentation surgery meets this goal, but more complex breast surgery involving implants for other medical reasons may not.
The overwhelming response is that breastfeeding with implants is safe for a baby:
On the flip side, in case it is a concern, breastfeeding is not harmful to breast implants either.
Generally, breastfeeding with implants likewise does not pose any health concerns for mother or baby.
Saline implants are implants filled with saline (saltwater), which does not affect mother or baby during breastfeeding. Even if the implant ruptures, the saltwater is reabsorbed into the body rather quickly.
There has been a small number of studies, however, concerning the effect of silicone implants on breast milk. It has been suggested that babies breastfed by mothers with silicone implants ingest silicone while breastfeeding. Although this is a concern, studies show otherwise.
Amongst all the scientific jargon, results show that silicone cannot travel from a mother’s implant, through the mammary gland, and into breast milk. Although it is (rare, but) possible that the rupture of a silicone implant can deposit silicone directly into a milk duct, silicone still has to travel through many cell membranes before it shows up in breast milk.
The FDA states that, “although there are currently no established methods for accurately detecting silicone levels in breast milk, a study measuring silicon (one component in silicone) levels did not indicate higher levels in breast milk from women with silicone gel-filled implants when compared to women without implants.”
There is currently no overwhelming evidence to indicate that breastfeeding with saline or silicone implants poses a health risk to mother or baby.
However, mothers are still encouraged to do their own research and consult with their trusted health physician(s) before and after breast surgery and before attempting to breastfeed.
This is because every woman (and baby) is unique and an individual assessment by a physician based on a mother’s own health and medical history would be safest.
As with most parenting decisions where there is no right or wrong, the same applies when it comes to choosing to breastfeed with implants. Not only is it a personal choice, it is also a risk as there is no conclusive evidence answering whether a woman can breastfeed with implants.
Though this may be unsettling, take the following bottom lines from this article:
Parting words from Schulmann: “Some women will have difficulty breast feeding, regardless of the presence of implants. Women should understand this so that they do not mistakenly feel that the breast implants are responsible and then carry an intense feeling of guilt about their decision to have breast augmentation.”
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