Nursing After the Knife

Can you breastfeed if you've had cosmetic or other breast surgery?


"I had bilateral silicone implants placed at age 17," says Kristen, a 39-year-old mother of two. "I nursed both of my children with no complications or problems. I even had a ruptured implant, which was encapsulated by scar tissue, and my doctor still recommended breastfeeding."

The American Society of Plastic Surgeons estimates that in 2004 (the last year for which statistics are available), their members performed nearly 76,000 breast lifts, 264,000 augmentation surgeries and 106,000 breast-reduction procedures. If all these women decide to breastfeed, will they be as fortunate as Kristen?

According to Diana West, I.B.C.L.C., author of Defining Your Own Success: Breastfeeding After Breast Reduction Surgery (La Leche League International, 2001), nearly all women are able to nurse, at least to some extent, after any type of breast surgery. "If milk production is low after surgery, it can usually be increased," she says, "although supplemental formula is still necessary sometimes."

The degree to which milk supply might be affected depends on a number of factors, West adds, including the type of surgery (reductions tend to result in more problems than implants and lifts), the location of incisions (the closer to the nipple, the greater the risk of breastfeeding complications), the surgeon's skill, the amount of time between surgery and breastfeeding (research shows better outcomes if the interval is more than five years) and a woman's inherent lactation capability.

If you have implants and are able to nurse successfully, there's also a question of whether you should. A small study published recently in Analytical Chemistry found that women with silicone implants may develop potentially hazardous levels of platinum salts, which can cause allergies, asthma, reduced immune response and nerve damage. (Platinum was found in the hair, urine and breast milk of the women studied.)

Earlier reviews found no evidence of platinum-related health concerns associated with implants. The U.S. Federal Drug Administration is reviewing the latest information. In the meantime, discuss any concerns with your doctor.

But cosmetic breast surgeries aren't the only type that can have an impact on breastfeeding; women who have undergone surgical biopsies may also experience complications. "There's a nerve that's critical to the letdown reflex located on the lower side of the breast," says Diana West, author of Defining Your Own Success: Breastfeeding After Breast Reduction Surgery (La Leche League International, 2001).

If an incision was made on or near the lower part of the areola (the dark area surrounding the nipple), it could have severed this nerve--although West points out that the nerve generally repairs itself within five years. (When sensitivity in the area returns to normal, it's a good indication that all's well.) As for incisions made on the upper half of the areola, horizontal cuts carry a greater risk of ductal damage than vertical cuts. The higher the incision, the better--regardless of the direction of the incision.

The bottom line: Don't make any assumptions. "I've seen women who have had several breast surgeries nurse with no problems whatsoever, and women with no history of surgery have a really difficult time," says lactation consultant Wendy Haldeman, R.N., C.L.C., co-owner of the Pump Station stores in Hollywood and Santa Monica, Calif. Regardless, if you're considering breast surgery for cosmetic purposes, waiting until you've finished nursing is probably the safest bet.