Breast-Feeding After Implants: Your Questions Answered

After breast augmentation, you may produce some milk without a full supply. Discuss your breastfeeding plans with your surgeon and maternity care team. After delivery, your baby’s clinician should monitor weight gain, and a lactation specialist can help if supply is limited.

Is breastfeeding with implants safe for my baby?

Breast implants come in several types, including saline, structured saline and silicone. Saline and structured saline implants have a shell made of medical-grade silicone.

Silicone is used in medical devices because it is:

• Resistant to bacteria
• Easy to sterilize
• Hypoallergenic
• Biocompatible
• Durable

Research on silicone from breast implants during breastfeeding is limited. The CDC notes no recent reports of infant clinical problems and cites the American Academy of Pediatrics’ 2001 position: the evidence was insufficient to classify silicone implants as a reason not to breastfeed.

Does it matter where my breast implants are placed?

Breast implants can be placed under the breast tissue (the subglandular position) or under the chest muscle (the subpectoral or submuscular position). Dr. Smith generally prefers the subpectoral position, for a more natural look and feel, a lower risk of capsular contracture (abnormal hardening of the pocket around the implant), and better visibility on mammograms.

Less dissection of the breast tissue is required when the implant is placed under the muscle, which means less disruption of the milk ducts than when the implant is placed under the breast tissue itself. There may therefore be less difficulty breastfeeding after breast augmentation when the implant is in the subpectoral position.

Does it matter where my incisions are?

There are three standard approaches for implant placement: inframammary, periareolar and transaxillary. The inframammary and transaxillary approaches largely avoid dissection through breast tissue and disruption of the milk glands, so in principle they pose the least risk to the ability to breastfeed after breast augmentation.

The periareolar incision requires dissecting through breast tissue to place the implant and can affect milk ducts and nerves. Milk production depends in part on which ducts and nerves remain functional, so an individual breastfeeding outcome cannot be promised.

What if my nipple is repositioned during surgery?

If you need a breast lift as well as an augmentation, the areola and nipple may need to be repositioned. Dr. Smith takes care to preserve the nerves in the nipple area and the integrity of the milk ducts.

A breast lift, or mastopexy, involves more manipulation of the breast tissue than an augmentation alone. There is therefore more risk to the milk ducts and a higher chance of difficulty nursing after a breast lift than after breast augmentation alone.

Dr. Smith recommends in most cases waiting until you are done having children before having a breast lift, because pregnancy and breastfeeding can cause a recurrence of the sagging or deflation that the lift was performed to address.

Next steps

If you are planning breast surgery and intend to breastfeed in the future, raise it at the consultation. It affects which approach and which implant position make sense for you.

Contact the office to schedule a consultation.