Episode 6: Can I Breastfeed After a Breast Augmentation?
Our patients frequently ask if they'll be able to breastfeed after they have a breast augmentation. There are a few issues that go into answering this question. First of all, an individual must have been capable of breastfeeding before breast augmentation to be able to breastfeed after a breast augmentation. And because in many cases, we're performing breast augmentations before someone has had children or attempted to breastfeed, we often don't know what their baseline breastfeeding ability is.
How can a breast augmentation affect breastfeeding?
Now, the reason that a breast augmentation could affect breastfeeding is that during certain approaches for breast augmentation, we are cutting through and disrupting the milk ducts that transport milk from the mammary gland out to the surface of the nipple and areola. In the majority of cases, patients are in fact able to breastfeed after having a breast augmentation, because the damage to the milk ducts tends not to be that severe.
There are some approaches to breast augmentation that are more likely to disrupt the ability to breastfeed than others. Specifically, approaches to breast augmentation that require more dissection through breast tissue are more likely to interfere with breastfeeding. So the inframammary approach, which is by far the most popular approach in my practice for breast augmentation, involves an incision under the fold of the breast that lets us get to the plane under the pectoralis muscle for implant insertion in a very direct manner without crossing the breast tissue much at all. So this technique is often believed to have the least possible impact on breastfeeding ability.
On the other hand, the periareolar approach to breast augmentation, in which an incision is made at the border of the areola and the regular breast skin does require us to dissect through a significant amount of breast tissue. And this approach therefore does place the milk supply at more risk because you are forced to cross through the milk ducts in order to get to the plane under the pectoralis muscle for placement of the breast implant.
Finally, in the transaxillary approach, there is also very little risk of damage to the milk ducts, as this approach also does not require much transit through the milk ducts, and as they are left intact, the milk supply is less likely to be interrupted.