So you’ve had a kid (or two, or five) and you’re ready to give the girls a little lift. Or you think you’d like to have your breasts augmented, but you’re not sure that you’re done having kids yet. Maybe you had a boob job years ago, before kids were even in the picture, and now you’re concerned about your ability to breastfeed with implants. But is it true that once you go under the knife, you can no longer breastfeed?
Not necessarily. “Women with silicone or saline implants are both able to successfully breastfeed,” says Dr. Mark Schwartz, Clinical Assistant Professor of Plastic Surgery at Weill Cornell Medical College. But that doesn’t mean that nursing with implants is a done deal. Here’s what you need to know about breastfeeding after implants.
Placement is what matters
Some research shows that women with breast implants may have some difficulty breastfeeding, but that’s not true across the board. One of the most important factors in determining your future breastfeeding success may depend on the placement of the implant itself. According to the Mayo Clinic, to insert the breast implant, a surgeon makes a single cut in one of three places on the body: In the crease under the breast (infra-mammary), under the arm (axillary), or around the nipple (periareolar).
Dr. Schwartz tells us that avoiding the nipple area is key. He says, “As long as the breast ductal tissue is “respected” during breast augmentation, there should be no change in a woman’s ability to breastfeed.” There also shouldn’t be any impact on the nursing infant from silicone or saline implants.
The best way to go about this is for your surgeon to avoid making any incisions around the areola, as that is where those very important milk-producing ducts reside. Dr. Schwartz favors placing the implant underneath the pectoralis muscle, he says, because it makes mammograms easier to interpret, can make the breasts appear more natural, and, “may provide additional safety when it comes to breastfeeding since the implant is further away from the ductal tissue.”
Prioritize longer healing time
But incision placement alone is not the only factor that can affect milk production after breast augmentation. The length of time between surgery and breastfeeding could be another predictor, says Leigh Anne O’Connor, IBCLC, a lactation consultant. “Typically the longer ago the surgery took place, the better the outcome for breastfeeding. This gives the body time to recanalize the milk ducts.” In layman’s terms, you want to give the body time to allow the severed ducts to heal and find their way back together.
Then, before you embark on your breastfeeding journey, set up a consultation with a lactation consultant, who can be your champion for breastfeeding with implants. They can show you how to ensure a proper latch with your newborn, how to stimulate milk production and other techniques for maximizing breastfeeding success.
If you can, hold off on breast augmentation until you’ve weaned
As many a breastfeeding mama knows all too well, nursing (and even pregnancy!) can take quite a toll on the boobs. Once you’ve weaned and your breasts seem to have settled to their final ‘resting state’, could breast augmentation be the magic ticket to give your girls back some pep?
You may want to hold off until you’re sure you’re done with baby-making. Dr. Schwartz says that when to have breast surgery is of course a personal choice, but his recommendation for the ideal timeline for surgery in a woman’s reproductive life would be after she is finished breastfeeding.
“I generally tell patients that if they are planning on having a child within the next year or so, to avoid breast augmentation and to return after they have completed breastfeeding.” Pregnancy alone can cause the volume in your breasts to change rapidly, and both pregnancy and breastfeeding could potentially affect the shape and size of the augmented breast.
What about women who got implants long before they even thought about having babies, and later, found themselves having difficulty producing milk? Was the surgery to blame? That could be possible, but more often than not, other factors may be the cause for low milk supply. Some women naturally have hypoplastic breasts, which are breasts that have insufficient glandular tissue (IGT) to produce enough breast milk. Certain breast types can be more predisposed towards hypoplasia, such as tubular shaped breasts, widely-spaced-apart breasts, and unevenly shaped breasts.
O’Connor says that “In some cases, breast augmentation masks underdeveloped breast tissue…Some women with small tubular breasts may have this condition and this may be the reason that leads her to want augmentation. If this is the case, she may have trouble building a full milk supply for her baby.” Basically, the woman who had a boob job and thinks that’s why she’s having trouble producing milk may have had that same difficulty all along, whether she had had the surgery or not.
A note from Motherly
There are a lot of things to consider when pondering the should-I-or-shouldn’t-I question about breast implants. But if you do your research, find the right doctor, talk to lactation experts (if you’re still planning on breastfeeding), and are clear about your breastfeeding goals, a boob makeover could be in the future for you. Or not. Either way, as with any surgery, never go in blindly and without an armful of facts and questions about the risks. Most importantly, do what makes you feel like the best version of you.
A version of this story was originally published on July 25, 2017. It has been updated.