Breastfeeding After A Breast Reduction

One prevalent misconception concerning breast reduction surgery revolves around its potential effects on breastfeeding post-surgery. But it is possible to breastfeed after a breast reduction surgery with the right support and knowledge, ensuring you can have a successful breastfeeding experience. Whilst breast reduction surgery can have an effect on your milk supply and breastfeeding ability, various strategies (such as consultations with a lactation specialist to prepare for breastfeeding) can significantly improve your chances of breastfeeding successfully. Throughout this article, we will explore these strategies to assist you on your breastfeeding journey. 

Whilst breastfeeding following breast reduction surgery is possible, many women find it challenging. Successful breastfeeding greatly depends on the type of breast reduction surgery performed, as well as individual factors. Most commonly, the ability to breastfeed may be preserved; however, there is a significant risk of reduced milk supply due to potential damage to nerves and milk ducts following the surgery. While some women may experience great success breastfeeding, other women may need to explore other alternatives such as the use of formula milk. It is crucial for women considering breast reduction surgery as well as possibly breastfeeding in the future to discuss their intentions with a qualified surgeon to explore techniques that may aid in preserving breastfeeding ability. In addition, seeking advice from a lactation consultant following childbirth can help with any potential challenges you may face, and ensure the best possible breastfeeding experience for both you and your baby. 

 Breast reduction surgery is beneficial for improving quality of life, as well as eliminating physical discomfort but it can pose challenges for those intending to breastfeed. This section explores breast reduction surgery and the potential impact it may have on lactation, as well as offers alternatives for women intending to breastfeed after undergoing the procedure. 

1. Introduction
2. Breast reduction surgery definition

Reduction mammoplasty, otherwise known as breast reduction surgery, is a surgical procedure that not only reduces the overall breast volume but also aims to maintain nipple-areola viability and creates a breast shape that is aesthetically pleasing.¹ 

2. Importance of breastfeeding for infant health and maternal bonding

Breastfeeding has been associated with a wide range of health benefits for both mother and child, as well as helping to build a strong emotional bond between you and your baby.² A key benefit to breastfeeding is that breast milk is readily available for your baby whenever your baby needs it, and it fulfillsall of your baby’s nutritional needs. Additionally, breast milk aids in protecting your baby from a variety of infections and diseases right into adulthood. The longer you decide to breastfeed, the greater the benefits for you and the baby as well. . Breastfeeding  provides a wide range of health benefits for the mother   lowering the risk of both ovarian and breast cancer, as well as cardiovascular disease.³ 

3. Challenges of breastfeeding after a breast reduction surgery 

While most women are able to produce some milk following breast reduction surgery, some mothers do not have an adequate milk supply to fully support their baby. Following a breast reduction surgery, your nipples may be less or more sensitive compared to normal, making it more difficult to pump milk. However, your chances of successfully breastfeeding are significantly improved if your milk duct system is left intact following the breast reduction surgery, for example, incisions made through the armpit or under the fold of the breast are less likely to cause difficulty in breastfeeding.⁴ 

Understanding breast reduction surgery and its impact on lactation

1. Overview of breast reduction surgery techniques 

This section aims to outline the 4-step surgical approach that is most commonly used during breast reduction surgery.

The first step involves the adjustment of the skin envelope as well as the reduction of breast tissue known as a vertical resection. The second step, known as a horizontal resection, involves the amputation of the base of the breast, before the third step which is the development of the medial and lateral flaps to provide contour and shaping of the breast. Finally, the last step involves positioning the nipple and areola to ensure there is a safe blood supply.⁵ 

2. How breast reduction surgery may affect breastfeeding ability and milk supply

It is vital to understand that there is a significant risk of reduced milk supply due to potential damage to nerves and milk ducts following the surgery. According to the Center for Disease Control and Prevention (CDC), nerves that were damaged during surgery may regain functionality, as well as damaged milk ducts may grow back together or form new pathways, enabling the mother to produce milk.⁶ The amount of milk supply greatly depends on the number of connected milk ducts as well as the correct functioning of the nerves that enable lactation. Some mothers may need further support in order to increase their milk supply and may need to supplement with formula or pasteurised donor human milk. Please consult your doctor or a lactation consultant for further advice. 

Factors affecting breastfeeding success after Breast Reduction Surgery 

1. Timing of the surgery in relation to future breastfeeding goals

Timing your breast reduction surgery in relation to future breastfeeding goals is crucial to consider. Whilst breast reduction surgery provides relief from physical discomfort, as well as enhancing your overall quality of life, this surgery may potentially impact your ability to breastfeed in the future. For women who plan on breastfeeding, it is advisable to discuss your breastfeeding plans with a certified plastic surgeon during your initial consultation. The surgeon will be able to assess specific surgical techniques that aim to preserve the nerves and milk ducts that are essential for successful lactation.⁷ In certain cases, the surgeon may opt to delay the surgery until after your breastfeeding journey. Open communication and careful consideration between yourself and the surgeon will help you to make an informed decision that best aligns with the desire for a breast reduction as well as your future breastfeeding goals.

2. The impact of the amount of breast tissue removed during the surgery on breastfeeding

The amount of breast tissue that is removed during the surgery can have a significant impact on your breastfeeding ability. Breast reduction surgery involves the removal of any excess breast tissue as well as reshaping the breast to create a more aesthetically pleasing visual and eliminate any physical discomfort. The amount of excess breast tissue removed can affect the number of milk-producing ducts that remain in the breast.⁴ In instances where a large amount of breast tissue has been removed, there is an increased likelihood of potential challenges in breastfeeding successfully. However, open communication with your surgeon to consider your breastfeeding goals can significantly increase your chances of successful breastfeeding following surgery.

3. Nipple and areola preservation and their impact on breastfeeding

Preservation of the areola and nipple during breast reduction surgery can have a significantly positive effect on breastfeeding outcomes. Throughout the surgery the nipple and areola are preserved on a pedicle or a graft, by keeping these areas intact the surgeon aims to preserve both sensory and lactation functions of this area.⁸ Preserving these areas increases the likelihood of successful breastfeeding following the surgery as both the nipple and areola retain both the milk ducts and nerve connections. However, it is crucial to consult with a certified plastic surgeon to assess your individual circumstances and determine the most suitable surgical approach for you. 

Preparing for breastfeeding after breast reduction

1. Pre-surgery counselling on potential breastfeeding challenges

Pre-surgery counselling on potential breastfeeding challenges is a key aspect of patient care. Throughout the counselling session, the plastic surgeon will aim to educate individuals on the potential risk of the surgery in regard to future breastfeeding goals. During the session, it is discussed how a breast reduction procedure could potentially alter the breast anatomy as well as affect milk supply and production. The surgeon may also address any concerns you may have and offer realistic solutions and expectations to aid you in making an informed decision about the surgery. Additionally, alternative breastfeeding methods and support systems may be explored, such as lactation consultants.⁹ Pre-surgery counselling is beneficial in empowering patients with the correct knowledge and expectations to enable patients to make an informed decision that aligns with both aesthetic desires as well as future breastfeeding plans. 

2. Identifying risk factors for low milk supply or other lactation issues

Identifying risk factors for low milk supply or other lactation issues following breast reduction surgery is essential to help prepare patients for any potential challenges with breastfeeding. There are several factors that can influence lactation outcomes post-surgery, for example, pre-existing hormonal imbalances, certain medical conditions as well as previous breastfeeding difficulties.¹⁰ Discussing these factors with your surgeon or healthcare professional can provide personalised guidance and support throughout your breastfeeding journey. 

3. Considering alternative feeding methods and supplementation

Some mothers may face breastfeeding challenges  following breast reduction surgery. In these circumstances, it is vital to consider alternative feeding methods and supplementation to ensure the well-being of both yourself and your baby. For mothers that experience challenges with lactation, it may be useful to formula feed which provides essential nutrition for your baby. In addition, using breast pumps and breastfeeding aids to pump and store breast milk can provide a partial breastfeeding experience, promoting the mother to bond with her baby whilst still providing valuable nutrients.¹¹ Consulting with a lactation specialist can help to explore different positions and techniques to help enhance the chances of successful breastfeeding following surgery. The focus of lactation specialists is to create a supportive environment that not only empowers the mother but also promotes a loving and strong parent and baby connection.

Summary 

Breastfeeding following breast reduction surgery can present both opportunities and challenges for mothers. Breast reduction surgery may potentially affect milk supply and production due to breast tissue removal damaging nerves and milk ducts. However, a range of personalised support and approaches can significantly help your breastfeeding journey. Pre-surgery counselling can outline potential challenges, allowing for surgeons to tailor specific surgical techniques to preserve breastfeeding capabilities. For mothers experiencing challenges after surgery, there are a range of alternative feeding methods to explore such as formula feeding or pumping and storing breast milk. Seeking guidance and support from lactation specialists and healthcare professionals will also increase the chances of successful breastfeeding despite surgery. Open communication with various healthcare professionals is essential to help mothers make informed decisions based on their individual circumstances such as aesthetic desires as well as future breastfeeding goals and ensures a fulfilling and loving mother-baby bond.