Breastfeeding after a breast lift, implants or reduction

Can you breastfeed after breast surgery?

Often, yes. Breastfeeding after breast surgery depends mainly on whether the milk ducts, the glandular tissue and the nerves to the nipple were preserved. The fourth intercostal nerve, which reaches the nipple from the side of the breast, plays an important role in the let-down reflex. Operations that keep the nipple attached to the underlying gland and do not cut through large amounts of tissue have the best chance of preserving breastfeeding.

Even before any surgery, some women produce less milk than others, so no surgeon can guarantee full breastfeeding. What a surgeon can do is choose a technique that protects the structures involved.

Breastfeeding with breast implants

Most women with implants are able to breastfeed. Implants placed through an incision in the breast fold (inframammary) and positioned under the muscle disturb the gland least. Incisions around the areola carry a slightly higher risk of affecting ducts and nipple sensation. Silicone does not pass into breast milk in any meaningful amount, and current evidence does not show harm to breastfed babies of mothers with implants.

Very large implants can put pressure on the gland and, in theory, reduce milk production. Your choice of size is discussed in our implant guide and on the breast augmentation page.

Breastfeeding after a breast lift

In a breast lift, the nipple is moved upwards while remaining attached to a "pedicle" of breast tissue that carries its blood supply, nerves and ducts. Because relatively little gland is removed, many women breastfeed successfully afterwards. The type of lift (periareolar, vertical or anchor) and the pedicle used make a difference; our page on breast lift techniques explains these. Ask your surgeon which pedicle they plan to use and why.

Breastfeeding after a breast reduction

A breast reduction removes a significant amount of glandular tissue, so the effect on breastfeeding is greater. With modern pedicle techniques that keep the nipple connected to the gland, many women can still breastfeed partly, and some fully; others need to supplement with formula. The free nipple graft technique, used for very large reductions, separates the nipple from the gland and generally makes breastfeeding impossible. If breastfeeding is important to you, discuss it openly – sometimes a slightly smaller reduction or a different technique is a reasonable compromise.

Pregnancy after breast surgery

Pregnancy and breastfeeding enlarge the breasts, stretch the skin and can make them sag afterwards. This affects all breasts, operated or not. After a lift or reduction the result may partly change; after augmentation, implants usually remain stable, but the tissue around them can stretch and sag.

There is no medical reason to avoid pregnancy after breast surgery, and implants do not affect the baby. However, if you are planning more children soon, it is often sensible to wait before a lift, so that the result lasts longer. Our page on the breast lift after pregnancy and the mommy makeover guide cover this in detail.

Best timing for surgery after pregnancy

• Wait at least six months after you stop breastfeeding, so that the breasts settle to their final size and shape.
• Be close to a stable weight you can maintain.
• Ideally, have finished planning your family, or accept that a future pregnancy may change the result.
• Have any due breast screening done before surgery.

After surgery, wait until full healing – usually at least three to six months – before trying to become pregnant, so that the scars and tissues are stable.

Tips if you breastfeed after surgery

Tell your midwife and health visitor about your operation. Watch your baby’s weight gain and nappies closely in the first weeks, and ask for early help from a lactation consultant. Frequent feeding and good latch help stimulate supply. If one breast produces less, this is common and does not mean you cannot breastfeed. Mastitis or a blocked duct is treated in the same way as in women without implants; see a doctor if you develop fever, a red painful area or a lump that does not settle – see also our page on breast pain.

Pumping, supply and when to seek help

If your baby is not gaining enough weight, your midwife may suggest expressing milk after feeds to boost supply, or supplementing with expressed milk or formula using a cup, syringe or supplemental nursing system at the breast. Partial breastfeeding is still valuable, and every feed of breast milk counts. Some women find that supply improves with each subsequent baby, as the ducts and nerves adapt over time. Contact a doctor promptly if you notice a red, hot area of the breast, fever, chills or a painful lump that does not soften after feeding. With implants, sudden swelling or a change in shape of one breast should also be checked by your surgeon.

How New City Clinic can help

During your free online assessment, tell your coordinator if you plan to breastfeed in the future. Plastic surgeon Dr. Fatih Kılıç will explain which technique best protects breastfeeding for you. New City Clinic also offers combined post-pregnancy procedures, described in the mommy makeover guide, and individual operations such as a breast lift or breast reduction on newcityclinic.com.