Nursing

Many young women who are considering breast implants wonder how adding saline or silicone implants will affect their ability to nurse a baby.  The idea that breast implants negate the possibility of breastfeeding is an unfortunate yet overly propagated myth. Although there is no guarantee that following the steps below will eliminate difficulties with lactation for all women with implants, evidence seems to indicate that a bit of advance planning could help a woman who wants to “have her cake and eat it too” to breastfeed with implants.  (One notable exception is women who are electing to have breast enlargement to enhance hypoplastic (underdeveloped) breasts.)

First, select the right incision.  Really, the only incision to avoid is the periareolar incision, which is done near the nipple.   Many doctors like this incision because the areola can hide scarring.  However, there are a few problems when it comes to breastfeeding.  Most importantly, this incision can damage the milk ducts or nerves in the area, which might result in decreased milk production or inability to initiate lactation.  A cut nerve can also increase nipple sensitivity, which may make nursing a particularly painful task for mom.  Performing breast augmentation through this incision also exposes the implant to the (natural) bacteria on the ducts, which could translate into an infection later.

Second, have the implant placed under the pectoral muscle.  Choosing this sub-muscular placement of the implant will reduce the amount of pressure that the implant exerts on the mammary glands.  These glands function best (that is, produce milk and maintain milk supply) when they are given adequate space to grow and receive sufficient blood supply. 

When a woman with implants attempts to nurse, she may be more prone to engorgement (overfilling of the breasts) and its associated symptoms including pain, chills, and fever.   Additionally, any procedure can technically cause changes in the sensations of the nipples and breasts, which could make nursing painful.

The next question on many women’s minds is often, “Okay, it’s possible.  But could the implants somehow contaminate my milk, especially if one ruptures?”  The chances of a modern silicone implant leaking are small to non-existent; the gel fillers of the newest implants are designed to remain cohesive (that is, to “stick together”) and the shells often have multiple protective layers.  However, even if silicone were to leak out, it would not be absorbed during digestion and, for this reason, would be unlikely to appear in breast milk.  Should a saline implant rupture, the mother’s body would like absorb the fluid; however, because the contents are water and salt this would not pose a problem for milk quality.

If you are trying to decide whether to get breast implants before having children, your decision will likely come down to how strongly you feel about breastfeeding your child; there is a chance that, even if you make all of the choices above, you will not be able to breastfeed.  There is also the possibility that you may not be able to breastfeed for other reasons.  Weigh the potential risks and benefits carefully with your family and doctor before making this decision.