Will a breast reduction surgery affect how a woman breastfeeds, or if she is able to breastfeed at all? While the surgery may have some lasting effects, chances are good that breastfeeding can still be a healthy part of you and your child’s feeding routine.

Background:

Breast reduction, also called reduction mammaplasty, is a very common procedure. In 2010, there were over 130,000 breast reduction surgeries in the United States, making it the fifth most popular surgery overall, a rank that has been maintained for a decade. On average, breast reductions cost around the $5,000 range.

It can be a beneficial survey for a variety of reasons—from cosmetic to medical. Larger breasts can cause undue stress on the back, neck and shoulders; creating chronic pain which surgery can alleviate. The procedure consists of using excess breast fat, glandular tissue and skin to achieve a breast size proportionate with the rest of the body, in addition to repositioning the nipple to accommodate the new, smaller breast. Scarring is likely but can usually be covered by a bra or swimsuit.

Risks:

Women who intend to breastfeed should take extra precautions with reduction mammaplasty. A breast reduction could reduce or eliminate lactation, along with a host of other potential complications. Other risks include: increased pain due to scar tissue in the area while breastfeeding, or increased chances of developing nipple discoloration, called “blanching,” Blanching is sometimes associated with Reynaud’s syndrome, but may also be an effect of surgical trauma, or an unrelated ‘latching’ problem during feeding.

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Education Is Extremely Important:

Many new mothers who have had a breast reduction give up on breastfeeding, merely because they do not have the appropriate information. While women who have had reductions should be able to breastfeed, they may not generate as much milk as necessary. Supplementing breast milk with formula is a viable option for some women, though others may find success through stimulating their milk supply with tools or medications.

Because the reduction is essentially tissue removal, some milk ducts and lactation tissue may be removed. The tissue can potentially grow back (a process called recanalization), but this physiological phenomena is relatively unusual. Since tissue is removed and can be scarred or otherwise damaged in surgery, milk may be produced but become “backed up” in the breast, leading to a painful engorgement. If multiple severed ducts continue to produce milk, an infection called “mastisis” can develop, requiring medical treatment if severe.

Since it is a major surgery, another impediment to lactation is nerve damage, particularly if the nipple was relocated on the breast. Nerve sensation may return, especially over time; reportedly the more time that passes, the more nipple and areola sensation, as well as amount of milk produced.

The Post-Op Wrap-Up

Ultimately, this surgery carries a risk of not being able to breastfeed, though the risk may be lower for some women than others. As with any surgery, it is absolutely imperative to be prepared beforehand and to follow up with your doctor afterwards.

It’s also important to remember that pregnancy itself will increase your breast size, possibly to the natural pre-surgery size. Breastfeeding in and of itself does not have an effect on breast size, though most women find their breast size diminished after weaning. Though there have not been many medical studies on the subject, the results of the few existing ones are promising: with enough time between surgery and pregnancy to allow for healing, lactation is not only possible, but very likely.