Breast surgery of any kind has the potential to impact your ability to breast feed in the future.
The outcome is difficult to predict as it depends on a number of variables related to your breasts and to your surgery.
The assumption is that the more disruption to the normal anatomy of the breast, the less likely you will be able to breast feed in the future. Following this rationale, the bigger the breast reduction, the larger the distance that the nipple is moved and the more disruption to the milk ducts in the nipple, the more impact on breast feeding you may see. A patient who has had a mastectomy will not be able to breast feed, while a patient who has had a small breast lump removed will have as good a chance of breast feeding after surgery as she did prior to her procedure.
This assumption is not clearly supported by our medical literature. This is a poorly studied topic with a wide variety of results that are difficult to interpret. There is no way of standardizing and measuring the degree of disruption to the breast tissue and milk ducts following surgery. Therefore, one breast reduction cannot be compared to another, let alone a lumpectomy or wide excision for breast cancer. There is also no standard definition of “successful” breast feeding. For these reasons, the medical literature provides little guidance for the counselling of patients facing breast surgery with concerns about breast feeding.
Breast augmentation does not usually involve any disruption of milk ducts and therefore should not influence any prospects of future breast feeding.
A simpler view acknowledges that all women, regardless of whether they have had breast surgery or not, will fall into one of three groups
- Able to breast feed successfully
- Have difficulty breast feeding
- Cannot breast feed
This is a simplistic view but is close to reality. It is important that you consider this before your surgery and discuss it with your surgeon. Keep in mind that there are lactational specialists who may be able to counsel you and guide you through breast feeding if need be.