Breast augmentation surgery

How do implants affect breastfeeding?

Women with implants may feel more breast pain when the milk comes in, and the breast and nipple root can become firm, leading to latching pain or even latching problems. Implant surgery may leave women with sensitive nipples and areolas. Other mothers with implants have less sensation in their nipples and don’t feel the pain that would normally warn them of a problem, leading to delayed treatment for injury or infection. The lack of sensation may impair the let-down reflex, resulting in poor milk removal from the breast. Complications of breast implants can have a variable effect on breastfeeding. Silicone from the implant does not appear to enter breast milk.   

A) Describing breast augmentation surgery

In breast augmentation surgery, a silicone sac containing salt water or silicone is placed between the pectoralis muscle of the chest and the breast or under the pectoralis muscle. This surgery may impact future breastfeeding.

B) Safety of breastfeeding with breast implants

Mothers with breast implants are encouraged to breastfeed, because the benefits of breastfeeding for mother and baby outweigh the risks posed by the implant.

One study (Semple 1998) showed that milk from mothers with breast implants contained about the same amount of silicone as milk from mothers without implants and that the levels were roughly one-tenth the level found in cow’s milk and one-one-thousandth the level found in infant formula. If any silicone is absorbed by the baby, it is likely passed through the baby’s gut.

C) Effect of breast implants on breastfeeding

Breast surgery can cause a number of breastfeeding problems. The following are the most common ones following augmentation surgery.  

1) Likelihood of breastfeeding  

Some studies show that mothers with implants are less likely to breastfeed and less likely to breastfeed exclusively (Bompy 2019; Cheng 2018; Cruz 2010; Marcacine 2018; Roberts 2015; Schiff 2014). However, a large study (Jewell 2019) of 3,500 American mothers with implants found that their breastfeeding rates and complication rates were similar to those of mothers without implants.

The way the implant is inserted has been thought to affect the amount of milk a baby can get from the breast. Implants can be inserted under the breast and from the armpit or from a cut made at the edge of the areola (peri-areolar).

Some researchers have found that peri-areolar insertions can cut ducts and reduce the sensitivity of the nipple and areola, but more recent studies have not found this (Cheng 2018; Cruz 2010; Hurst 1996; Jewell 2019; Lund 2016; Neifert 1990; Strom 1997).

A woman may have breast augmentation surgery because she has small or irregularly shaped breasts due to insufficient glandular tissue (IGT) and wants her breasts to look more typical. In this case, IGT, and not the surgery, is likely the cause of a low milk supply. This may also be the case for mothers who have one breast that is much smaller than the other.

2) Pain with breastfeeding

Women who have had breast implants may feel more breast pain when the milk comes in. The implant may reduce the space in the breast that can accommodate the milk that is suddenly present, and the breast and nipple root can become excessively firm. This may create latching problems.  

Breast augmentation surgery may leave women with very sensitive nipples and areolas. Mothers with breast augmentation are more likely to have nipple pain and damage (Marcacine 2018). 

3) Decreased breast sensation

Other mothers have decreased sensation and don’t feel the pain that would normally warn them of a problem. This is dangerous, because the treatment for nipple damage or infection may be delayed, increasing the risk of mastitis (Shalev Ram 2021).

Decreased sensation may also impair the let-down reflex and result in poor milk removal and in a decreased milk supply over time.

D) Other conditions that can affect breastfeeding after breast augmentation

Women who have breast implants can develop problems and the impact on breastfeeding can vary.

1) Implant complications

Complications from the implant include those that:

a) Develop soon after surgery:

  • Infection
  • Scarring
  • Fluid or blood around the implant
  • Breast pain
  • Poor cosmetic outcome
  • Nipple or breast sensation changes

b) Develop later:

  • Movement of the implant
  • Leaking or flattening of the implant
  • Scarring of the tissue around the implant
  • Breast cancer (anaplastic large cell lymphoma)

Correction of these may require further surgery. Ideally, this is not done while the mother is breastfeeding.

2) Effect of silicone on the body

Silicone was previously thought to be inert (Institute of Medicine 1999). There seems to be a debate over whether silicone breast implants cause diseases in which the body attacks itself (autoimmune diseases) (Coroneos 2019; Rohrich 2019).

3) Polyacrylamide hydrogel

Breast augmentation by injecting gel (polyacrylamide hydrogel) into the breast was popular in some countries in the 1980s and 1990s. It is rarely used today and many countries have banned the procedure (Margolis 2015). Women who had this procedure have developed complications such as infection, breast lumps, breast hardening, and connections between the breast tissue and skin (fistulas). The presence of the gel and the complications from this procedure and surgery needed to treat them can affect breastfeeding (Ebisudani 2021; Bourke 2018).

4) Breast cancer 

Certain type of implants (textured) have a risk, albeit low, of causing a unique type of breast cancer (anaplastic large cell lymphoma) (Leberfinger 2017; Quesada 2019). This type of cancer can declare itself when the breast suddenly becomes enlarged. Please see your health-care providers if you notice this.


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