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Breastfeeding After Breast Reduction Surgery
Breast reduction surgery reduces the volume (size) of breasts. There are many different surgical techniques but most usually to reduce milk production capability, at least with the first baby born after the surgery.
The surgical techniques that reduce milk-making capability the least do not completely severe (cut) the areolae and nipples (even if they’re moved higher), and don’t remove tissue below the areola.
If you don’t know which technique your surgeon used, you can either call the office to ask or you can find it listed on the surgeon’s surgical notes, which you have a legal right to see in the US and most countries and should be easily obtained from the hospital medical records department.
Frequently Asked Questions About Breastfeeding After Breast Reduction Surgery
YES! Breastfeeding after breast reduction surgery is certainly possible!
Advances in breast reduction surgical techniques are increasingly able to preserve milk-producing tissue so that breasts can produce more milk.
Breastfeeding after reduction can be successful if you have:
- at least one breast
- with a nipple and areola
- and a baby willing to latch
There are also many ways to increase the milk-producing capability in tissue that’s still intact, connected, and functional.
Breast reduction surgery (reduction mammoplasty) is a very extensive surgery and has significant risks. It’s usually not considered cosmetic or aesthetic because most people have it after suffering from the weight of large breasts. In fact, most health insurance carriers cover this surgery for that reason.
But there are also significant and painful psychological reasons, including damage to self-esteem and sexual harassment that too commonly happens in societies that equate large breasts with sexual promiscuity (the bigger the breasts, the more they want sex). It’s absurd and wrong, of course, bit it still happens all over the world.
The scars from breast reduction surgery vary widely depending on the technique used. They usually include:
- a scar around the areola
- a scar in a vertical line from the areola to the inframammary fold (the crease below the breast)
- a very small half-inch horizontal scar at the base of the breast
- a short horizontal scar of about two inches somewhat above the inframammary fold
- or a long horizontal scar along the inframammary fold
Some scars are hidden on the areola, some resemble an inverted T, and others resemble an anchor. It’s not possible to know which surgical technique was used just from the pattern of the scar.
The most common techniques are the “pedicle” techniques that move the areola and nipple up to a higher position while still attached to a mound of tissue called a “pedicle” that contains the still-connected ducts, nerves, and blood supply. There are also specialized variations of each technique.
Although pedicle techniques leave a scar around the areola, the nipple and areola are not been completely severed, which protects milk production and release (letdown).
The most common pedicle technique is the Inferior Pedicle Technique, also known as “McKissock,” “Robbins,” or “Moufarrege” techniques. It removes tissue above the nipple, where less milk-making tissue is located. Most people have the most milk after this technique.
The Superior Pedicle Technique, also known as “Lejour” and “Lassas,” keeps the areola attached and in place. It’s been shown in studies to result in less milk production because it removes more tissue below the areola where most of the milk-making tissue is located, and typically severs the primary nerve that affects sensation and milk release.
The Medial Pedicle Technique preserves the tissue on the sides of the areola. Outcome vary depending on how much milk-making tissue was removed and whether the critical nerves were cut.
The Free Nipple Graft Technique is not a pedicle technique because it cuts the nipple and areola completely from the breast. But even with this technique, nipple sensitivity can come back over time as nerves heal and reconnect, and many people have some milk production and release (letdown) capability.
There are many complex reasons to have breast reduction surgery, including both physical and psychological issues, so the benefits of the surgery have to be weighed against the likelihood of having a full milk supply for any future children. It’s a very personal decision with many factors to consider. It’s important to take time to research as much as possible about the surgery and surgical techniques, read about common breastfeeding experiences after the surgery, and learn about resources available to help.
Consider Waiting
Even if you decide to definitely have breast reduction surgery, it may still be wise to wait until you’ve finished breastfeeding all the children you want to have. Not only will you have more milk for future babies, you’re also likely to have a much better surgical result because the reduction will happen after all your pregnancy and lactation hormonal changes have ended.
As parents, we often have to make hard choices and sometimes we have to make sacrifices for our children. This is one area that you can make a personal sacrifice that will have HUGE rewards. You can put off this surgery for a few years and nurse your children without worrying about the difficulties that many have breastfeeding breast reduction surgery.
Advice About Waiting from BFAR Parents