Whether to breastfeed your children is a very personal decision that you, as a woman, can make, and it isn’t always straightforward. Life and possibly your anatomy may get in the way. Even under the best circumstances, your child may have difficulty latching on or getting enough milk. Adding breast reduction surgery to the mix (referred to as a reduction mammaplasty) is no small matter and shouldn’t be taken lightly in the least.

Many women who have had breast reductions have gone on to successfully breastfeed their babies, even with twins. If you are considering a breast reduction and have concerns about breastfeeding, make sure to discuss this thoroughly with your plastic surgeon before any surgery.

Also, it is vital to remind you that breastfeeding does not have to be an “all or nothing” endeavor. You may just need to re-define what “success” means when it comes to breastfeeding after a breast reduction. Anytime a woman has a physiological factor that (in any way) can affect milk supply, we always want her to understand that any amount of breastmilk is fulfilling and amazing. Whether you can provide 10% or 100% of what your baby needs, you are doing a fantastic job.

Depending on your priorities, the goals you and your surgeon set may change, as well as the surgical technique used.

To understand this issue, it is helpful to understand a bit about the anatomy and physiology of the female breast. During your breast reduction surgery, some glandular tissue is usually removed, milk ducts and nerves may be cut, and (in some singular cases) the nipple itself may be moved. According to current medical data, however, when the nipple-areola complex was kept attached, there was virtually a 100 percent breastfeeding success rate. When it was left partially intact, breastfeeding was successful approximately 75 percent of the time.

Of course, any physiological changes in the breast could impact its ability to produce and express milk, thus stopping any further nursing of your children.

Discuss all of this in detail with your cosmetic surgeon, and make sure you both agree on the exact outcome you want or can expect.

As with most cosmetic surgical procedures, letting your surgical team know exactly what you are expecting during and after your procedure is an extremely important conversation which you must have.

Simply, How Does Breastfeeding Work?

The breast (mammary gland) is made up of fatty and glandular tissues, ligaments, nerves, and blood vessels. The milk itself is produced in glandular structures called lobules and transported through a system of ducts, or channels, to the nipple. The nipple together with the darker skin around it is called the nipple-areola complex, and this area plays a critical role in breastfeeding. Nerves in the area send signals to the brain to start milk production and flow; Small glands, like sweat glands, lubricate the nipple; and tiny muscles contract to support breastfeeding.

Most women have about the same amount of milk-producing tissue, meaning women with larger breasts are no better at producing milk than women with smaller breasts. The amount of milk produced is approximately the same. The difference in size is primarily due to the amount of fat and other non-milk-producing structures in the breast.

Does the Specific Surgical Technique Affect the Outcome I Want?

Smaller breast reductions surgeries may only involve liposuction, but most require an incision at least around the nipple and often down toward the breast crease. The areola is usually reduced in size and moved higher on the chest.

This can be done (and usually always is, in most cases) while keeping the blood supply, nerves, and milk ducts intact. In very large reductions, however, the nipple-areola complex may need to be detached completely and reattached like a skin graft.

Although the research results are impressive and many doctors have had success with many patients breastfeeding after a reduction, none of that is a guarantee. Breast reductions always come with some risk that breastfeeding will be affected. Discussing the entire procedure with an empathetic cosmetic surgeon and their team, and asking the questions you need to know, should be a big part of deciding whether breast reduction at this time is right for you.

The Importance of Setting Goals for Your Breast Reduction With your Surgeon.

It’s known to be true that the impact of a breast reduction on the ability to breastfeed is most affected by the degree to which the nerves and milk-producing tissues are cut. This, in turn, depends on the amount of breast tissue removed to meet your personal goals. While these goals may be cosmetic, they may also be related to pain and dysfunction caused by overly large breasts.

Establishing your priorities and setting goals is an important part of planning any kind of plastic surgery, and that requires detailed, specific, and empathetic communication with your surgeon. If breastfeeding is a top priority, your Wellesley or Boston Cosmetic surgeon will be sure you understand exactly what is involved, and what to expect.

Also, the information you receive may help you decide to opt for a smaller reduction if it means you are more likely to breastfeed. The size of the reduction, meaning the extent of tissue removed, the incisions required, and the technique used to move the nipple vary widely.

I Do Want to Have Surgery, and Breastfeed My Child, What Should I Do First?

As stated previously, make sure you work with a surgeon that will listen to your goals, and professionally guide you, and provide you with the information you need to meet your personal expectations. The entire surgical team at Wellesley Cosmetic surgery has been refining their patient’s natural beauty with care, compassion, and empathy throughout a myriad of procedures. Consult with them first, and make sure what you do is right for you, your children, and your family.