The effects of breast augmentation surgery on future ability to lactate.

The majority of women receiving breast augmentation surgery do so at a time in their lives when both reproduction and lactation are common. It does not occur to most women to consider the possible effects breast augmentation surgery may have on their future ability to exclusively breast-feed their baby. Most women raise concerns about their inability to exclusively breast-feed years after surgery when they have a child. It is therefore important that women considering breast augmentation surgery be fully informed of the possible effects surgery may have on their future ability to lactate. The possible direct effects of surgery on the breast tissue and the complications of breast surgery on future ability to lactate are discussed. Surgical technique, i.e., implant type and placement, are also discussed. The types of incisions made into the breast tissue and the positioning of the implants once inside the breast parenchyma are analyzed and their possible effects on future ability to lactate are explored. Women who undergo breast augmentation surgery have a greater incidence of lactation insufficiency. Factors directly related to the surgical procedure as well as short- and long-term complications of surgery compromise future ability to exclusively breast-feed a baby. Factors directly related to surgery include severing of the lateral and medial branches of the fourth intercostal nerve or the nerve endings of the nipple-areolar complex, which, lead to reduced sensation and loss of the suckling reflex resulting in decreased milk production. Hematoma formation increases the risk of developing capsular contracture therefore necessitating the need for further surgical intervention. Infection also requires further intervention and as a result, further risk to the breast tissue. Long-term breast pain, capsular contracture, and pressure effects on the breast from the implant are all possible long-term complications that compromise a woman's future ability to lactate and exclusively breast-feed her baby. With good surgical technique and proper postoperative management, most of the complications associated with surgery that may result in insufficient milk production can be minimized but not always avoided. Compared with nonaugmented women, women who have had augmentation surgery have a higher incidence of lactation insufficiency.