Breast surgery and milk supply problems, or insufficient milk, can go hand-in-hand. Here is an overview of the different types of breast surgery and how they may affect milk supply.
- Augmentation: This is a breast enlargement. The implants used are either silicone or saline. There are four different techniques.
- Infra-submammary, where the incision is made under the breast.
- Periareolar, where the incision is made around the areola and nipple. This technique commonly causes a loss of sensation.
- Transareolar, where the incision is made across the areola and nipple region. Unfortunately, the glandular tissue, nerves, and blood supply are damaged immensely. It is nearly impossible to obtain a full milk supply following this surgery.
- Axillary, where the incision is made in the armpit. This is an excellent option as there are not many scars and there is no disruption of breast tissue and milk supply.
- Mastopexy (or breast lift): This involves the removal of extra skin and breast tissue and lifting the nipple. Although you might have a minor loss of sensation in the nipple or areola, this should not affect the capacity to breastfeed.
- Breast Reduction (or Mammoplasty): Two techniques can be used:
- Pedicle: During this procedure, the nipple and areola stay attached to the breast gland on a pedicle while the excess tissue is trimmed -- a section is removed from the sides and underside of the breast. On the whole, the breast, milk ducts, blood supply and some nerves stay undamaged. Breastfeeding is still possible after this surgery, although a full milk supply may not necessarily be established.
- Free-nipple: Typically performed on women with large breasts, this procedure involves removing the entire nipple and areola from the breast and safeguarding it in saline while the glandular tissue of the breast is removed. Next, the nipple and areola are sutured back in place. Unfortunately, breastfeeding is seldom possible with this technique as the blood supply of the nipple and areola is totally detached.
Biopsies
Although not a major surgery, a biopsy can still cause trauma to the breast posing potential milk supply issues. Here is a quick look at what happens to the breast with some of the common biopsies.
- Fine-needle biopsy: Draws a few cells or fluid.
- "Tru-cut" biopsy: Cuts a little sample of tissue without an incision.
- Incisional biopsy: Removes a significantly larger sample of tissue.
- Excisional biopsy: Removes a lump in its entirety.
Source:
Riordan J, Auerbach KG. Breastfeeding and Human Lactation. Jones and Bartlett, MA.
