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  Women's Health

August 2011
Where the Size Matters
FAQs on breastfeeding with implants...
Dr K Ramachandran
 
Breast augmentation is either opted by women for aesthetic purposes with respect to their breast size or by those who have their breasts altered or removed due to breast cancer. Even though there is a risk of decreased ability to breastfeed, for the most part, women can breastfeed successfully after implants without much of a problem. In any case, the benefits of breastfeeding far outweigh any risk of problems with breast implants.

Can I breastfeed after the implants?
Yes, you very much can! It all depends on the site of incision for inserting the implants. If your surgery involved incisions made under the fold below the breast or through the armpit, there should not be much of a trouble in breastfeeding. But, if the incision is made around the areola (periareolar incision), you will face problems in nursing. If the nerves around the areola and the milk duct system remain intact during surgery, you may be able to nurse without any problems. Nerves are vital to breastfeeding because they trigger the brain to release prolactin and oxytocin, two hormones that affect milk production.If underdeveloped breasts are the reason for you to opt for the breast augmentation, use a pump after each nursing session to stimulate milk production.

Will I be able to lactate sufficiently? 
If the nerve damage is partial, a close monitoring of the baby’s weight by the pediatrician will reveal the same and you will have to supplement the baby’s diet with formula milk. Some studies indicate that any kind of breast surgery, including breast implant surgery, makes it at least three times more likely that a woman trying to breastfeed will have an inadequate milk supply (lactation insufficiency). Women who had breast surgery through an incision in the nipple area (periareolar incision) were five times more likely to have lactation insufficiency as compared to women without breast surgery. Having breast implants also can deter women out of feared lactation insufficiency from attempting to breastfeed. Another possibility is that the pressure on the breast tissue by the implant can result in reduced milk production.

Other possible problems?
Women with breast implants might have abnormal lactation or other breast problems such as breast engorgement, mastitis (bacterial infection of the breast), galactorrhea (breast milk production by a woman who is not pregnant or has not delivered yet), or galactocele (a milk-filled tumour in a blocked breast milk duct) formation, increased or decreased nipple sensitivity. Surgical scars, improper size of the implant and infections may also make breastfeeding uncomfortable or even painful at times.

How safe is nursing with implants for the baby?
Both silicone and saline implant pose no real risks to the breastfed babies.

What is the right size for breast implants? 

Not so very long in the past, all women could do to make up for the unattractive breasts was to wear a padded bra. While you might not take any time deciding to opt for breast augmentation, it will be the part of choosing the right size of breast implant that will take longer. Even though women going for the implants because of aesthetics generally tend to believe in ‘the bigger, the better’, they should actually be guided by factors like their body frame and type, and the ‘look’ they are going for as per their taste. Equally important is the professional opinion of an expert plastic surgeon for breast augmentation.

Breast enhancement surgery (also known as augmentation mammoplasty) using saline or silicone breast implants makes it possible for women to choose virtually any cup size they desire. It's wise, however, to temper such freedom of choice with a healthy measure of rational thinking, especially when you consider the investment in time, money and personal sacrifice that you'll be making.

An experienced, board-certified plastic surgeon, who specializes in breast augmentation, can be invaluable in helping you decide how large you want to go. He or she can evaluate your anatomy and take accurate measurements of your chest and breasts to determine the proper proportions for your frame. The surgeon will also take into account how lax, or loose, your skin is — an important consideration because, for an aesthetically pleasing augmentation, you must have enough tissue to cover the breast implants.

Dr K.Ramachandran is Senior Consultant and Cosmetic Surgeon Apollo Hospitals Chennai


    
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