10 November 2012

Breastfeeding After Surgery

Today we have a great feature for you all from the very lovely (and gorgeous) Marc Pacifico, a consultant plastic surgeon who specialises in both reconstructive and cosmetic surgery and works at McIndoe Surgical Centre in West Sussex www.mcindoesurgical.co.uk. I'm asking him about breastfeeding after surgery so here's what he has to say.

So first things first Marc, tell us a little bit about yourself and what you do?
I am a consultant plastic surgeon, with both a reconstructive and cosmetic practice. My reconstructive side is predominantly breast surgery - both post-cancer reconstruction and surgery for women with developmental breast problems (such as breast asymmetry or tuberous breasts). On the aesthetic side of my practice, apart from surgery to the face and body, I do a considerable amount of cosmetic breast surgery, including breast enlargement, breast lifts, breast reductions and nipple operations. I really enjoy my work, but have two small children at home, so my rule is to work very hard during the week, but wherever possible keep my weekends free for family time!

Breastfeeding after surgery is not something often discussed at antenatal groups, maybe due to lack of knowledge? So is breastfeeding after, say a breast enlargement, possible?
Breast feeding after a breast enlargement (augmentation) is possible as the milk ducts are not damaged during the operation. Furthermore, it is also safe - in fact a study some years ago looked at the amount of silicone found in the breast milk of mothers with breast implants and compared it with the amount of silicone in formula milk from the bottle of bottle-fed babies. Surprisingly there was less free silicone in the breastfed group! In both groups the amount of silicone was so small it was not at all clinically relevant in any case.

What about after a breast reduction or nipple surgery?
Regarding breast reduction, the answer as to whether breast feeding is possible is - possibly. It really depends on the size of reduction, the technique used, and also an element of chance. So although I would never say never, I would say that a breast reduction may affect breast feeding in the future. I would always recommend trying to breast feed, but be prepared for it not to work after a breast reduction. The important thing, however, is that you will do no harm trying.

Are there any increased problems such as mastitis when breastfeeding with implants or any other form of breast surgery?
The short answer is no. Theoretically there may be a slightly higher chance after a breast reduction as the ducts may have been partially damaged, but this has not been borne out in reality. Therefore, I would still recommend trying to breast feed if you can.

Also for the women out there already breastfeeding but having to undergo surgery (not on the breasts), how long should they wait before breastfeeding their baby again?
For women who have breast fed and seek elective breast surgery (such as a breast lift) I would wait a minimum of 6-months after breast feeding. However, for surgery during breast feeding, such as for an abscess, breast feeding should be continued as soon as possible, to reduce the risk of further mastitis, infection and abscess formation.

Is there anything women can do to maximise their breast milk production after breast surgery?

Unfortunately, apart from eating a balanced and healthy diet, nature will dictate how efficient your milk production is!

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