Breast Feeding after Reduction Mammoplasty (can be also spelled mammaplasty)
Breast feeding requires:
- Glands to produce the milk
- Ducts to bring the milk to the nipple
- An interface for the child's mouth - nipple
- Emotional component
Breast reduction surgery can leave intact the ability to breast feed. This depends on the type of surgery. Breast reduction mammoplasty normally:
- Restores the nipple and areola to a higher position - excess skin may need to be removed or redraped.
- Lessens excess mass and weight by removing:
- Breast glandular tissue
The design of this surgical sculpture is to remove the excess, yet keep the remaining tissue alive with a good blood supply and sensation. To maintain function, the gland - duct - nipple connection must remain intact.
There are many types of breast reduction sculpture that keep glandular tissue attached to the nipple and areola. When blood and nerve supply are left attached, the tissue moved is called a pedicle flap. Each of the many types of flaps has its own characteristics for sensation and amount of remaining attached gland. The choice of flap design is part of the surgical sculpting and what is the best depends on your specific problem. Not all methods are suitable for every breast.
All pedicle flap breast reductions have less gland than before surgery. The ability to breast feed after surgery will depend on
- how much milk producing gland remains
- how well the the gland attachments to the nipple have been preserved
- sensation issues
- how you have healed
Free Nipple Graft
In cases of massive breast reduction mammoplasty, there may be just too much tissue to preserve the nerves and blood vessels to the nipple and areola. Using a "free nipple graft" means that the nipple and areola are disconnected from the underlying gland, blood vessels and nerves. The breasts are then reduced. The areola and nipple are attached to the skin as a "graft" that needs to reestablish their blood supply to the superficial tissues of the breast. Sensation can restore to a degree from the local nerves but may not be as strong as with the "pedicle" techniques.
Remaining glands in the breast enlarge with hormonal stimulation. Since the connection to the ducts and glands is divided, milk production that gets to the nipple is very uncommon with a free nipple graft reduction. This operation is best reserved for the unusual case of massive breasts when breast feeding is no longer a concern.
Breast Feeding without Sufficient Milk Production
There are ways to breast feed without producing enough of your own milk. There are lactation consultants who specialize in showing you how to optimize what ever milk production is possible. Your child can then still get nutrition, and you can still enjoy the bonding of the breast feeding. One method is to tape a tube to the skin from a bag about the neck. You will need to ask your doctor for such help or explore several web sites that can direct you to resources.
How do I find answers to my own breast feeding questions?
I prefer to explore my patients concerns about breast feeding before their surgical sculpture. When convenient, breast reduction is best after pregnancies.
Issues about breast feeding are best discussed with the doctor who is planning or has done your reduction mammoplasty. If that doctor is not available, then for me to offer an opinion you would need a consultation. It is easier to discuss breast feeding issues for my own patients and my own breast reduction mammoplasty. After another doctor's surgery analysis is easier when the patients bring copies of their prior surgery reports, doctor's office notes, and photographs before surgery.