Can a breast augmentation using periareolar incision cause low milk supply? (Photos)

Question

My Plastic surgeon preferred periareola incision and assured me breastfeeding wouldn't be a problem! Eight years later, I am not producing enough breast milk to feed my baby fully I have a good latch, feeding a lot, and taking taking milk flow supplements. still not producing enough. Could my incision scars damage my milk ducts? Is there anything I can do? I also wonder if the sebum from old nipple piercings could block milk ducts...

Farbod Esmailian, MD · Answer

Incisions around the areola usually do not affect milk production as that is a different process in the body.  There are plenty of intact ducts that can carry the milk.  The process of breast feeding is very complicated as there are many pathways that are involved in the breast feeding process.

Any prior procedures such as inverted nipple surgery and piercings of the nipple can affect the ducts in the nipple area which may cause problems with the release of the milk through the ducts.

Hope that helps.

Daniel Barrett, MD · Answer

Dear hannah100588,
I tend to prefer the periareolar incision because its the most well hidden. There is a natural border between the areola and the rest of the breast skin the hides the incision extremely well. You have to be completely naked to see it vs other incisions like transaxillary and inframammary are visible in clothing such as sleeveless shirts and bikini tops when extending your arms up. I've also noticed increased rates of bottoming out with inframmary incisions that is not reported. Transaxillary implants are always wide in appearance because the surgeon is not able to dissect medially enough to provide better cleavage. Ultimately, I can perform any of the incisions but I recommend the periareolar. There is no difference in sensation because the nerves that control nipple sensation come in laterally from the back and injury to them occurs when surgeons dissect to far laterally which is why transaxillary incisions have the highest nipple sensation disruption. There is no difference in breast feeding ability. One study did show a slight increase in capsular contracture with use of periareolar but that study was small and did not incorporate modern techniques such as below muscle placement, keller funnel usage and triple antibiotic irrigation. 
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Camille Cash, MD · Answer

It is not possible to say if you would not experience these issues if you had never had breast surgery.  However if the milk ducts are disrupted during augmentation this can impact future breastfeeding.  I've included a video I hope you find helpful.

Connie Hiers, MD, FACS · Answer

Piercings can damage milk ducts more than the peri-areolar incision. However, any breast augmentation can decrease milk flow.  also, every pregnancy is different and milk production may not be the same, especially as you age.

Can a breast augmentation using periareolar incision cause low milk supply? (Photos)

Answers (4)

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