Breast augmentation during menstruation. Would the milk ducts be more prone to getting damaged?

Thank you abrizzle for your question.  Whenever you make a periareolar incision your breast feeding risks do go up, but not significantly.  I typically recommend the inframammary incision for multiple reasons. Scarring tends to be better, nipple sensation loss tends to be less and breast feeding complications are less.  I would recommend addressing any of your concerns with your plastic surgeon.  Best of luck to you. 

There is always some damage to milk ducts during a periareolar breast augmentation because to get to the space under the breast and muscle you have to go through the breast, which means cutting some ducts.  Usually this does not injure enough of them to interfere with breast feeding.  Being on your period should not make any difference in this regard as the extent of the dissection is unchanged.
One reason for not doing a breast augmentation through a periareolar incision is bacterial colonization of the implant with staph species.  This is well known, that the periareolar approach through breast tissue has a higher incidence of capsular contracture. This is thought to be associated with bacteria that are on and in the breast. An inframammary approach using a Keller funnel results in less transfer of staph to the pocket and implant, something I always discuss with my patients when considering various surgical approaches.

Dear abrizzle,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

No this should not be affected.   I recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable with.   Finally, make sure your surgeon is a Double-Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery (ABPS), a member of the American Society of Plastic Surgery (ASPS), a member of the American Society of Aesthetic Plastic Surgery (ASAPS), and a fellow of the American College of Surgeons (FACS).Best,Dr. DesaiBeverly Hills Institute for Aesthetic Plastic SurgeryHarvard Educated, Beverly Hills & Miami Beach TrainedDouble Board-Certified, Double Fellowship-Trained Beverly Hills Plastic Surgeon

Thank you for your question.  My advice is to communicate with your plastic surgeon regarding risks associated with a peri-areolar incision and your specific concerns.  It is always best to go into any surgical procedure feeling confident and well informed regarding risks and expectation of results.  Best of luck.

Hi.  Menstruation is not as important as the method involving a periareolar incision. There are many reasons that women seeking breast augmentation have trouble nursing afterwards, including that there is little breast tissue to begin with and possibly sensitivity issues along the scar that may make latching on painful or even difficult to accomplish.  Talk to your PS again and visit the options of an approach from underneath the breasts or through the armpit--your anatomy and the type/size of implant, etc. will need to be considered.  Best wishes,

Being on your period won’t harm the ducts anymore than while you are not on your period. That said there are many reasons not to choose a periareolar incision and having trouble breast feeding afterwards is one of them. I would have a discussion with your PS about what would be best for your body and future plans. Good luck!

The milk ducts will be damaged either way with a periareolar incision, whether they are swollen or not won't change things. If you are worried about breastfeeding after your procedure then I would suggest going with an inframammary crease or armpit incision. Best of luck! 

Although a peri-areolar incision does increase your risk of damaging the milk ducts, the increased risk is negligible compared to other incisions when performed correctly. Also, although some ducts may be damaged, the majority of your ducts and ability to breastfeed should still be functional. So although it may affect your breastfeeding, even if it does happen, it may be so slight that there will be no discernable affect on your breastfeeding. Hope this helps!Johnson C. Lee, MD
Board-Certified Plastic Surgeon
IG: @drjohnsonlee

Hello and thank you for your question .   Any time the areola is incised for instance during a lift, the percentage of being unable to breast feed goes up, however, it doesn't go up significantly.  I always put my scars in the breast fold where it is hidden and there is no compromise to the mild ducts.  Ask your PS for the incision to be in the inframammary breast fold.