Should I stop lactating before breast augmentation?

Question

I was surprised by a surgeon’s request that I stop lactating six months before breast implantation. Is this the consensus? I do still make milk, but my breast size has been stable since I stopped actually breastfeeding. Is it too dangerous to do this surgery on a lactating patient?

Brian May, MD · Answer

This is a great question. I generally recommend the same for my patients as breast tissue undergoes a lot of changes once breastfeeding and lactation stops. There is reduction in the gland size and there can also be changes to the fatty tissue in the breast as well due to the hormonal changes. One of the main reasons I recommend my patients wait is that these changes can be unpredictable and the final shape and size of your breast after breastfeeding/lactating can change significantly. Operating too soon can lead to unpredictable final size/shape of your breasts if augmentation is done before these changes have occurred and your breasts have stabilized. Best of luck with your surgical journey!

Kristopher Hamwi, MD · Answer

I would agree with your plastic surgeon. Operating on breasts that are lactating can lead to development of complications such as galactoceles or cysts filled with milk.

Leila Kasrai, MD, FRCSC · Answer

This is generally recommended. Once you’ve stopped lactating, the breasts can change in shape and if you’ve gotten surgery, your results may be negatively affected.

Tek Przylecki, MD, FACS · Answer

The recommendation for timing of breast augmentation after pregnancy is approximately six months after stoping lactation. This is sound advice. The change in breast size and atrophy of the breast gland due to hormonal changes is one factor for this recommendation. Additionally, infection rates as well as cyst formation risk is increased if augmentation is performed too soon. In my practice I recommend waiting 6 months. Good luck on your journey.

Ted Eisenberg, DO, FACOS, FAACS · Answer

This gives the breasts time to normalize. You will then know where you will actually start  in size and shape. If you are still lactating well after you have stopped breastfeeding, you should be checked by your doctor to see if this is normal or not. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Gerald Minniti, MD, FACS · Answer

Evidence based best practices dictate using an inframammary incision and creation of a subpectoral pocket. Additionally, nipple areolar complexes should be covered with a sterile self-adhesive sheet. These steps will diminish the risk of bacterial contamination of the surgical field. Women who have not breast feed in 20 years still have 'milk' inside ducts in their breast tissue, so it doesn't really make a difference that you still make milk.

Tyler Frew, MD · Answer

Hi there,
Yes, in general you should be milk free for 3-6months before implantation. If you are lactating it can cause issues and complications with your breast surgery. Not life threatening complications but those that will effect your final results, such as capsular contracture 
All the best

Daniel Barrett, MD · Answer

Dear Fabulous5808,
the ideal timing for breast augmentation when you are breastfeeding is about six months after you have completely stopped breastfeeding. You can speak and visit a board-certified plastic surgeon to further discuss your preferences and the options that are available for you, especially if you are looking forward to having another child.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Jeffrey S. Yager, MD · Answer

Aside from the fact that medications can pass into your milk from anesthesia and pain management, in order to get the size and shape right, you want the milk ducts back to baseline.  I agree with what you have been told, but I usually wait 3 months

Connie Hiers, MD, FACS · Answer

If you have not nursed in 6 months or more, you can have the breast surgery. Some women will produce a small amount of milk until they start menopause. While you are breast feeding, your breast is still swollen plus we don't want to give your baby any drugs from surgery.

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