Thank you for asking about the appropriate waiting period after childbirth before undergoing a breast procedure. This is a crucial consideration for ensuring the best possible outcomes from the surgery. After pregnancy and childbirth, hormonal changes and milk production cause the breasts to enlarge. It’s essential for the breasts to return to their post-pregnancy state before proceeding with elective breast surgery, which typically occurs within 4 to 6 months after delivery. Waiting is important for several reasons: Breast Engorgement and Milk Production: If there’s still milk present in the ducts at the time of surgery, there’s a risk of postoperative complications, such as infection or the formation of lactoceles (localized milk-filled fluid collections). Breast procedures commonly involve cutting or transecting the milk ducts, making it important to ensure milk production has ceased or significantly diminished. Size Stabilization: Engorged breasts are larger than their normal post-pregnancy size. If a breast lift or reduction is performed too soon, when the breasts are still enlarged, it may result in an inadequate procedure. For instance, if the surgery reduces you from a DDD to a D while the breasts are still enlarged, you might find that your breasts shrink further as they stabilize, leaving you with less lift or reduction than desired. Regarding presenting a note for work, this varies based on individual circumstances, such as the nature of your job, your recovery process, and the policies of your employer. Some women are able to use maternity leave or Family Medical Leave Act (FMLA) provisions to recover from such surgeries, but this is something you should discuss with your plastic surgeon and employer. Each patient’s situation is different, and your approach will depend on your specific needs and the type of work you do. I hope this provides a clear understanding of why it's important to wait for a certain period post-childbirth before undergoing breast surgery, and how this timing can affect the success of the procedure. Wishing you the best as you plan your procedure and navigate the decisions around work and recovery. Sincerely, Dr. Katzen