PREGNANCY, MILK PRODUCTION, AND BREAST AUGMENTATION
As a Santa Ana breast augmentation surgeon, the question of pregnancy and breast augmentation often comes up.
Obviously, if you are pregnant, the surgery has to be delayed until after delivery. But how long after delivery can breast augmentation be performed? The recommendation from the American Society of Plastic Surgeons is to delay breast augmentation for six months after breast feeding. This is a guideline, however, and every case should be individualized. I agree with waiting the six month period, mainly to allow the breast, and hopefully the patient’s weight, to return to a stable size. It will be a mistake to size the breast with an implant if the breast is still “swollen”, since a smaller implant will be chosen leading to patient dissatisfaction.
What if there is still milk expressed from the nipple after the six month period? This can get tricky. In general, if the patient requires a full lift (which means there is a scar at the bottom of the breast) and the amount of milk expressed is very small, then the implant can be placed through the inframmamary incision (the incision at the base of the breast), thus avoiding majority of the breast tissue and milk ducts. The rest of the breast lift is removing skin only and does not affect the breast tissue. If the patient requires a less invasive type of lift, then the breast tissue has to be entered for implant placement, exposing the implant to the milk ducts. In this situation, I recommend waiting until the breast milk “dries out”. If the patient does not require a lift, the implant can be placed through the inframmamary incision, thus avoiding majority of the breast tissue.
It is important to realize the presence of milk theoretically can increase the risk of infection. Milk contains lactose (a form of sugar) and bacteria love sugar! However, I have had several patients who were one or two years post breast feeding and had no milk expressed on exam, only to find small amount of milk in the milk ducts at the time of surgery! I thoroughly cleaned the breast tissue with antibiotic solution until all the milk was removed and continued the surgery. As of yet, no patient has developed an infection. This is not to recommend a “cowboy” approach to breast augmentation in the presence of breast milk production. My point is that the rate of infection may be higher, but still low.
Michael A. Jazayeri, M.D. is a board certified plastic surgeon in Santa Ana and a member of American Society of Plastic Surgeons. His office is located in central Orange County. If you like to schedule a complimentary consultation, please call (714) 834-0101.