Breast Reduction Before Pregnancy

18th Oct 2018

Many patients looking for the breast reduction procedure are quite young and have plans to give birth in the future. A question that commonly arises with these types of patients is if they should have the procedure done before pregnancy. In other words, they are worried that they will not be able to breastfeed after breast reduction.
To answer this question, we need to discuss about what lactation requires:
• A functional mammary gland
• Intact milk ducts
• Natural sensitivity of the nipple
• Preservation of the nervous system producing prolactin and oxytocin, hormones essential for breastfeeding
Now we need to look at how breast reduction surgery is performed:
• Breast reduction without displacement of the nipple or with a slight displacement in the case of moderate breast ptosis (moderately sagging breasts). This operative technique allows for preserving and keeping the milk ducts intact.
• The breast reduction where the areola-nipple complex is detached from the breast tissue with repositioning of the nipple. These are cases where breast ptosis is severe. This type of operative technique induces the section of the galactophorous ducts (in particular the terminal arborization which is behind the nipple) and the sensitive nerve branches.
If the milk ducts have been sectioned during the breast reduction procedure, the milk can’t flow, hence breastfeeding becomes difficult or impossible.
During a breast reduction, a part of the mammary gland is resected, but the remaining breast tissue is usually sufficient to ensure further breastfeeding.
The temporary loss of sensitivity at the level of the areola is not uncommon. However, it disappears with time, and the erection reflex of the nipples recovers spontaneously.
Following breast reduction, breastfeeding after pregnancy is possible but depends on the operative technique used and the amount of mammary tissue that was removed during the procedure.
If you want to have a breast reduction prior to having children, make sure to wait at least six months, preferably a year after the surgery before getting pregnant.

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