Many women of childbearing years face the dilemma of wanting breast reduction surgery prior to having children but also hope to breastfeed.
It is true that chances for nursing are reduced somewhat if a women has breast reduction surgery. The technique for reduction can make a big difference in the ability to nurse. Surgeries that are done on the areola and nipple almost always affect breastfeeding. Most surgeons these days leave some of the tissue attached to the areola called the lactiferous sinuses, which are greatly responsible for lactation.
The most common technique for San Francisco Bay Area women is the pedicle procedure in which the areola and nipple are moved to a higher position while attached to a mound of tissue called a “pedicle” that contains the still-connected ducts, nerves, and blood supply, making successful breastfeeding more likely.
For women with extremely large breasts the technique most often used is the “free nipple graft” which involves completely severing the blood supply to the nipple and areola, and almost always causes some degree of nerve damage. If major nerves are cut during surgery, it leaves little or no sensation in the nipple and areola, which can decrease milk production because the baby’s sucking is what stimulates nerve endings which send the pituitary gland the signals to produce milk. When the free-nipple technique is used, complete breastfeeding without supplements is rarely possible. You may produce a full supply of milk, but not be able to pass it all through the damaged ducts. The more ducts that have been damaged the less milk the baby will receive. There have been some reports of mother’s milk ducts growing back, this is called “recanalizing” although this is unusual.
Research shows that women who wait at least five years after reduction mammoplasty surgery before trying to breastfeed will have a greater chance of being successful. Breastfeeding will become easier with each pregnancy as breast tissue grows during these times to get the body ready for lactation.
Women can usually tell before pregnancy if they will be able to breastfeed by how sensitive to touch or hot and cold stimulation the nipple and areola are. The more sensitive, the better your chances will be to lactate. Sensitivity is a sign that the nerves have repaired themselves.