Can You Breastfeed with Implants?

For women considering breast augmentation (augmentation mammaplasty), whether implants will affect future breastfeeding is one of the most common questions raised at consultation. The short answer is that many women with breast implants are able to breastfeed, although several factors can influence the experience. These include the type of incision used during surgery, where the implant is placed, individual anatomy, and breastfeeding factors that have nothing to do with surgery at all. The longer answer is more nuanced and worth understanding before making a decision either way.

Breastfeeding and Breast Implants

In most cases, breast implants do not prevent breastfeeding. Studies have found that the majority of women with implants are able to breastfeed when they choose to. The rate of breastfeeding among women with implants is somewhat lower than in women who have not had breast surgery, and some women experience reduced milk supply or other challenges that may or may not be related to the surgery itself.

Whether breastfeeding will be possible, and how it will go, depends on a combination of surgical and non-surgical factors that are worth understanding before making decisions about breast augmentation, particularly for patients who plan to have children in the future.

How Breast Augmentation can Affect Breastfeeding

Breastfeeding relies on three interconnected components within the breast:

• The glandular tissue (alveoli) that produces breast milk
• The milk ducts that carry milk from the glandular tissue to the nipple
• The nerves around the nipple and areola that trigger the let-down reflex, the release of milk in response to a baby’s suckling

Breast augmentation involves placing an implant either behind the breast tissue (subglandular) or behind the pectoralis major muscle (submuscular or dual plane). The incision used to insert the implant can be made in several different locations. Depending on the surgical approach, the procedure can affect one or more of these structures to varying degrees, although in many cases the surgery is performed in a way that preserves them as much as possible.

Surgical Factors That may Affect Breastfeeding

Several aspects of breast augmentation surgery can influence breastfeeding capacity. These are the factors that are within the surgeon’s control and worth discussing at the consultation.

Incision Location

Breast augmentation incisions are commonly placed in one of three locations:

• Inframammary (under the breast fold). This incision sits in the natural crease beneath the breast. It is generally considered the lowest-risk approach for preserving breastfeeding capacity, as it is placed well away from the milk ducts and the nerves of the nipple.
• Transaxillary (in the armpit). This incision sits in the armpit, with the implant tunnelled into position. It also avoids the milk ducts and the nipple-areola complex.
• Periareolar (around the areola). This incision sits at the border of the areola. Because it is closer to the nerve supply of the nipple and the underlying milk ducts, it carries a higher theoretical risk of affecting breastfeeding capacity than the other two approaches.

Patients who plan to breastfeed in the future and are deciding between approaches should raise this preference at consultation, as the surgical plan can take it into account.

Implant Placement

Implant placement also influences breastfeeding outcomes:

• Subglandular (above the muscle: The implant sits between the breast tissue and the chest muscle. Because it sits closer to the milk ducts and glandular tissue, it has a slightly higher potential to apply pressure to these structures.
• Submuscular or dual plane (below the muscle): The implant sits partially or fully behind the pectoralis major muscle. This placement keeps the implant further away from the glandular tissue and ducts, generally reducing pressure on the milk-producing structures.

Most modern breast augmentation procedures use submuscular or dual plane placement, although the appropriate placement for an individual patient depends on anatomy and personal goals.

Implant Size

Larger implants exert more pressure on the surrounding breast tissue, which may have a small effect on milk ducts in some patients. Smaller implants are less likely to interfere with the underlying anatomy. Implant size is one of several factors discussed at consultation.

Type of Implant

Both saline and silicone gel implants are widely used in breast augmentation. Major regulatory and plastic surgery bodies do not advise against breastfeeding with either implant type.

Factors not Related to Surgery

Some breastfeeding challenges have nothing to do with breast augmentation. These include:

• Insufficient glandular tissue (IGT or hypoplasia): A condition in which the milk-producing tissue of the breast did not develop fully during puberty. Women with IGT often have low milk supply regardless of whether they have had any breast surgery. In some cases, the appearance of the breasts may be one of the reasons a patient sought augmentation in the first place.
• Hormonal factors: Lactation is hormonally driven. Conditions affecting thyroid function, polycystic ovary syndrome, retained placental tissue, and other hormonal issues can all affect milk supply.
• Latch and feeding technique: Many breastfeeding challenges relate to how the baby attaches to the breast rather than the underlying anatomy.
• Stress, sleep, and post-birth recovery factors.

For this reason, low milk supply in a woman with breast implants is not always caused by the implants. A lactation consultant can help identify contributing factors and develop a plan to address them.

Is Breastfeeding With Implants Safe for the Baby?

Major plastic surgery and lactation bodies do not advise against breastfeeding for women with breast implants. There is no clinical evidence of harm to babies from breastfeeding by mothers with either saline or silicone implants. The Australian Breastfeeding Association supports breastfeeding for women with breast implants where they are able to do so, and the Therapeutic Goods Administration has not identified breastfeeding-related safety concerns for implants used as intended.

Timing: Surgery Before or After Having Children?

A common question is whether breast augmentation should be performed before or after having children. There is no single right answer.

1. Surgery before children: The patient experiences the appearance changes from the procedure for longer. However, pregnancy and breastfeeding can change the shape, size, and position of the breasts, which may affect the appearance of the surgical outcome over time. Some patients consider revision surgery after completing their family.
2. Surgery after children: The breasts have settled following pregnancy and breastfeeding, and the surgical plan can take post-pregnancy anatomy into account, including any volume loss, skin laxity, or ptosis (drooping) that may have developed. Most plastic surgeons recommend waiting six to twelve months after stopping breastfeeding before considering breast surgery, to allow the breasts to return to their non-lactating state.

For patients who are planning a pregnancy within the next twelve months, surgery is generally deferred until after pregnancy and breastfeeding.

For Patients who Already Have Implants and Want to Breastfeed

For women who already have breast implants and are planning to breastfeed, the following may be useful:

• Discuss surgical history with an obstetrician and lactation consultant during pregnancy. This allows any potential concerns to be identified and a plan to be developed before the baby is born.
• Initiate breastfeeding as soon as possible after birth. Early and frequent breastfeeding helps establish supply.
• Monitor the baby’s weight gain and wet nappies. These are the most reliable signs of adequate milk intake.
• Seek lactation consultant support early if challenges arise. Many issues can be addressed effectively with timely intervention.
• Be aware that supply may need additional support. Pumping between feeds or hand expressing can help build supply in some cases.

The Australian Breastfeeding Association offers free information and counselling support to women navigating breastfeeding challenges.

Risks and Considerations of Breast Augmentation

It is worth noting that breast augmentation is a surgical procedure that carries risks beyond any effect on breastfeeding. These include:

• Bleeding, bruising, and infection
• Adverse reaction to anaesthesia
• Changes in nipple or breast sensation, which may be temporary or longer-lasting
• Implant-related complications, including capsular contracture, implant malposition, and implant rupture
• The need for future surgery, as breast implants are not lifetime devices and may require revision or replacement over time
• Scarring

These risks are discussed in detail at consultation, alongside any breastfeeding-specific considerations.

What to Discuss at Consultation

Patients considering breast augmentation who plan to breastfeed in the future should raise this preference at consultation. Specific points to discuss include:

• The preferred incision location given breastfeeding plans
• Whether subglandular or submuscular placement is recommended for the patient’s anatomy
• The patient’s family planning timeline and how it may inform surgical timing
• Any history of issues with breast development that could affect breastfeeding independently of surgery
• What support is available if breastfeeding challenges arise after pregnancy

Being open about future breastfeeding intentions allows the surgeon to plan a procedure that takes these goals into account.

About Dr Terrence Scamp

Dr Terrence Scamp is a Specialist Plastic Surgeon (FRACS) based on the Gold Coast, with more than 30 years of experience in plastic and reconstructive surgery. He is a Fellow of the Royal Australasian College of Surgeons and a member of the Australian Society of Plastic Surgeons (ASPS) and the Australasian Society of Aesthetic Plastic Surgeons (ASAPS). His AHPRA registration as a Specialist Plastic Surgeon (MED0001157212) can be verified on the public register.

Dr Scamp performs breast augmentation alongside a range of other plastic surgery procedures. At consultation, he takes time to understand each patient’s individual circumstances, including any future breastfeeding plans, before discussing surgical options.

Considering Breast Augmentation on the Gold Coast?

Patients considering breast augmentation on the Gold Coast can request a consultation with Dr Scamp to discuss surgical options, including the considerations relevant to future breastfeeding. Please complete the enquiry form below, and a member of the clinic team will be in touch to arrange an appointment.

Breastfeeding With Implants FAQ

Do Breast Implants Reduce Milk Supply?

Some women with breast implants experience reduced milk supply, although many do not. The likelihood depends on factors including incision location, implant placement, individual anatomy, and underlying breast development. Low milk supply also occurs in women without implants, so it is not always related to the surgery itself.

How Soon After Breastfeeding can Breast Surgery be Considered?

Most plastic surgeons recommend waiting six to twelve months after stopping breastfeeding before considering breast surgery. This allows the breasts to return to their non-lactating state, so that the surgical plan reflects the patient’s settled anatomy.

Can Breast Lift or Breast Reduction Affect Breastfeeding Differently from Augmentation?

Yes. Breast lift (mastopexy) and breast reduction generally involve more extensive work around the nipple and underlying ducts than breast augmentation alone. These procedures carry a higher potential for affecting future breastfeeding, and timing relative to family planning is often discussed in more detail with patients considering them.

Should the Surgeon be Told About Plans to Breastfeed in the Future?

Yes. Patients planning to breastfeed in the future should raise this at consultation, so that the surgical plan can take it into account where possible. The chosen approach may differ slightly from one optimised purely for cosmetic considerations.