Breast Implants and Breast Feeding.

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Is Breast Feeding after Breast Augmentation safe for your baby?


Several thousands of women undergo breast augmentation every year. Many of them in childbearing age. A frequent concern regarding silicone implants is whether or not the ability to breast feed is preserved, and if so, is it of any consequence to the baby. Fortunately, to date, there seems to be no major implication to the child in these circumstances. Studies analyzing the amount of silicone contained in the milk of lactating mothers when compared to commercial formulas have found little difference in the silicone content. The importance of breast feeding is undeniable. Medical literature has documented the nutritional and immune-stimulating properties of  of maternal milk when compared to commercial formulas. Maternal milk seems to be particularly protective against common childhood conditions such as Eczema, Iron deficiency anemia and Otitis media. Other less common and more serious diseases seem to be unequivocally mitigated by breast feeding; upper and lower respiratory infections and lymphoma amongst others.
For these reasons, it is recommendable to breast feed if the mother is able to do so. Approximately 50% of women are able to breast feed at baseline, and it is important for the physician to discuss this prior to undergoing breast augmentation with silicone or saline implants since it is unknown whether a patient is able to breast feed at baseline prior to the procedure.

                                                      Angelina Jolie Breastfeeding Courtesy of fashionexplorer.net






A study published in PRS in 1998 undertook the arduous task of comparing the levels of silicone in breast milk from lactating women with and without silicone implants.
Two other sources were also included in the study consisting of cow's milk and infant formula for silicon content.
The samples were prepared in a special class one hundred "ultraclean" laboratory and analyzed via graphite furnace atomic absorption spectrophotometry. Silicon levels were analyzed in breast milk, whole blood, cow's milk, and 26 brands of infant formulas.

-Lactating women with implants were found to be comparable to control groups when measuring silicon levels:

(55.45 +/- 35 and 51.05 +/- 31 ng/ml, respectively) 

-In blood (79.29 +/- 87 and 103.76 +/- 112 ng/ml, respectively). 

-The mean silicon level measured in store-bought cow's milk was 708.94 ng/ml, and that for 26 brands of  commercially available infant formula was 4402.5 ng/ml (ng/ml = parts per billion)

-lactating women with silicone implants are similar to control women with respect to levels of silicon in their  breast milk and blood. 

-Silicon levels are 10 times higher in cow's milk and even higher in infant formulas.

In conclusion: there is no current evidence that would suggest that silicone implants have any undesirable effect on the child in the breast feeding period.

- Do silicone implants reduce the ability to breast feed?

The breast tissue that produces milk is in reality a modified sweat gland. It lies over the pectoralis major muscle and is composed of units known as lobes. Each lobe is composed of lobules. Small ducts emanate from the lobules where the milk is produced and then channeled toward the nipple where they coalesce into several lactiferus sinus which then empty into the nipple. Silicone implants are always placed behind the gland and does not divide the ducts or damage them. If the lobules and ducts are intact, the production of milk shouldn't change. Of the four procedures to insert implants, only one may divide the breast tissue containing the ducts, namely, the Trans-areolar approach. In general, even this approach usually does not affect breast feeding.


Breast implant approaches:


-Trans-Areolar: divides breast tissue, but usually does not affect lactation
-Inframammary incision: This incision is made under the breast crease and introduces the implant behind the breast tissue, avoiding the gland alltogether
-Trans-axillary Incision: In this method, the incision is in the axilla and the implant is once again introduced behind the breast tissue without damaging the glandular breast tissue
-TUBA Trans-umbilical Breast Augmentation: this procedure is only appropriate for saline implants and it uses a scope for dissection from the umbilicus to the retro-mammary space (behind the mammary gland) and does not affect the gland.

It has been documented that a women undergoing breast implant placement have a 2.6 to 3 times greater risk of not being able to breast feed than the rest of the population. This is in part attributable to the surgical approach which may be trans-areolar, and to the possible unwillingness of the mother to lactate after augmentation.
It should also be mentioned that if a woman is already lactating and wishes to have breast implants, it is advisable to wait for 6 months prior to undergoing augmentation. Milk accumulation has been documented in the peri-prosthetic space after surgery when augmentation is performed earlier.


Stay tuned.....

Bibliography:

1.Breast Milk Contamination and Silicone Implants: Preliminary Results Using Silicon as a Proxy Measurement for Silicone Semple, John L.; Lugowski, Stan J.; Baines, Cornelia J.; Smith, Dennis C.; McHugh, Alana .  Plastic & Reconstructive Surgery. 102(2):528-533, August 1998.
2.Berlin, C. M. Silicone breast implants and breast-feeding. Pediatrics 1994; 94:546-49.
3. Silicone Breast Implants and Breastfeeding, Cheston M. Berlin, Jr. MD, Hershey Medical Center, Hershey, PA, from Breastfeeding Abstracts, February 1996, Volume 15, Number 3, pp. 17-18.
4. National Academy of Sciences Institute of Medicine, Safety of Silicone Breast Implants, National Academy Press, Washington, D.C., 1999, p. 197.

*Always consult with your plastic surgeon prior to undergoing any cosmetic procedure.Make sure your cosmetic surgeon is an ABPS (American Board Of Plastic Surgery) Board Certified or Board Eligible Plastic surgeon.

Rafael Magana MD
http://maganaplasticsurgeryarts.com/