Posted on April 6, 2019
By: Dr. Asaf Yalif
Breast augmentation has become one of the most common plastic surgery procedures performed today. When our Atlanta and Alpharetta GA patients come in for a consultation they have lots of excellent questions. Today’s blog is about one of the most frequent questions—the timing of breast augmentation. Should it be before or after pregnancy?
Breasts will normally engorge and grow during pregnancy, thanks to the hormonal changes occurring. This will take place over the entire pregnancy and during the time the mother chooses to breastfeed.
The breast is normally partially made up of both fatty tissue and of glandular tissue, so when the breast tissue grows, the breast size and shape can change dramatically. Externally the nipples and areola change as well, often becoming larger and darker in color.
When pregnancy is over and breastfeeding has finished, the breasts will usually change back as the hormones that tell the body to make breast milk stop being produced. This will lead to shrinking of the glandular component of the breast. This can make the breast appear different or deflated. These changes may be permanent—meaning the breast may not fully regain its pre-pregnancy appearance, regardless of whether there is or is not a breast implant present.
This means that either way it is possible that you may want a breast lift (or breast revision surgery if you have an implant) after any pregnancy.
There are a few parts to this seemingly simple question that need to be addressed. First, when placing a breast implant, if you want to have the ability to breastfeed afterward you should notify the physician. This is because certain incisions (e.g. periareolar) require breast glandular tissue to be cut to place the implant. This does not mean that you can’t breastfeed, but may make it more difficult, or predispose you to mastitis. If you tell the surgeon that it is important to preserve your ability to breastfeed, the incision choice may change to help that remain possible. (You can read more about breast augmentation incision options in a related blog post.)
Second, once an implant is in place, usually either behind the breast or behind the pectoralis muscle, the breast should still function normally. This means that you can breastfeed if you choose. Third, there’s the question of whether the implant material is secreted in breast milk. There is some data to suggest that very small amounts of silicone do make it into breast milk, but there is no scientific data suggesting that any child has been impacted negatively by drinking breast milk from a mother with breast implants. We are all acutely aware of the current concern about implants, and there is honestly no data to support any concern over breastfeeding with breast implants in place.
The Centers for Disease Control and Prevention offers additional information about breastfeeding after breast augmentation.
I advocate for patients to weigh the above information versus their current goals and desires. If you want to have bigger breasts now, absolutely you can, and we can design the surgery so that it is very safe for you to breastfeed afterward. We understand that if you choose to become pregnant, your breasts will change, and after you are finished having children, your breasts may change further. These changes may require additional surgery to achieve the breast shape/look you desire at that time.
Waiting until after you have finished having children to have a primary augmentation is also a reasonable option, though you may need a breast lift in conjunction with the augmentation depending on how your breasts change with pregnancy and breastfeeding. In other words, both choices are totally reasonable and are personal decisions. There is no right or wrong answer.
I would be remiss if I did not also reinforce that the FDA recommends implant exchange for all implants every 10-15 years. So, depending on the age at which you first decide to get your breast implants, it will be recommended that you undergo at least one or two exchanges in your lifetime. This is regardless of pregnancy/breastfeeding but may help with consideration of the timing of procedures, implant choices, etc.
Visit our gallery of primary breast augmentation before-and-after photos to see examples of patients who chose their surgery both before and after pregnancy.
It has been some time since this posted so we thought to update you on the latest concepts. While there is an increasing conversation about Breast Implant Illness (BII) and the possible causes and treatments, the FDA feels that implants have been and continue to be safe and effective for augmentation. There is no indication that breast augmentation, with saline or silicone implants, interferes with breast feeding and there is no direct causality between breast implants and BII. Pre or post pregnancy, the implants are safe and effective. That being said, they are devices so please be aware of them and if anything changes with how they feel or look, please notify us so we can help evaluate what is happening.
With regards to the implants themselves, the companies that make them continue to perform research and gather data to insure safety and are always refining their processes in making the devices. While not much has changed the last few years, the silicone implant gels offered have increased in cohesivity (thickness). This means they are less likely to migrate if there is a silent rupture or leak.
We are here for you as a resource! And we welcome the opportunity to talk through any additional concerns you may have.
Need more information? Here is a recent post with more details about breast augmentation and the surgery itself.
As an experienced, triple board-certified plastic surgeon, I make sure we spend time with you to help you realize your goals in breast augmentation, facilitate timing decisions, and answer all your questions.
Renew your look with expert, personalized treatment from Dr. Y. Begin the planning process with a one-on-one plastic surgery consultation in Alpharetta or Atlanta, Georgia. We are excited to welcome you to Y Plastic Surgery!