If you are considering breast implants, there may be many questions swirling in your head. There are the immediate concerns, and then there are the concerns that may affect future decisions. Will I be able to breastfeed? Will my breast milk be safe for my baby?

Researchers still debate whether breast implants can affect nursing. There are many studies that have looked at factors that may affect a woman’s success at breastfeeding. Some of these factors are type of surgery and implant.

Type of Surgery

One aspect of successful breastfeeding is having enough breast milk for your baby. Not being able to make breast milk will limit breastfeeding, regardless of whether you have breast implants. Your ability to make milk after having had surgery may depend on your surgery and the location of your incisions. There are 3 main incision sites:

• Transaxillary—The incision is made under the arm.
• Inframammary—The incision is made within the breast fold.
• Periareolar—The incision is made around the nipple.

Of the 3 incision sites, the periareolar incision leaves the least visible scar. Some studies suggest that women who have a breast implant through this incision have a harder time breastfeeding than women who have axillary or inframammary incisions. This may be because surgery around the nipple involves cutting milk ducts and nerves.

Damaged ducts and nerves can affect the amount and delivery of milk. Nerves are important for breastfeeding because they trigger the brain to make prolactin and oxytocin, 2 hormones that affect milk production. Damaged ducts will also limit milk delivery.

A study found that women who undergo any breast surgery are 3 times more likely to have a low milk supply. Women who have surgery around the nipple area are 5 times more likely to have a low milk supply compared to women who do not have breast surgery.

The location of the implant may also impact milk production and delivery. Implants placed under the muscle, which may require less cutting of breast tissue, may be less likely to impair these processes.

Some women who have breast implants, although able to breastfeed, choose not to because they are afraid it will affect how their breasts and/or implants will look. However, studies have not shown that breastfeeding affects breast implant appearance.

Type of Implant

Studies have found that the type of surgery you have can affect breastfeeding, but what about the type of implant? There are 2 types of implants: silicone-filled gel implants and saline-filled implants. Silicone is present in both types (it encases the saline in saline-filled implants). The type of implant can pose some concerns for breastfeeding. However, given the concerns, research shows that there is not enough evidence to prove that breast implants are harmful when breastfeeding:

• Silicone implants were thought to leak silicone gel into the body and into breast milk. They were removed from the market in 1992. However, after many studies by the US Food and Drug Administration (FDA), it was determined that silicone gel implants were safe and they were reintroduced in 2006.
• Organizations like the American Academy of Pediatrics do not feel that there is enough evidence against breastfeeding for women with silicone breast implants.
• Researchers are still not certain if silicone can leak into breast milk. But one study did show that women with silicone-filled implants did not have higher levels of silicon (a component of silicone) in their breast milk compared to those without implants.

Keep in mind that silicon is a plentiful element on earth. In fact, cow milk and formula milk have higher concentrations of silicon compared to breast milk from humans with implants. Until larger studies are done, there is no strong evidence that having silicone- or saline-filled breast implants poses a threat to a nursing baby.

Working With Your Doctor

Some women with breast implants have been able to breastfeed successfully, but this may not be the case for every woman. If you are considering having children in the future, talk to your surgeon about your implant options. There may be steps to minimize the amount of breast tissue, milk ducts, and nerves cut during surgery.

If you have implants and are pregnant, talk to your doctor about breastfeeding. Work with your maternity healthcare providers or a breastfeeding specialist to develop effective breastfeeding habits. With proper knowledge and steps, you may be able to increase your chances of being able to successfully breastfeed.