Last update: Feb. 6, 2020
Moderately safe. Probably compatible.
Mild risk possible. Follow up recommended.
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The surgery for reduction of the breast with preservation of the pedicle is the one with the highest probability of conservation of innervation of nipple and hence the sensibility of that area, as well as the integrity of milk ducts (Kraut 2017). Even though, there is still five times more probability of lactation failure among women who undergo this kind of surgery with 2/3 of women having less nipple sensibility and more troubles while breastfeeding. Mean duration of lactation among treated women was 5 days versus 3 months among those who did not undergo a surgery: two months versus six months for mixed lactation (Nguyen 2013, Molivere 2013, Andrade 2010).
At date of latest review no study was found that has shown significant differences on functional results of breastfeeding, among various type of surgical techniques for preservation of the pedicle: upper pedicle, lower pedicle or both with different orientation of the scar (Bilgen 2019, Ren 2014, See 2014, Sinno 2013, Huang 2012, Letertre 2009, Copcu 2009, Chiummariello 2008, Cruz 2007, Cherchel 2007).
The free-graft technique hampers a big deal the achievement of exclusive breastfeeding, since it cuts the innervation and glandular ducts. As it has been seen, at start, the possibility of breastfeeding should not be excluded, since after years reinnervation and partial recanalization may occur, although it rarely will be exclusive, because of the lost of a lot of sensibility that would ensure the functioning of the neuro-endocrine reflex that is instrumental for milk production. The normal secretion of colostrum at the end of pregnancy does not guarantee the success of lactation since it is not related to the neuro-endocrine reflex (instead it is indicative of a possible recanalization of ducts)
Liposuction techniques have less untoward effects on lactation but they are limited to certain indications.
A rare complication of augmentation mammoplasty is galactorrhea, which is usually transient and treatable ( (Mestak 2014, Arnon 2006, Inguenault 2005).
Several papers reporting results that were published by plastic surgeons failed to find a relationship between reduction mammoplasty and breastfeeding troubles. They assumed that the reason for breastfeeding failure is partly due to pessimistic opinions of health care givers who are in charge of those patients.
The plastic surgeon should adequately inform the women who are willing to breastfeed their offspring after a reduction mammoplasty (Tran 2014)
We do not have alternatives for Breast Reduction Mammoplasty.
Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
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