Now that silicone breast implants are back for breast augmentation, they are rapidly becoming the preferred implant over saline for primary breast augmentation. Due to their more natural feel, lack of implant rippling, and lower risk of detectable implant failure, they now represent 90% of implants that I put in for breast augmentation. One of the many ’safety’ questions that arises with the use of silicone breast implants for younger women is……do they interfere with the potential for breast feeding?……and will any silicone ‘leak’ into the breast milk and potentially harm my baby?
First and foremost, the vast majority of implants in breast augmentation are submuscular…meaning that the breast tissue between the nipple and the muscle is undisturbed. Therefore, the breast implant does not impinge on the breast ducts and no interference is possible. Furthermore, the most common incisional approach for silicone breast implants is through the inframmary fold, not the nipple, completely eliminating any potential damage to the breast ducts.
The blood and breast milk chemistries (content) of women with silicone implants has now been studied and published. Dr John Semple from Toronto has published the definite work to date on this subject entitled ‘Breast-Feeding and Silicone Implants’ in the Supplement to Plastic and Reconstructive Surgery, December 2007, Silicone Breast Implants: Outcomes and Safety. In his study, he compared women with silicone breast implants to women without and showed that the mean silicon levels were not different in these two groups in either their breast milk or in their blood. Interestingly, silicon levels in other methods of infant nutrition, such as store-bought cow’s milk and commercially-available infant formulas, were much higher. Cow’s milk had a nearly 10 fold increase in silicon levels and commerecial infant formualas were as high as 50 times greater!
It would be fair to say based on this evidence that silicone breast implants pose no significant known risks to breast feeding. Our clinical experience would back this finding as well.

Dr Barry Eppley
http://www.eppleyplasticsurgery.com
http://www.ologyspa.com
Clarian North Medical Center, Carmel, Indiana
Clarian West Medical Center, Avon, Indiana
Indianapolis

Saggy Breasts after Breast Feeding ??

It is a near universally-held concept amongst women that their breasts may sag because they had breast feed. I hear this frequently said during consults with women who want to improve their breast shape or size. The sagginess of their breasts, what we call ptosis, is due to stretched out skin and loss of breast tissue (post-partum breast involution). The combination of more skin and less breast tissue, deflating the balloon so to speak, creates the altered shape of the breasts. The question is…..does breast feeding make this happen?

In a recent study published in the flagship journal of plastic surgery, Plastic and Reconstructive Surgery, their findings refute this longheld belief. Based on an assessment of 136 women, the authors found that other factors, such as smoking and number of childbirths that a woman has, were more significant causes of breast sagging. Breast feeding did not turn out to be a cause.

On the surface, this seems to make biologic sense. How would a child sucking on a nipple stretch out the entire breast? However, it is clear that breastfeeding does prolong the engorged size of the breast for a time period much loner than pregnancy. Does a longer engorgement phase ultimately sag the breast more than the pregnancy phase alone? Apparently not….at least according to this new study.

Dr Barry Eppley
http://www.eppleyplasticsurgery.com/
http://www.ologyspa.com/
Clarian North Medical Center, Carmel, Indiana
Clarian West Medical Center, Avon, Indiana
Indianapolis