Patient Guide

Breast Augmentation and Breastfeeding

UNE Plastic Surgery · Dr. Kim Uigeon, board-certified plastic surgeon · Published 2026-09-21 · Updated 2026-09-21

1. Breastfeeding success rate after breast surgery

One study compared 107 women who had saline-implant augmentation and later gave birth with 105 similar-aged women who had no surgery (Cruz & Korchin, Annals of Plastic Surgery, 2010).^[1]

A 25-percentage-point gap, statistically significant. But read the number with two things. One is who the controls were: the comparison group had come in with naturally small breasts, so it is not a comparison against the whole general population. The other is that 63% is not a low number — more than six in ten succeeded. The accurate phrasing is not “cannot” but “may become a little harder.”

A study comparing 200 at the time of birth

There is also data followed prospectively at the delivery itself, not by survey. Of 3,950 births at one Argentine hospital in 2013–2014, 100 mothers with implants and 100 well-matched without were chosen, and feeding was checked at 24 hours, 48 hours, and 30 days (Filiciani et al., Plastic and Reconstructive Surgery, 2016).^[2]

• At 30 days, the share breastfeeding (exclusive or mixed) was 93% in the implant group and 99% in controls — not a statistically significant difference.
• The share feeding breast milk only, without formula, was higher in the no-implant group.
• Between inframammary and periareolar incisions there was no difference at any point.

The same picture as the survey: feeding itself works for most, while the share needing supplementation rises a little.

An older study with the opposite result

For balance, the other side: a study using a US children’s-hospital lactation-support program compared 42 women with implants and 42 without, and 64% of the implant group had insufficient milk versus under 7% of controls (Hurst, Obstetrics & Gynecology, 1996);^[3] among incisions, periareolar was most strongly linked to insufficient milk. The numbers differ sharply for a reason: the subjects were records of women who came to a lactation clinic because they had difficulty feeding — a sample skewed toward problems from the start — and it was early-1990s surgery, where how the gland was traversed differs from now. So this study is read as a warning that “periareolar can be risky,” not as grounds for “cannot.”

The common thread: with implants, feeding works for most, only the chance of falling short rises a little — and the incision effect shrinks in more recent data, likely because a technique that passes without disturbing the gland has taken hold.

2. The difference by incision position

This is the point most in need of correction. It is often said “cutting the areola severs the ducts, so feeding fails.” It sounds theoretically right, since ducts run below the areola. But in the studies above there was no difference in feeding success between periareolar and inframammary, and the share reporting reduced nipple sensation was the same 2% on both sides. The reading: what divides the result is less where the incision is placed than how far the gland is left undisturbed within it. Even the same periareolar incision is completely different when it bores through the gland versus rounds the lower border of the gland. Of course, with a feeding plan, the axillary or inframammary is preferred first, being physically far from the ducts — but “periareolar means you cannot feed” is not supported by the data.

3. Whether silicone transfers to milk

This is the top worry. The conclusion first: there is no evidence for it. A study directly collected milk from 15 breastfeeding women with silicone implants and 34 without, and measured silicon concentration (Semple et al., Plastic and Reconstructive Surgery, 1998).^[4]

With or without implants, the silicon concentration in milk was essentially the same, and formula was 80× higher than breast milk. Blood silicon also did not differ between groups. (The formula figure averaged 26 commercial products.) The sample of 15 is small and reflects 1990s implants, but today’s cohesive gels leak far less, so repeating the test would if anything favor the result, not worsen it. The direction is clear: the US FDA and the American Academy of Pediatrics regard breastfeeding with implants as generally possible.^[5] If there is a rupture or contracture, though, separate evaluation is needed, so confirm the implant state at periodic screening.

4. Reduction and lift

These differ a little from augmentation, because tissue is cut away. A reduction actually excises glandular tissue, and how much is removed — and how well the vessels and ducts to the nipple are preserved — governs feeding potential. Current techniques do not fully detach the nipple but keep it on a tissue pillar and only reposition it, with ducts and vessels preserved inside that pillar, so feeding potential is higher than before. A lift does not remove much tissue but tailors the skin, so its effect is smaller than a reduction. Either way, there are more variables than in augmentation, so if there is a clear feeding plan, say so at consultation — the technique choice changes.

5. Implant changes during breastfeeding

Feeding itself does not cause implant problems — a baby suckling does not compress or burst an implant. But two things are worth knowing. One is mastitis: it can happen to anyone during feeding, and with an implant it is a little harder to distinguish. If one side alone swells, hurts, and is warm, it may be mastitis or inflammation around the implant — do not self-judge; get seen. The other is size change: during feeding the gland enlarges so the breast is bigger than usual, and the shape should not be judged then — the original state returns a few months after feeding ends.

6. The difference by plane

Which plane the implant sits in is also often asked. Submuscular or dual plane is one layer further from the gland, so not directly pushing the glandular tissue is theoretically favorable. Placed just under the gland, the implant lifts the gland, and direct data that this affects feeding is limited — but with a clear feeding plan, submuscular is preferred first.

7. What to disclose before surgery

At consultation, one line — “I plan to have children later” — changes the surgical plan.

• Incision position: leaning toward the axillary or inframammary.
• Plane: considering submuscular first.
• Dissection: taking a route that does not cross the gland.
• Implant size: leaving margin, since pregnancy and feeding change the breast.

Discuss the timing of pregnancy too. The result takes 6 months to a year to settle, and pregnancy before that changes the shape again before it sets; during pregnancy, hormones develop the gland and add volume so the cup can rise a stage or two even with an implant, and stretching skin can create new droop. So the order is one of two: settle for a year after surgery, then go through pregnancy, birth, and feeding, and touch up after another 6 months if needed; or, if pregnancy is near, finish birth and feeding first and operate after 6 months of settling. If pregnancy is planned within a year, the latter gives a more stable result.

8. Breast changes after breastfeeding

This should be known in advance too: pregnancy and breastfeeding change the breast with or without implants. During feeding the gland enlarges and the breast grows; when feeding ends, the gland shrinks and leaves that space empty, with the skin stretched. The implant is unchanged, but the tissue covering it has shrunk — so some feel droop or upper-pole hollowing after feeding. This is not a failed surgery but a changed body. A lift or implant exchange is considered then if needed — but the judgment should wait until feeding has fully ended and the breast has stabilized for 6 months or more.

Summary

• Possible, but the chance of needing supplementation rises a little. In a survey, 63% vs 88%; in prospective follow-up at birth, 93% vs 99%. Knowing it in advance is better.
• Incision position is not decisive. There was no difference between periareolar and inframammary; preserving the gland matters more than the incision.
• There is no evidence silicone crosses into milk. If anything, formula’s silicon concentration was far higher than breast milk.

The most important thing is to state a plan for children at the pre-op consultation — that one line changes the incision, plane, dissection route, and size.

References

1. Cruz NI, Korchin L. Breastfeeding after augmentation mammaplasty with saline implants. Ann Plast Surg. 2010;64(5):530–533. doi:10.1097/SAP.0b013e3181c41090. (107 vs 105; survey-based; saline implants.)
2. Filiciani S, Siemienczuk GF, Nardín JM, et al. Cohort study to assess the impact of breast implants on breastfeeding. Plast Reconstr Surg. 2016;138(6):1152–1159. doi:10.1097/PRS.0000000000002784. (100 vs 100; 30-day feeding 93% vs 99%; no incision difference.)
3. Hurst NM. Lactation after augmentation mammoplasty. Obstet Gynecol. 1996;87(1):30–34. doi:10.1016/0029-7844(95)00349-5. (Lactation-clinic records, 42 vs 42; insufficient milk 64% vs under 7%.)
4. Semple JL, Lugowski SJ, Baines CJ, Smith DC, McHugh A. Breast milk contamination and silicone implants: preliminary results using silicon as a proxy measurement for silicone. Plast Reconstr Surg. 1998;102(2):528–533. doi:10.1097/00006534-199808000-00038. (15 vs 34; milk 55 vs 51 ng/mL; formula 4,402 ng/mL.)
5. U.S. Food and Drug Administration. Breast Implants: Risks and Complications.