Former Playboy model and reality TV star Kendra Wilkinson, wife of Indianapolis Colts wide receiver Hank Baskett, gave birth to a boy Friday morning. During her pregnancy, Wilkinson announced her intention to nurse her child despite having breast implants. Do implants affect a mother's ability to breast-feed?
Generally, no. Most women who get breast implants, whether made of saline or silicone, can go on to breast-feed. But some types of breast augmentation surgery are more likely than others to result in complications when it comes to nursing. The two most common methods of implantation are peri-areolar incision (slicing just below the nipple) and inframammary incision (slicing along the crease below the breast). Cutting around the areola, the dark circle of skin surrounding the nipple, is much more likely to interfere with the network of nerves, glands, and milk ducts located toward the front of the breast that produce and carry milk to the nipple. Cutting underneath the breast allows the surgeon to circumvent that whole system rather than going straight through it. If a woman wants to breastfeed after getting implants, doctors usually recommend inframammary procedure, or an alternative route of insertion like the underarm or the belly button. Some doctors, however, still favor the peri-areolar technique because it allows for more precision when placing the implant and can produce less noticeable scarring. (Other considerations for which procedure to get include breast size, pain, and risk of the implants hardening.)
The likelihood of nursing problems also depends on where, exactly, the surgeon places the implant. Subglandular placement—behind the mammary glands but in front of the chest muscles—has a higher risk of breastfeeding complications. That's because the tissue surrounding the implant is more likely to harden when it's in that position, which can make nursing difficult or painful. (The advantage is that the operation itself is quick and relatively painless.) The alternative is to slip the implant behind the chest muscle, separating the balloon from the lactation system entirely. This procedure is more common and generally better for breastfeeding. The downside of submuscular placement is that it's more painful—the doctor has to fidget with the muscle itself—and it takes longer after surgery for the implant to "drop" into a more natural-looking position.
Implants could also interfere with nursing if they're too big compared with the amount of skin and tissue surrounding them. Lactation proceeds most smoothly when the mother's milk-producing lobes—arranged around the center of the breast—have room to expand and contract. If an implant puts too much pressure on the lobes, that can reduce the amount of milk generated.
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Explainer thanks Stephen Greenberg and Miriam Labbok of the University of North Carolina Gillings School of Global Public Health.
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