Breast augmentation or a baby, what first?

Breast augmentation or a baby, what first?

By : Birgit Stark for RPS Date : Apr 16,2021

Breast augmentation or a baby, what first?


Are you thinking about having breast augmentation with implants and have some doubts about future pregnancies? The safety of breast implants has been a matter of debate and concerns for many people. RPS decided to publish a series of informative articles that focus on patients’ most frequently asked questions. Let us start with family planning, pregnancy and breast feeding.

Is it wise to consider breast implant surgery before starting a family?

We do not recommend breast augmentation surgery when pregnancy is being planned for the short term. This is because of the unpredictable hormonal variations of the breast that could change the aesthetic result. Many women that have small breasts before having children although very satisfied with the outcome of their augmentation surgery could face alterations during pregnancy and /or breast feeding. Pregnancies will most likely interfere with the initial shape and good results. A new operation can be considered to improve the aesthetic result after pregnancies if the patient is not happy with the modifications that the pregnancy and breast feeding may have brought. This option would entail recovery time so if the patient is back to work, taking time from work as sick leave would be necessary. The costs for a new operation with the risks involved has to be considered.

Is breast-feeding possible with implants?

The ability to breast-feed is maintained when the correct implant has been used. The plastic surgeon choses the right implant after a discussion with the patient with regard to her initial breast volume and shape. The implant should be selected very carefully, respecting the patients’ personal anatomy. Unproportionally large implants could however have a negative effect on the ability to breast feed. This aspect should be discussed during the preoperative consultations.

Is there a risk that implants harm the health of my baby in case of breast-feeding?

As to the best of our knowledge, there is no evidenced based data that the health of a newborn child is harmed by breast-feeding in the presence of implants.

Does breast-feeding and pregnancy increase the risk for implant rupture or capsular formation?

No data has ever indicated that implants are more prone to rupture due to pregnancies or breast feeding. It can, however, not be excluded that these conditions might have some influence on the mechanism of capsular formation around the implant. Breast-feeding could expose the breast to bacterial load which is considered as one of the reasons for capsular formation.

What is the optimal time frame after breast-feeding for aesthetic surgery of the breast?

It is mandatory to wait at least 6 months after breast-feeding has ended until any aesthetic procedures should been considered. Breasts and body weight should have come back to normal levels before a correct choice of implants can be made. In addition, the risk for infection of the augmented breast is significantly higher when performing breast augmentation during breast-feeding

Do breasts change after pregnancies and breast feeding? How do they influence the longevity of my aesthetic result?

Hormonal, body and breast weight variations during pregnancy and breast-feeding along with ageing factors influence the aesthetic result of the augmented breast. But also of the normal breast ;-) . Many women experience notable changes of their body contour including the augmented breast tissue. Even initial small breast volumes might change to droopy larger breasts and high riding implants (so-called waterfall deformity). It is however unpredictable how these variations influence the outcome on an individual level.

I have had a macrotextured implant for many years. Should it be removed before getting pregnant?

Macrotextured implants are more frequently involved in BIA-ALCL compared with microtextured or smooth implants. BIA-ALCL is still a rare malignant disease with a multifactorial origin. There is no data today indicating that BIA-ALCL appears more often because of pregnancy or breast-feeding. In general, women do not need removal of breast implants before pregnancies if there are no symptoms or real concerns. This statement is even valid for macrotextured implants. Women with painful and hard breasts, however, should discuss this condition with her plastic surgeon before a pregnancy is planned.
There are no data indicating that breast implants cause breast cancer.

Take home message:

Breast augmentation is not recommended if you plan to get pregnant soon. Implants are not dangerous for the baby; breast feeding is possible. Pregnancy and breast feeding have an impact on your breasts with or without implants. Wait at least 6 months after pregnancy and breast-feeding before considering any aesthetic procedure.

Birgit Stark for ">RPS