Ability to Breastfeed After Breast Reduction.

Background: Breast reduction surgery is increasingly performed in reproductive age women, raising concerns for potential breastfeeding implications. We evaluated breastfeeding outcomes in patients that underwent reduction mammaplasty with one of three pedicle types and subsequently conceived and delivered at our institution. The primary objective was to determine the impact of reduction mammaplasty on breastfeeding success. The secondary objective was to explore other factors influencing breastfeeding success.

Methods: Twenty patients were included. Patients' charts were queried for demographics, comorbidities, pregnancy outcomes, and surgical details. The independent samples T test was utilized to analyze continuous variables. The Pearson's Chi-squared or Fisher's exact test was used for categorical variables.

Results: Of the twenty patients who attempted breastfeeding after reduction mammaplasty in the study's timeframe, 11 (55%) were successful. Breastfeeding success was not significantly affected by the type of pedicle chosen for the procedure, the tissue excision weight, age at breast reduction, time between surgery and pregnancy, age at pregnancy, BMI, smoking status, chronic hypertension, pre-gestational diabetes, preterm delivery, delivery method, or neonatal birthweight. Delivering a small for gestational age infant significantly reduced the chance of breastfeeding success (p=0.05).

Conclusions: In our study, the ability to breastfeed was not significantly affected by a history of breast reduction surgery, regardless of pedicle type, tissue excision weight, or demographic factors. OBGYNs and plastic surgeons should engage in shared decision making with potential surgical patients and counsel them that while the literature is overall reassuring, there is a potential impact on breastfeeding ability given that milk-producing breast parenchyma will have been removed.

Level of evidence iii: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .