Last update Dec. 26, 2020

Breast Reduction Mammoplasty

Likely Compatibility

Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.

The surgery for reduction of the breast with preservation of the pedicle is the one with the highest probability of conservation of innervation of nipple and hence the sensibility of that area, as well as the integrity of milk ducts (Kraut 2017). Even though, there is still five times more probability of lactation failure among women who undergo this kind of surgery with 2/3 of women having less nipple sensibility and more troubles while breastfeeding. Mean duration of lactation among treated women was 5 days versus 3 months among those who did not undergo a surgery: two months versus six months for mixed lactation (Nguyen 2013, Molivere 2013, Andrade 2010).

At date of latest review no study was found that has shown significant differences on functional results of breastfeeding, among various type of surgical techniques for preservation of the pedicle: upper pedicle, lower pedicle or both with different orientation of the scar (Bilgen 2019, Ren 2014, See 2014, Sinno 2013, Huang 2012, Letertre 2009, Copcu 2009, Chiummariello 2008, Cruz 2007, Cherchel 2007).

The free-graft technique hampers a big deal the achievement of exclusive breastfeeding, since it cuts the innervation and glandular ducts. As it has been seen, at start, the possibility of breastfeeding should not be excluded, since after years reinnervation and partial recanalization may occur, although it rarely will be exclusive, because of the lost of a lot of sensibility that would ensure the functioning of the neuro-endocrine reflex that is instrumental for milk production. The normal secretion of colostrum at the end of pregnancy does not guarantee the success of lactation since it is not related to the neuro-endocrine reflex (instead it is indicative of a possible recanalization of ducts)

Liposuction techniques have less untoward effects on lactation but they are limited to certain indications.

A rare complication of augmentation mammoplasty is galactorrhea, which is usually transient and treatable ( (Mestak 2014, Arnon 2006, Inguenault 2005).

Several papers reporting results that were published by plastic surgeons failed to find a relationship between reduction mammoplasty and breastfeeding troubles. They assumed that the reason for breastfeeding failure is partly due to pessimistic opinions of health care givers who are in charge of those patients.

The plastic surgeon should adequately inform the women who are willing to breastfeed their offspring after a reduction mammoplasty (Tran 2014)

Alternatives

We do not have alternatives for Breast Reduction Mammoplasty.

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

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Group

Breast Reduction Mammoplasty belongs to this group or family:

References

  1. Bilgen F, Ural A, Bekerecioğlu M. Inferior and Central Mound Pedicle Breast Reduction in Gigantomastia: A Safe Alternative? J Invest Surg. 2019 Aug 12:1-7. Abstract
  2. Kraut RY, Brown E, Korownyk C, Katz LS, Vandermeer B, Babenko O, Gross MS, Campbell S, Allan GM. The impact of breast reduction surgery on breastfeeding: Systematic review of observational studies. PLoS One. 2017 Oct 19;12(10):e0186591. Abstract
  3. Ren M, Wang Y, Wang B, Zhang Y, Xu J, Chen Y. [Nipple reduction by using a modified Z-shaped incision technique]. Zhonghua Zheng Xing Wai Ke Za Zhi. 2014 Abstract
  4. Tran PL, Houdjati H, Barau G, Boukerrou M. [Breastfeeding after breast surgery: patient information]. Gynecol Obstet Fertil. 2014 Abstract
  5. Mestak O, Mestak J, Borsky J. Hyperprolactinaemia: a cause of severe postoperative complication after reduction mammaplasty. J Plast Surg Hand Surg. 2014 Abstract
  6. See MH. Central pedicle reduction mammoplasty: a reliable technique. Gland Surg. 2014 Abstract Full text (link to original source) Full text (in our servers)
  7. Lawrence RM. Circumstances when breastfeeding is contraindicated. Pediatr Clin North Am. 2013 Feb;60(1):295-318. Abstract
  8. Sinno H, Botros E, Moufarrege R. The effects of Moufarrege total posterior pedicle reduction mammaplasty on breastfeeding: a review of 931 cases. Aesthet Surg J. 2013 Abstract
  9. Nguyen JT, Palladino H, Sonnema AJ, Petty PM. Long-term satisfaction of reduction mammaplasty for bilateral symptomatic macromastia in younger patients. J Adolesc Health. 2013 Abstract
  10. Moliver C, Kargel J, Sullivan M. Treatment of nipple hypertrophy by a simplified reduction technique. Aesthet Surg J. 2013 Abstract
  11. Huang WC, Yu CM, Chang YY. Geometric incision design for reduction nippleplasty. Aesthetic Plast Surg. 2012 Abstract
  12. Habbema L, Alons JJ. Liposuction of the female breast: a histologic study of the aspirate. Dermatol Surg. 2010 Abstract
  13. Thibaudeau S, Sinno H, Williams B. The effects of breast reduction on successful breastfeeding: a systematic review. J Plast Reconstr Aesthet Surg. 2010 Abstract
  14. Andrade RA, Coca KP, Abrão AC. Padrão de aleitamento materno no primeiro mês de vida em mulheres submetidas a cirurgia de redução de mamas e implantes. [Breastfeeding pattern in the first month of life in women submitted to breast reduction and augmentation]. J Pediatr (Rio J). 2010 Abstract Full text (link to original source) Full text (in our servers)
  15. Copcu E. A versatile breast reduction technique: conical plicated central U shaped (COPCUs) mammaplasty. Ann Surg Innov Res. 2009 Abstract Full text (link to original source) Full text (in our servers)
  16. Letertre P, Lasserre G, Ricbourg B. [Large breast hypertrophy and gigantomastia management by postero-inferior pedicle reduction technique. About 20 cases]. Ann Chir Plast Esthet. 2009 Abstract
  17. Chiummariello S, Cigna E, Buccheri EM, Dessy LA, Alfano C, Scuderi N. Breastfeeding after reduction mammaplasty using different techniques. Aesthetic Plast Surg. 2008 Abstract
  18. Cruz NI, Korchin L. Lactational performance after breast reduction with different pedicles. Plast Reconstr Surg. 2007 Abstract
  19. Cherchel A, Azzam C, De Mey A. Breastfeeding after vertical reduction mammaplasty using a superior pedicle. J Plast Reconstr Aesthet Surg. 2007 Abstract
  20. Arnon O, Mendes D, Winkler E, Tamir J, Orenstein A, Haik J. Galactorrhea complicating wound healing following reduction mammaplasty. Aesthet Surg J. 2006 Abstract
  21. Chamblin C. Breastfeeding after breast reduction: what nurses & moms need to know. AWHONN Lifelines. 2006 Abstract
  22. Inguenault C, Capon-Degardin N, Martinot-Duquennoy V, Pellerin P. [Galactorrhea after mammary plastic surgery]. Ann Chir Plast Esthet. 2005 Abstract
  23. Witte PM, van der Lei B, van der Biezen JJ, Spronk CA. [Successful breastfeeding after reduction mammaplasty]. Ned Tijdschr Geneeskd. 2004 Abstract
  24. Cruz-Korchin N, Korchin L. Breast-feeding after vertical mammaplasty with medial pedicle. Plast Reconstr Surg. 2004 Abstract
  25. Johansson AS, Wennborg H, Blomqvist L, Isacson D, Kylberg E. Breastfeeding after reduction mammaplasty and augmentation mammaplasty. Epidemiology. 2003 Abstract
  26. Hefter W, Lindholm P, Elvenes OP. Lactation and breast-feeding ability following lateral pedicle mammaplasty. Br J Plast Surg. 2003 Abstract Full text (link to original source) Full text (in our servers)
  27. Souto GC, Giugliani ER, Giugliani C, Schneider MA. The impact of breast reduction surgery on breastfeeding performance. J Hum Lact. 2003 Abstract
  28. Zimpelmann A, Kaufmann M. [Breastfeeding nursing after breast surgery]. Zentralbl Gynakol. 2002 Abstract
  29. Mottura AA. Circumvertical reduction mammaplasty. Clin Plast Surg. 2002 Abstract
  30. Brzozowski D, Niessen M, Evans HB, Hurst LN. Breast-feeding after inferior pedicle reduction mammaplasty. Plast Reconstr Surg. 2000 Abstract
  31. Tairych G, Worseg A, Kuzbari R, Deutinger M, Holle J. [A comparison of long-term outcome of 6 techniques of breast reduction]. Handchir Mikrochir Plast Chir. 2000 Abstract
  32. Akpuaka FC, Jiburum BC. Reduction mammaplasty by the inferior pedicle technique: experience with moderate to severe breast enlargement. West Afr J Med. 1998 Abstract
  33. Savaci N. Reduction mammoplasty by the central pedicle, avoiding a vertical scar. Aesthetic Plast Surg. 1996 Abstract
  34. Mandrekas AD, Zambacos GJ, Anastasopoulos A, Hapsas DA. Reduction mammaplasty with the inferior pedicle technique: early and late complications in 371 patients. Br J Plast Surg. 1996 Abstract Full text (link to original source) Full text (in our servers)
  35. Liu D, Xu G, Zhang Y. [Reduction mammaplasty and mastopexy with a circumareolar incision]. Zhonghua Zheng Xing Shao Shang Wai Ke Za Zhi. 1995 Abstract
  36. Marshall DR, Callan PP, Nicholson W. Breastfeeding after reduction mammaplasty. Br J Plast Surg. 1994 Abstract
  37. Widdice L. The effects of breast reduction and breast augmentation surgery on lactation: an annotated bibliography. J Hum Lact. 1993 Abstract
  38. Caouette-Laberge L, Duranceau LA. [Breast feeding after breast reduction]. Ann Chir. 1992 Abstract
  39. Bruck JC. Galactorrhea: a rare complication following reduction mammaplasty. Ann Plast Surg. 1987 Abstract
  40. Soules MR, Hansen LW, Tucker KR, Buehler PK. Prolactin secretion in women after plastic breast augmentation and reduction. Ann Plast Surg. 1986 Abstract

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