Successful breastfeeding after reduction mammoplasty: a survey study
Amy Yao*1, Yi-Hsueh Lu1, Peter Shamamian1, Caroline Baker1, Katherine Chemakin1, Julia Grande1, Katie Weichman2
1Plastic Surgery, Montefiore Medical Center, New York, NY; 2Hansjörg Wyss Department of Plastic Surgery, NYU, New York, NY
Reduction mammoplasty is among the most common plastic surgery procedures. However, there is no consensus regarding the impact that reduction mammoplasty has on subsequent breastfeeding. Furthermore, several social and economic factors influence an individual’s ability to exclusively breastfeed. Given the many well-known benefits of breastfeeding, the authors sought to characterize the effect of breast reduction on successful and exclusive breastfeeding.
A retrospective review of all patients that underwent reduction mammoplasty at a single institution from February 2016 through June 2019 (n=725) was conducted. All patients 45 years of age or younger at the time of their reduction mammoplasty were contacted and surveyed for their ability to successfully and exclusively breastfeed pre- and post-operatively, as defined by World Health Organization (WHO) criteria. Charts were reviewed for operative characteristics including pedicle choice, resection weight, and complications. Patients who attempted breastfeeding in any capacity both pre- and post-operatively were treated as a cohort for analysis.
489 patients met inclusion criteria, of whom 149 (30.4%) completed the survey. Sixty-five patients reported attempting breastfeeding preoperatively, compared to 28 patients postoperatively. 47% of patients who had children after breast reduction were able to exclusively breastfeed preoperatively, versus 8.3% postoperatively (p=0.03, OR=5.72). 46% of patients reported feeling that their breast reduction surgery contributed to difficulties with breastfeeding. The most common rationale given was that their breasts were perceived as too small to produce enough milk.
To our knowledge, this is the largest study of successful and exclusive breastfeeding following reduction mammoplasty. Reduction mammoplasty appears to impact the ability to exclusively breastfeed postoperatively. Communication and support remain paramount when considering patients of childbearing age for breast reduction surgery.
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