Tag Archives: breast lift

Why is it important to be nicotine free before surgery?

While smoking is detrimental to a person’s health for a number of reasons, it is poses particular problems for patients undergoing surgery.   Nicotine, whether from cigarettes, patches, gum, etc., causes vasoconstriction in the small vessels that we count on to heal newly created wounds.  This is especially true in certain procedures where the normal blood supply is disrupted and the tissues are tightened at the time of closure, such as with a facelift, abdominoplasty, breast lift, breast reduction, and breast reconstruction.


We feel strongly that in certain cases the risk of significant wound healing problems outweighs any benefit we would provide with the procedure.  In these types of cases, we will decline to do the operation unless our patient is nicotine free.  This does not apply to all procedures we perform, so be sure to ask us when this rule applies.


Some patients may choose to go elsewhere for their surgery because of our caution on this issue.  While surgery on patients that use nicotine products can be successful in some cases, we feel the risks of a bad outcome are unacceptably high.


Breast-feeding after breast surgery

Patients who are considering breast surgery such as breast augmentation, breast reduction, or a lift often ask us about their ability to breast feed after surgery if they have children.  They want to know if breast-feeding will be possible, and have often heard different answers from various medical practitioners and friends.  The answer depends on the type of surgery being performed and how it will be done.


After Breast Augmentation

In most cases, yes.   Of course that’s the same answer I would give a woman who has not had a breast augmentation.

Most women without breast implants are able to successfully breast feed their babies, but some struggle with inadequate milk production, mastitis, and other problems that may make breast-feeding difficult.

The same could be said for women after breast augmentation.  Because the implants are placed behind the breast tissue, pushing it forward, the glands and ducts that allow for milk production are left intact.  Therefore, although most women are able to breast-feed after surgery, it cannot be guaranteed.


After breast reduction and breast lift (mastopexy) 

As in the case of breast augmentation, the answer is usually yes, but the full answer is a little more complicated.

I always ask patients who have previously had children about their ability to breast feed during the consultation.  I am struck by how many of these patients describe difficulties despite the large amount of breast tissue present.  When I warn patients about the possibility that a breast reduction operation may interfere with breast-feeding, most are willing to accept this potential loss.  To paraphrase these patients, “If you think my breasts are big now, you should have seen me when I was pregnant!  I’m not going through that again.”

Since breast tissue is actually removed during the operation, the technique used during the operation may affect the ability to breast feed afterward.  We utilize a technique that has proven to be reliable in preserving the nerves, ducts, and blood supply to the nipple, and therefore most patients are able to breast feed successfully after surgery.

Rarely, the breast is so large that we must actually remove the nipple completely from the breast and place it back on as a graft.  When we anticipate this will be required, we tell our patients preoperatively that they will not be able to breast feed after surgery.  In almost 18 years of breast reduction surgery, I have only had to perform this type of reduction twice, and both patients were past their childbearing years.

With a breast lift, we typically are removing little to no breast tissue, so the chances of disrupting nerves, milk ducts, or the blood supply to the breast tissue are less than with a reduction.  However, there is still a chance to interfere with breast feeding if a significant reshaping is performed.

In summary, while most patients are able to breast-feed after a reduction, breast augmentation, or breast lift, we cannot guarantee it.  If this is a risk you are unwilling to take, it might be better to delay your surgery until after you are finished having children.