A Female Plastic Surgeons’ Perspective

As a plastic surgeon, I’ve treated many women who have lost volume in their breasts or have had sagging breast tissue after breastfeeding. It was only recently that I personally underwent these post-partum breast changes I had seen in many of my patients. As a recent mother who breastfed and pumped, I started to notice these changes in my breasts after my baby weaned to formula. The upper part of my breasts no longer had the same volume, and on the side view, it looked like I was flat from my collarbone down to my nipple, and then below my nipple was the majority of my breast.

During pregnancy, estrogen and progesterone enlarge the milk ducts and glandular tissue, resulting in breast enlargement. After birth, these two hormones decrease, signaling your body to produce milk. Prolactin is released after birth, telling your body to produce milk and oxytocin aids in the release of milk into the ducts. When mothers wean from breastfeeding, it may take several months for the prolactin levels to return to normal. Approximately six months after weaning, the milk-producing tissue is replaced with fatty tissue. If you return to your pre-pregnancy weight, your breasts may return to the same size, but they won’t be as “perky” due to the stretch of the breast ligaments and skin from the previous breast enlargement, and gravity.

Many women choose to have breast surgery after breastfeeding their children to restore their pre-pregnancy breast size and shape. Depending on the condition of each individual’s breast condition, there are several options that we can offer. It may be that a woman needs an augmentation, lift, augmentation with lift or reduction. Options for augmentation include implants of either silicone or saline and patient fat transfer. I will discuss all available options during an in-depth consultation with each patient using the Vectra 3D software to show a simulation of how the augmentation will look.

To ensure the best possible results from your augmentation, lift or reduction, I recommend that you wait a minimum of six months after weaning for your breasts to undergo the necessary post-partum changes which entail replacing the milk-producing tissue with fatty tissue.

Most women are back to work after one week from breast augmentation, lift, or reduction. At this time, you are off pain medication and are feeling back to normal. Most of my patients don’t need pain medication past 2 or 3 days at the most. You can drive after one week provided you are off pain medication. At four weeks, you can start gradually doing upper body conditioning, starting with low weight and running. Up until that point, walking is encouraged with a supportive molded cup bra.

Cosmetic breast surgery is a special interest of mine and more so now that I, myself, have experienced these changes that come with childbearing and breastfeeding. I am fellowship trained in reconstructive and aesthetic breast surgery and feel honored to help women restore confidence in their bodies after breastfeeding.

I am available for consultation to discuss post-partum breast surgery, call our office 919-297-0097 or request a consultation on our website.

–Dr. Cindy WU, FACS