Theoretically, you should be able to breastfeed so long as the milk ducts (channels from the gland to the nipple) are not cut during surgery.
In breast augmentation, the implant is placed behind the breast tissue. When incisions are made under the breast or in the armpit, the gland and ducts are not disturbed. A cosmetic incision around the areola extends directly through the breast and although a few ducts may be cut this does not matter in practice and most ducts remain intact.
With a breast lift or mastopexy, the gland and ducts are not disturbed.
In a breast reduction, part of the gland is removed, but it is already too large and theoretically, this should not matter as long as ducts still connect and drain the remaining breast. Older techniques would have cut many ducts, but newer techniques leave many ducts intact. This is a point to discuss carefully with your surgeon.
A point to remember is that many patients, particularly those with very large breasts are unable to breastfeed anyway and it is difficult to know after surgery whether you might be one of these and the inability to breast feed is nothing to do with surgery.
Grafted fat is mostly placed around the edge of the glandular tissue and would not affect feeding. When fat is placed into glandular tissue, there maybe pressure on the gland and ducts, but one would not expect this to be a long term issue. You will not be pregnant at the time of surgery and there will be plenty of time to settle in.
Occasionally patients with extremely large breasts are treated with a method which involves temporarily removing the nipple and areola completely, thus dividing all the ducts for certain. At the end of the procedure, the nipple is grafted back. All patients are told that they will never breastfeed. However, there are occasionally cases where patients were able to breastfeed after this. There must be a mechanism by which cut ducts search for the free end to reconstitute the means of milk reaching the nipple. Nature is on your side.
Remember, there are a number of factors you should consider when determining which procedure is right for you. Each type of breast surgery will give you a different end look and may come with different concerns. It is important for you to keep that in mind when weighing other factors such as breast feeding in the future.
Be open and honest about your plans, goals, and concerns with your surgeon during your consultation and rest assured that you’re in the best of care at the Cadogan Clinic.