Breast Implants, Pregnancy and Breastfeeding: What to Expect

Pregnancy and breastfeeding are two of the most common reasons women hesitate before a breast augmentation, and two of the most common reasons women with implants come back to see us. The questions are usually the same: can you breastfeed with a boob job, will it harm the baby, and does pregnancy ruin breast implants? This guide answers them using the published evidence rather than reassurance, and covers breastfeeding after a breast lift, a breast reduction and fat transfer as well.

If you already have implants and are pregnant, the short version is that your implants are safe, you can plan to breastfeed, and your breasts will change in ways that have more to do with pregnancy than with the implants. If you are planning surgery and want children later, the most useful thing you can do is say so at your consultation, because it shapes the choice of incision, implant placement and size.

Can You Breastfeed With a Boob Job?

Yes. Most women who have had breast augmentation are able to breastfeed, and the evidence on this is now reasonably large. A 2023 systematic review in the Aesthetic Surgery Journal pooled 11 studies and found that 8,197 of 9,965 women with implants (82%) breastfed successfully. In the five studies with a comparison group, 88% of women without implants did so. The difference is real but modest.

The largest single study, the Breast Implant Follow-up Study, followed women who gave birth after a first augmentation, covering more than 5,700 births. Of the women who had a baby, 79% breastfed at least one child. The most common problem was insufficient milk, reported for about one birth in five (19.6%), which the authors noted was similar to rates reported for breastfeeding women in general. Complication rates were similar regardless of incision type, implant size or pocket.

Where implants do make a difference is in exclusive breastfeeding, meaning feeding with breast milk alone. Two separate meta-analyses have found that women with implants who breastfeed are around 40% less likely to do so exclusively, with relative rates of 0.60 and 0.63. In practice, this means some women with implants breastfeed alongside formula or expressed milk rather than exclusively. Knowing that in advance makes it easier to plan for, and to see as a normal outcome rather than a failure.

How Do Breast Implants Affect Breastfeeding?

An implant sits behind the breast tissue, or behind the chest muscle, rather than inside the milk-producing glands, so it does not stop the breast making milk. There are four ways breast augmentation can still affect breastfeeding.

• Nerve changes. Nipple stimulation triggers the let-down reflex. If nipple sensation changes after surgery, let-down can be less reliable. In large implant studies, lasting changes in nipple sensation are uncommon.
• Disruption of ducts or glandular tissue. Any incision through breast tissue can divide some milk ducts. How much depends on the approach, which is why the incision was the focus of early research.
• Pressure. A large implant, particularly one sitting directly behind the breast tissue, can press on the gland. A Brazilian study of 115 new mothers with implants found that women with implants above the muscle used milk-boosting medicines more often and reported more pain than those with implants below it.
• The breast you started with. Some of the difference may have nothing to do with the implant. A proportion of women who choose augmentation have naturally underdeveloped, widely spaced or tuberous breasts, which can have less milk-producing tissue to begin with, with or without surgery.

Does the Incision or Implant Placement Matter?

The idea that the incision decides whether you can breastfeed comes largely from a 1996 study of 42 women seen at a lactation clinic in Texas. Of these, 64% had insufficient milk, compared with under 7% of women without implants, and the periareolar incision (around the edge of the areola) was the approach most strongly linked to it. That study was small and drew on women who had already sought help with feeding, so it was always likely to overstate the problem.

Later evidence is more reassuring. A 2018 meta-analysis found no clear reduction in exclusive breastfeeding with periareolar incisions, and the Breast Implant Follow-up Study found similar complication rates across incision types and pockets. The honest summary is that neither the incision nor the pocket has been shown to make a large difference on its own, but both are reasonable to take into account if breastfeeding matters to you:

• Incision. At Centre for Surgery, most breast augmentations use an inframammary incision in the crease beneath the breast. It gives direct access to the pocket without cutting through the ducts that run towards the nipple.
• Pocket. Placing the implant partly under the muscle (dual plane) keeps it further from the glandular tissue. It has other trade-offs, including movement of the implant when the chest muscle contracts, so your surgeon weighs it against your anatomy rather than choosing it for breastfeeding alone.
• Size. A proportionate implant puts less pressure on the breast tissue and the skin, which also matters for how the breast looks after pregnancy.

Is It Safe to Breastfeed With Silicone Implants?

Yes. Breastfeeding with breast implants is considered safe for both mother and baby. The concern that silicone could pass into breast milk was tested directly in a Toronto study that measured silicon, the element used as a marker for silicone, in breast milk. Levels in women with silicone gel implants (about 55 ng/ml) were no different from those in women without implants (about 51 ng/ml). By comparison, shop-bought cow’s milk contained around 709 ng/ml and infant formula around 4,400 ng/ml.

Modern cohesive gel implants, including the Silimed implants we use, hold their shape even if the shell is damaged. There is no evidence that pregnancy or breastfeeding causes an implant to rupture; the risk of implant rupture relates mainly to the age of the implant. If you notice a change in the shape or feel of an implant while pregnant or breastfeeding, see a surgeon. A breast implant check starts with an examination, with a scan arranged only if it is needed.

Breastfeeding With Implants: Mastitis and Capsular Contracture

Mastitis is inflammation of the breast, usually caused by milk building up in a blocked duct, sometimes with infection. It causes a painful, red, hot area of the breast and flu-like symptoms. A study of 28,383 births in Israel found that women with breast implants were slightly more likely to develop mastitis in the six months after birth: 8.3% compared with 6.6% of women without implants.

This matters more with implants because infection and inflammation near an implant are thought to be among the triggers for capsular contracture, where the scar tissue around the implant tightens and the breast becomes firm or changes shape. If you develop symptoms of mastitis:

• keep feeding or expressing from the affected side, as emptying the breast is part of the treatment
• see your GP or midwife promptly rather than waiting, as antibiotics may be needed
• tell them you have breast implants
• seek urgent help if you feel very unwell, the redness spreads quickly or a lump does not settle

The NHS has a clear guide to mastitis symptoms and treatment.

Breast Implants and Pregnancy: What Changes?

Breast implants are not affected by pregnancy. They do not change size, move inside you or harm the baby, and they do not interfere with antenatal scans. What changes is the breast around them.

During pregnancy, hormones enlarge the milk ducts and glands (our guide to breast changes in pregnancy covers these trimester by trimester) and increase blood flow, so the breasts become larger, heavier and more tender. The areolas usually darken and may widen, and stretch marks can appear. After you stop breastfeeding, the glandular tissue shrinks back. The skin has been stretched, so the breast often looks emptier at the top and sits lower than before, while the implant stays the same size. This is why some women with implants notice the breast tissue drooping over or in front of the implant after pregnancy.

A common assumption is that breastfeeding causes this. A study of 93 women seeking breast surgery after pregnancy found that the independent risk factors for sagging were older age, higher body mass index, more pregnancies, a larger bra size before pregnancy and smoking. Breastfeeding itself was not. The authors concluded that expectant mothers can be reassured that breastfeeding does not appear to harm breast appearance, and the same applies if you have implants.

Can Pregnancy Ruin Breast Implants?

Pregnancy cannot damage the implants themselves, and you do not need to replace them because you have had a baby. Whether your result changes depends on your skin, the size of the implant relative to your tissue, how much weight you gain and how many pregnancies you have. Some women look almost the same as before; others notice sagging, loss of upper fullness or asymmetry.

If your breasts have changed and it bothers you, wait until they have fully settled before deciding what to do, as they can keep changing for months after you stop breastfeeding. The options then include:

• A breast lift to raise the nipple and remove stretched skin, with or without new implants. Our guide to how soon after pregnancy you can consider a breast lift covers the timing, and breast lift vs breast augmentation explains which problem each solves.
• Implant replacement with a different size or profile, often combined with a lift.
• Areola reduction if the areolas have stayed enlarged.
• Doing nothing, which is a perfectly reasonable choice if the implants are healthy and you are happy with how you look.

More results are in our breast lift before and after gallery.

How Long After Breastfeeding Can You Get a Boob Job?

We advise waiting at least three months after you have completely stopped breastfeeding, and ideally around six, before having breast surgery. By then your breasts have usually returned to a stable size, your hormones have settled and your surgeon can see what your breasts actually look like, which leads to a more accurate result. If you did not breastfeed, allow at least six months after the birth.

It is just as important that milk production has fully stopped. Some women continue to produce small amounts of milk for months after weaning. A 2024 case report from two London hospitals described a patient who had stopped breastfeeding more than six months earlier but was found to be lactating during breast surgery with implants. She developed an infection that needed the implant to be removed. The authors recommend delaying implant surgery until lactation has completely resolved. If you still notice any milk or discharge, tell your surgeon at consultation.

We do not carry out cosmetic breast surgery during pregnancy or while you are breastfeeding.

Should You Have a Boob Job Before or After Having Children?

There is no single right answer. Pregnancy changes the breast in most women, so if you are planning a family soon, waiting means your surgeon operates on the breasts you will actually live with, and you are less likely to need a second operation. If children are years away or uncertain, many women reasonably decide not to put their life on hold, knowing that further surgery may be needed later.

If you decide to go ahead first, tell your surgeon about your plans. It is a reason to favour a proportionate implant, an incision in the breast crease and careful handling of the breast tissue, and it helps set realistic expectations about how the breasts may look after pregnancy. Implants do not last for life whatever you decide, and our guide to how long breast implants last explains what to expect over the decades. For planning other procedures around a family, see timing your cosmetic surgery around pregnancy.

Getting Pregnant After Breast Augmentation

Ideally, give your breasts time to heal and the implants time to settle before you try to conceive. Implants usually take three to six months to drop and settle into their final position, and pregnancy during that time makes it harder to judge the result. There is no evidence that becoming pregnant sooner is dangerous to you or the baby, but tell your surgeon if you become pregnant during your recovery so your follow-up can be adjusted.

Tell your midwife that you have implants. It does not change your antenatal care, but it is useful background if you develop breast problems while feeding.

Breastfeeding After a Breast Lift, Reduction or Fat Transfer

Breastfeeding after a breast lift

Breastfeeding after a breast lift is usually possible. In most lifts, the nipple stays attached to the breast tissue beneath it while it is moved higher, which preserves many of the ducts and nerves. A lift does involve more reshaping of the breast than an implant alone, so there is more potential to disturb ducts, and the more dramatic the reshaping, the greater that potential. A later pregnancy will also stretch the lifted breast again, which is why many women wait until their family is complete.

Breastfeeding after a breast reduction

Breast reduction has the greatest effect on breastfeeding of any cosmetic breast operation, because it removes glandular tissue and moves the nipple. The technique matters. A systematic review found that breastfeeding success was highest when the column of tissue beneath the nipple was fully preserved and fell to around 4% when it was not. Most women having a reduction today have a technique that keeps the nipple attached to its underlying tissue, and many go on to breastfeed, though often with some topping up. Our guide to breast reduction risks covers this alongside the other risks of surgery.

Breastfeeding after fat transfer to the breasts

Fat transfer to the breasts uses your own fat, injected in small amounts into and around the breast tissue through tiny incisions, so it does not involve an implant or large cuts through the gland. It is not thought to interfere with breastfeeding, though good research is limited. Tell your breast screening service or radiographer that you have had fat transfer, as it can leave small benign changes on imaging.

Mummy makeover and nipple surgery

A mummy makeover is designed to correct the changes of pregnancy, so it makes most sense once your family is complete; our guide to a mummy makeover after pregnancy covers timing. Inverted nipple correction can divide some ducts depending on the technique, so mention future breastfeeding before you have it.

Tips for Breastfeeding With Implants

• Get support early. Ask your midwife or health visitor for a feeding assessment in the first few days, or contact an infant feeding specialist. Help given early is more effective than help given once problems are established.
• Feed often. Eight to twelve feeds in 24 hours in the early weeks gives your body the strongest signal to make milk.
• Check your baby is getting enough. By around day five, expect at least six heavy wet nappies a day, and make sure your baby’s weight is checked by your midwife or health visitor.
• Treat blocked ducts and mastitis early, and tell whoever treats you that you have implants.
• Wear a soft, supportive nursing bra without underwire. The advice in our guide to wearing a bra after breast augmentation applies here too.
• Top up if you need to. Combining breastfeeding with expressed milk or formula is a common and valid outcome with or without implants.

Frequently Asked Questions

Breast Surgery at Centre for Surgery

At Centre for Surgery, breast augmentation, lifts, reductions and implant replacement are carried out by GMC-registered plastic surgeons at our CQC-regulated hospital at 95–97 Baker Street, as day cases under TIVA. The surgeon who assesses you is the surgeon who operates, so your plans for pregnancy and breastfeeding are discussed with the person making the surgical decisions. We use Silimed implants, and we recommend a two-week cooling-off period after every consultation. To book, call 020 7993 4849.

References

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