I am a nursing student at the University of North Dakota and have
been reading lactnet for about a month now.  This semester we have the
opportunity to follow an expectant mom in one of our classes.  My client
is a 21 year old primigravada with an EDC of 12-31-97 and wants to
breastfeed which is great.  The problem is that she had a breast
reduction in the fall of '95 and wasn't thinking that she may want to
breastfeed later in time.  From what I have been reading there are two
different procedures used in mammoplasty.  According to Riordan and
Auerbach, one is the pedicle technique (where the nipple and areola
remain attached to the breast gland on a pedicle, while the excess tissue
is "reduced"), and the other is called the free nipple technique (which
involves removing the nipple/areola entirely from the breast and
preserving it in saline while the breast glandular tissue is removed).
     As far as breastfeeding after these surgeries, there has been much
success with breastfeeding.  Belford stated that three out of five women
who had had a reduction managed to exclusively breastfeed their babies.
But these were only pedicle technique surgeries.  When talking about the
free nipple technique she stated, "Breastfeeding is not possible after
this type of operation."  Lawrence stated many success cases also, all of
which were the pedicle technique.  We have obtained my client's medical
records of the surgery and to our understanding, we think it's the free
nipple procedure.  My client is planning to call her doctor and clarify
the type of surgery and damage done to her ductal and nerve areas.  So as
of now, it looks challenging, but I told her every case is different.  I
did also find some hope by Mohrbacher and Stach.  They did not say it
wasn't possible in the free nipple procedure, just that the chances for
success decrease moreso than the pedicle.  They also talk about some
women's milk ducts recanalizing or growing back after the surgery, and
stated a case that was fully successful in breastfeeding!
     One last thing I'd like to mention is about nerve damage.  My client
told me that her nipples can be stimulated to become erect now and have
been able to do so for over a year now.
     So if anyone has any experience with women breastfeeding after a
free nipple breast reduction, I would appreciate any advice you may have
or other references I could look into.
Thank you.

Valerie Christenson
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References:
     Belford, H.  (1995) "Feeding after Mammoplasty."  Nursing-Times May
24-30, 57-8.
     Lawrence, R. (1994).  Breastfeeding 4th Edition (pp. 530-531).  St.
Louis, MI:  Mosby-Year Book, Inc.
     Mohrbacher, N; Stach, J. (1997).  The Breastfeeding Answer Book
Revised Edition (pp.436-438).  Schaumburg, IL:  La Leche League
International.
     Riordan, J.; Auerbach, K. (1993).  Breastfeeding and Human Lactation