I recently worked with a mom with a very similar surgery.  She had
originally not planned to breastfeed because of it, but decided 30
minutes before being discharged that she might like to try it.  Her
doctor had told her is was doubtful she would be able to nurse.
Needless to say, I was able to do very little education in the few
minutes I had and the mom wasn't willing to try to nurse before she
left.  I kept in touch with her afterwards and she attempted to get
baby to nurse, but baby would not cooperate.  As you can see, her
committment to really trying to make it work was minimal.
Nevertheless, she never experienced ANY breast fullness and the
little nursing that baby did had no evidence of milk transfer.  I
suspect that the peeling back of the breast tissue may not be the
biggest part of the problem.  I don't see how that can be done
without major interruption of the innervation of the breast.  (The
mom I mentioned did state that her nipples were not very
sensitive-not sensitive as in sore, but sensitive as in responding
to touch.)  Without that nerve connection to the pituitary, oxytocin
and prolaction production has got to be greatly inhibited.
Of course every case is different.  If I run into another mom with a
similar history who wants to try to nurse I will certainly encourage
her to try along with being sure there is close follow-up, she knows
the potential for supply concerns and she knows there are
alternatives such as a supplementer if she does have problems.
Winnie

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