A musing worth the effort, Jean and point well taken. The cases I am seeing  
are related to "enhancement.' In my primary workplace, which is in a fairly  
affluent area, women who have these have done so out of a desire for enhanced  
appearance. Most of the time, they don't even mention implants on the history 
or  intake form and I find out purely by accident - during my usual thorough 
exam  and history. I try hard not to be judgemental or to lecture them; always  
share engorgement information in a clinical manner and as anticipatory  
guidance. It's amazng how many women seem to think that "rock hard" breasts are  
normal and a good sign of milk production. Sigh.....
Mary Kay Smith, RN, IBCLC
Canton MI

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