Chrissa, My comment is that it seems to me the answer to the question you posed depends as much (or more) on the pre-op physical status of the individual breast as it does on the surgery, placement of incision, etc. itself. There is currently, to my knowledge, no accurate way to assess whether there is insufficient glandular tissue in a resting breast, to begin with. Though the basic ductal structure is laid down in the embryonic and fetal period, most of the lobular development takes place later. The young adolescent nullipara has about 90% fatty and connective tissue in the breast. (The advertising and entertainment worlds don't breathe a word of that!) Full breast development, with fat being gradually evacuated from the breast to make room for the budding and increase of alveoli, is only stimulated by repeated menstrual cycles and much moreso, by pregnancy and lactation, after which alveoli largely involute following weaning, (like the leaves of a tree fall in autumn.) If weaning is gradual, re-importation of fat occurs gradually, only to again move out for re-budding mostly new alveoli with the new placental stimulation of a subsequent pregnancy (like new leaves on a tree in spring.) Elective breast surgery would occur on a "resting breast, either before this sequence or between pregnancies, so in an unknown number of cases, there may be predisposing factors for insufficient milk supply before surgery is ever contemplated. There have been cases discussed on LN within the past 2 months of mothers who had signs suggestive of insufficient glandular tissue, such as a wide distance between breasts, or frank tubular breasts, with subsequent difficulty in bringing in an adequate supply despite pumping, domperidone, frequent nursing with supplementers, etc. So the impossibility of objectively defining the number of lobes, etc. in the breast, before augmentation itself takes place, would enter into the equation long before the mother elects a cosmetic procedure for subjective social and psychological reasons. Perhaps we as LC's, physicians and nurses should be asking the mother more about the what actual shape and size characteristics of her breast were before augmentation (perhaps using for comparison pictures from articles and textbooks, such as "The Breastfeeding Atlas" by Wilson-Clay and Hoover)., to have a better idea of how her genetically endowed equipment may have placed her at risk of insufficient supply even without surgery. "This complex organ therefore has to be described in its anatomy, histology, ultrastructure, physiology, or response to hormones not as a static picture, but as a dynamic phenomenon in which each phase is transitory and heavily dependent on the age at which it is studied, and the specific conditions of the host . . . the development of the mammary gland has to be evaluated based on the architecture of the organ at each given period of time for each individual woman." Russo J, Russo IH Development of the Human Mammary Gland in: The Mammary Gland, Development, Regulation, and Function ed. by Neville MC, Daniels CW 1987 Plenum Press, NY. pp. 67-93. This book chapter is based on dissection and study of 114 surgical or autopsy breasts specimens, and contains an interesting set of pie-charts and other graphic representations of differing amounts of various types of tissue depending on age/parity (though I might add, there is no mention of lactation history as a variable.) Jean ************ K. Jean Cotterman RNC, IBCLC Dayton, Ohio USA *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(R) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html