Dear Fiona, the issue of breast surgery and continuing lactation is at best not well understood by breast surgeons who I have met. I recently got a call from a patient who was at the University Hospital here in town because she had a breast abscess I and D'd, and her doctors didn't know what to tell her about breastfeeding continuation. She asked them to call me, and they wouldn't because they didn't know me, but if they would have, they would have found out that I am on staff with the med school. In other words, not even interesting in seeking the info. Of course it is easy to tell a woman to wean, as breast surgeons only know the breasts in their nonfunctional state. I think the patient you have is comparable to a breast abscess patient. I see no reason to wean, and I see no reason to tell her that she can't nurse in the future. I am at home and without my references, but the incisions that pose the the most risk for future failed lactation are the periareolar ones, or ones that result in decrease in nipple sensation, due to lack of neural feedback to give rises in prolactin and oxytocin. Her breast should heal while she is still nursing. For her to stop nursing may result in engorgement, and increase risk of infection/sepsis. There are really not alot of studies on this, as I did try to dig up info on this topic 3 months ago for a talk. Hope this helps-Anne EglashMD