Barbara: Ditto to all your comments re. breastfeeding and implants. I'm happy to share any information re. the study with you. The data was obtained from the client records that we use in our lactation program. We have always asked about previous breast surgery, however, the information we ask the mothers for has been expanded on through the years to include placement of implant (either behind the glandular tissue or behind the muscle), type of incision utilized, any loss of nipple sensation following surgery, problems with the implants themselves (i.e. contractures), and subsequent procedures (i.e. closed capsulotomy). As you mentioned, periareolar incisions are NOT RARE, as seen from the sample in the study ( 11 or 41% of the 42 mothers studied). I might add that the comments made be Dr. Little do not surprise me given the lack of research regarding this issue. The bulk of literature I was able to find during my investigation on lactation and implants in medical journals was the SIDE EFFECT of spontaneous lactation following breast augmentation surgery. Now explain to me why it is so hard to believe that manipulation of the nipple-areolar complex and surrounding glandular tissue can effect future lactation performance when it has been well documented that these procedures can spontaneously bring on milk production in a nulliparous woman. What do you say to that Dr. Little! One other comment on your most recent post, Barbara. The reason that you may have seen some success with lactation in women with periareolar incisions might be due to the actual location of the incision around the areola. Farina et al studied the nerve supply and changes in nipple sensation after augmentation mammoplasty. They determined the precise course of the lacteral cutaneous branch of the fourth intercostal nerve and offered suggestions for preserving sensation in the nipple-areola complex after surgery. They determined that the nerve went into the left mammary gland at the 4 o'clock position and the right at the 8 o'clock position. Based on these findings, they modified the incision for the periareolar approach to a "10 to 5 o'clock" and "7 to 2 o'clock position. Because of this modification, post-op nipple sensation was not decreased. Could this also prevent disruption of the ductal and nerve supply to this area to preserve lactation? Not sure, but it is something to consider.