Many good points already made on a difficult situation.  Even if this 
breastfeeding parent weaned abruptly today -- which she does not want to 
do! --  in one month post-weaning, the functioning breast would likely 
not involute completely back to its resting state, which would improve 
the chances in an attempt to surgically match it to the reconstructed 
breast.  There are many layers to this question -- and everything in the 
situation is being driven *not* by medical concerns, but by the 
insurance requirement on the surgery's timing.   Is there any way to 
appeal that ruling? Perhaps with a letter of support from knowledgeable 
doctor?  (Is there anyone from the Academy of Breastfeeding Medicine 
there?)

I don't know how Spain's healthcare system works.  Insurance everywhere 
is about the bottom line, and so it can also be pointed out that the 
financial cost for this procedure will be the same whether it takes 
place next month or years from now.   And plastic surgery on breasts is 
often not "one and done," -- procedures are often re-done for various 
reasons, so perhaps holding off on the initial procedure will reduce 
later adjustments.

Likely no one else is valuing what is being gained, physically and 
emotionally, from breastfeeding, and not just for the lucky nursling.   
Cancer treatments can often affect the healthy breast as well.  This 
breastfeeding mother, a cancer survivor, has already accomplished 
something remarkable with sustaining her breastfeeding for this child to 
a biologically normal age.  This is rarely done in our modern world, 
even in ordinary circumstances -- so it's likely being viewed by 
everyone around her as just an indulgence.  She may have found 
breastfeeding emotionally very healing  --  to feel that her body, which 
has been the source of pain and terror and worry, can do something so 
happy and life-sustaining as birthing and feeding.

After facing cancer at such a young age, she also faces the possibility 
of cancer returning.  Statistically, sustained breastfeeding does reduce 
breast cancer risks in the general population. She needs every advantage

  Did I miss in the discussion if there was any possibility that she 
will have another child?  Even though reduction surgeries do seem to be 
improving at preserving lactation potential, the impact of a reduction 
on milk production is always unpredictable and often detrimental -- and 
for one-sided breastfeeding, all the capacity is needed. She obviously 
values what she's accomplished, and someone this determined would 
certainly want to do the same with another child.

It sounds like the person herself is considering the reduction because 
perhaps it would feel like a step forward to have her breasts seem more 
aesthetically right again -- that making them look more normal would be 
putting the awful experience of cancer further behind her.  (Although 
there are plenty of mismatched breasts out there without any such 
traumatic story, and breast surgeries do not always create 
picture-perfect results).  But maybe the decision  could be reframed 
that the surgery is a step that can be taken when the surviving breast 
has also served its normal function to her satisfaction.

Best wishes to all,

Margaret Sabo Wills, IBCLC, Maryland, USA



>> -----Original Message-----
>> From: Lactation Information and Discussion<[log in to unmask]>  On Behalf Of Laura L ópez Fuentes
>> Sent: Tuesday, April 9, 2024 11:36 PM
>> To:[log in to unmask]
>> Subject: Breast reduction surgery during breastfeeding
>>
>> Hello all of you from Spain,
>>
>> First of all, sorry about my English.
>>
>> I want to ask you about your experience with breast reduction surgery during breastfeeding.
>>
>> A breastfeeding mother had breast cancer and a total mastectomy on her right breast. She has an expander in her right breast now.
>>
>> She is now having the final implant placed in her right breast and her surgeon has proposed reduction surgery on her left breast to make them more symmetrical.  Her left breast is larger than the breast size she will have with the implant in her right breast. That is why the surgeon, and the woman as well, wants to do the reduction surgery on the left breast.
>>
>> The woman is breastfeeding her 17-month-old baby from the left breast and does not want to stop breastfeeding now.
>> Surgeon proposes surgery for May.
>> She is going to ask to have it delayed so that she has more time to find out about other options or to wean more quietly.
>>
>> For insurance reasons the woman cannot postpone the surgery on the left breast and has to have both surgeries (left and right breasts) done at the same time.
>>
>> Do you have experience with breast reduction surgery during breastfeeding?
>> If it is possible doing this kind of surgery during breastfeeding, which kind of surgery technic is better for breastfeeding?
>>
>> I know it's a difficult situation and may be the answer is "it's impossible" but I need to know all the possibilities.
>>
>> Thanks in advance.
>>
>> Best regards,
>>
>> Un saludo,
>>
>> Laura López Fuentes
>> IBCLC L-300239
>> MATERNANZA, lactancia materna
>> Consultas de lactancia materna a domicilio en Lugo y Zamorahttps://maternanza.wixsite.com/maternanza
>> [log in to unmask]
>> Tlf: +34 646 536 305
>> Coordinadora Formación eCrianza
>> https://ecrianza.com/
>> Socia de AELAMA
>> https://aelama.org
>> Socia de AECCLM
>> https://ibclc.es
>>
>>              

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