Sara
In my experience, it is not a big problem. However, there are some caveats.
Like you mentioned, you have to find out about the breasts pre-surgery. If
the breasts were very hypoplastic, markedly assymetric or similar, then the
augmentation per se probalby has less effect on milk supply issues than the
original anatomy did. However, the surgical procedure itself can compound
the problem for these clients, like with a periareolar incision. As I'm sure
you know, some mothers report altered sensations as well. Anecdotally I have
seen increased incidence of what I would consider pathologic engorgemen,
possibly due to already 'stretched to the limit' skin. This depends again on
the extent of the augmentation. I consider all augmentation clients to be in
a high risk category and (even though they most often do very well) they
need careful, close followup.

Laurie Wheeler, IBCLC, MN, RN
New Orleans Louisiana, s.e. USA


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