Breastfeeding after Breast Reduction Surgery: What the Evidence Says and How to Prepare

Ashley Strengholt
Sep 26
4 min read

Many people considering reduction mammaplasty worry about how the surgery might affect future breastfeeding. The short answer: breast reduction can change lactation potential, but outcomes vary widely depending on surgical technique, how much glandular tissue is removed, and postpartum support. Below I summarize what the research shows and practical steps to maximize your chances of breastfeeding successfully.

What the Research Finds

Studies show a wide range of breastfeeding outcomes after breast reduction, largely because different surgical techniques preserve varying amounts of milk duct and glandular tissue. A systematic review by Kraut and colleagues (2017) found that when the subareolar tissue—the column of breast tissue under the nipple—is fully preserved, breastfeeding success rates were close to 100%, compared with much lower rates when it was only partially preserved or not preserved at all (Kraut et al., 2017).

More recent literature reviews estimate that overall breastfeeding success after reduction mammaplasty is around 60%, but women with prior surgery are at increased risk of being unable to breastfeed compared with controls (Koussayer, 2024). Rates also differ depending on the pedicle/technique used (inferior, superior, lateral, etc.), which helps explain the variability in individual outcomes.

Importantly, research emphasizes that outcomes are not determined solely by anatomy. Prenatal counseling, early postpartum lactation support, and encouragement from healthcare providers can make a meaningful difference in whether someone is able to breastfeed after surgery (American College of Obstetricians and Gynecologists [ACOG], 2021).

Why Surgical Technique Matters

Milk production and delivery depend on intact glandular tissue, ducts, and the nerve/blood supply around the nipple-areolar complex. Techniques that preserve the subareolar parenchyma and nipple-areolar blood/nerve connections (so-called “pedicle” techniques) are associated with higher rates of successful lactation compared with those that sever or remove those structures (Kraut et al., 2017; Koussayer, 2024).

Procedures that involve removal and reattachment of the nipple-areolar complex (sometimes called “free nipple grafts”) usually eliminate the possibility of breastfeeding from that breast.

Practical Guidance for People Planning Surgery

Discuss your goals with your surgeon. If breastfeeding in the future is important to you, ask which technique they plan to use and how much subareolar tissue they will preserve. Surgeons can often adapt their approach to protect milk ducts and nerves when this is a priority (Kraut et al., 2017).
Consider timing. If surgery is elective and you plan to breastfeed in the near future, you may wish to delay the procedure until after childbearing. If symptoms such as back pain or skin breakdown make waiting impossible, informed decision-making is essential (Koussayer, 2024).
Plan for postpartum lactation support. Even with a favorable surgical technique, early and skilled lactation support improves outcomes. A recent study found that women with previous reduction mammaplasty who received lactation consultant support were more likely to achieve partial or exclusive breastfeeding compared with those who did not (Mao et al., 2024). Connecting with an International Board-Certified Lactation Consultant (IBCLC) during pregnancy can help you prepare.
Know your supplementation options. If milk supply is reduced, strategies such as frequent breast stimulation, pumping, galactagogues (discussed with a healthcare provider), or using a supplemental nursing system (SNS) can help maintain breastfeeding relationships (ACOG, 2021).

The Bottom Line

Breast reduction can affect the ability to breastfeed, but outcomes are not uniform. Preserving subareolar tissue and nipple innervation during surgery significantly increases the chance of breastfeeding success (Kraut et al., 2017; Koussayer, 2024). With advance planning, prenatal counseling, and strong postpartum lactation support, many people with a history of breast reduction are able to provide partial or even exclusive breast milk for their babies (Mao et al., 2024; ACOG, 2021).

If breastfeeding is a priority for you, bring it up early with both your surgeon and obstetric provider. Together, you can develop a plan that gives you the best chance of meeting your breastfeeding goals.

Personal Note

After my own breast reduction, I wasn’t sure if breastfeeding would even be possible. My supply wasn’t always abundant, but with the help of a lactation consultant, I was able to provide breast milk for my baby while also using supplementation when needed. Ultimately due to my surgery I was not able to successfully feed at the breast. I was, however, able to exclusively pump for my son and pumped until he was 20 months old. This experience showed me that breastfeeding isn’t “all or nothing.” Every ounce matters, and the bonding and closeness with my baby were just as meaningful as the milk itself.

References

American College of Obstetricians and Gynecologists (ACOG). (2021). Optimizing Support for Breastfeeding as Part of Obstetric Practice.
Kraut, R. Y., Brown, E., Korownyk, C., Katz, L. S., Vandermeer, B., & Babenko, O. (2017). The impact of breast reduction surgery on breastfeeding: Systematic review of observational studies. Plastic and Reconstructive Surgery, 139(6), 1324–1332.
Koussayer, B. (2024). Breastfeeding ability after reduction mammaplasty: A comprehensive review. Annals of Plastic Surgery.
Mao, S., et al. (2024). Breastfeeding outcomes among women with prior breast reduction surgery: A survey-based study. Breastfeeding Medicine.
American Society of Anesthesiologists. (2024). Statement on Resuming Breastfeeding after Anesthesia.