Silicone Prosthesis and Breastfeeding: What the Media Said

This is one of the most frequently asked questions during augmentation mammoplasty consultations: if I get silicone implants now, will I be able to breastfeed later? The short answer is yes — the vast majority of women with implants breastfeed normally. The long answer involves technical decisions we make during surgery to preserve ducts and innervation.

Why this topic appeared in the media

In 2020 and 2021, with the increase in younger women undergoing augmentation mammoplasty before having children, outlets such as UOL VivaBem, R7 Saúde, Terra, Yahoo Notícias and Bonde contacted Dr. Fernando Amato to clarify what is myth and what is fact about silicone implants and breastfeeding.

Myths that need to die

• "Silicone leaks into milk and contaminates the baby." False. Decades-long follow-up studies do not show increased levels of silicon in breast milk. Silicone baby bottles and infant formulas contain more silicon than this milk.
• "Mothers with implants need to have a C-section." False. There is no relation whatsoever between breast implants and mode of delivery.
• "Those with silicone implants produce less milk." False in most cases. When there is low production, the reason is usually previous mammary hypoplasia (which existed before the surgery), inadequate surgical technique, or breastfeeding management issues.
• "You have to remove the implant before getting pregnant." False. The implant remains in place normally throughout the entire pregnancy and breastfeeding period.

Technical decisions that protect breastfeeding

Incision approach

• Inframammary fold (underneath the breast): preserves ducts and innervation. The scar is hidden by the fold itself. It is the most common approach in our service for young patients.
• Axillary: scar in the armpit, no scar on the breast. Preserves ducts and innervation very well. Has technical limitations when the implant is very large.
• Periareolar (around the areola): higher risk of crossing lactiferous ducts and nerves. Reserved for selected cases, especially when associated with mastopexy.

Implant plane

• Submuscular (behind the pectoral muscle): separates the implant from the gland. Excellent for young women who plan to breastfeed.
• Dual plane: partly covered by muscle, partly by gland. Combines advantages — it is currently the most used plane internationally.
• Subglandular: implant in direct contact with the gland. Technically simpler, but less protective for lactation. Reserved for selected cases.

What scientific evidence shows

Systematic reviews and meta-analyses published in journals such as Plastic and Reconstructive Surgery and Annals of Plastic Surgery indicate that women with implants have breastfeeding rates similar to women without implants when the technique is adequate. When difficulties arise, the periareolar approach and subglandular plane appear as risk factors — confirming the importance of technical choices during surgery.

The FDA (United States) and ANVISA (Brazil) do not contraindicate breastfeeding by mothers with silicone implants. The American Academy of Pediatrics classifies silicone as compatible with breastfeeding.

When low production is NOT due to silicone

• Previous mammary hypoplasia — breast with little glandular tissue from the start.
• Inadequate latch — correctable with a lactation consultant.
• Long intervals between feedings — reduces stimulation.
• Maternal stress, sleep deprivation, and dehydration.
• Early formula supplementation — decreases demand and production.
• Untreated hypothyroidism.

Time between surgery and pregnancy

We recommend at least 12 months between augmentation mammoplasty and a planned pregnancy. This time is necessary for:

• Complete accommodation of the implant in the pocket.
• Stabilization of the pericapsular capsule.
• Full tissue recovery (sensation, innervation).
• Evaluation of the definitive aesthetic result.

What to expect during pregnancy and postpartum

A breast with an implant increases in size and becomes sensitive during pregnancy — exactly like a breast without an implant. After weaning, the gland involutes, and the breast usually "empties," potentially appearing more flaccid. Some women opt for a mastopexy (lift) years later — but this is independent of the implant and also happens in women without implants.

Warning signs in the postoperative period

• Persistent nipple sensation loss beyond 6 months.
• Painful hardening of the breast (suspected capsular contracture).
• Progressive asymmetry.
• Recent change in shape in an already stable patient.

Press coverage

This set of guidelines was presented in articles in UOL VivaBem (2021), R7 Saúde (2021), Terra (2020), Yahoo Notícias (2021) and Bonde (2020). The message has always been the same: silicone and breastfeeding are compatible when the surgery is well-planned — the technical decision makes the difference, not the existence of the implant itself.

Frequently asked questions

Can someone with silicone implants breastfeed?

Yes — the vast majority breastfeed normally. Studies show similar breastfeeding rates between women with and without implants when the surgical technique is appropriate. Lactation capacity depends on the integrity of the ducts and innervation, not the presence of the implant.

Does silicone pass into breast milk?

Not in significant amounts. Studies with mothers breastfeeding for decades (including FDA investigations and systematic reviews) have not shown increased levels of silicon in breast milk from women with implants compared to women without implants. In fact, infant formulas and silicone bottles contain more silicon than the milk of a mother with an implant.

Is there a risk to the baby?

There is no evidence of risk. Research following babies breastfed by mothers with implants — some with over 20 years of follow-up — found no increase in digestive, respiratory, autoimmune, or developmental problems. Pediatricians and the American Academy of Pediatrics do not contraindicate breastfeeding by mothers with implants.

Which incision approach best preserves breastfeeding?

The inframammary fold approach (under the breast) and the axillary approach (armpit) better preserve the lactiferous ducts and nipple innervation. The periareolar approach (around the areola) has a higher chance of affecting ducts and sensitivity, although it is well indicated in selected cases. The choice is technical and individualized.

Submuscular or subglandular plane — which is better for breastfeeding?

The submuscular plane (behind the pectoral muscle) distances the prosthesis from the mammary gland and tends to better preserve lactation function. The subglandular plane (between the gland and the muscle) is technically simpler but is in direct contact with the gland. For young women planning to have children, we usually prefer the submuscular or dual plane.

How long should one wait between surgery and pregnancy?

We recommend at least 12 months between surgery and a planned pregnancy — the time needed for complete accommodation of the prosthesis, capsule stabilization, and full recovery of tissues. Becoming pregnant sooner poses no risk to the baby but may compromise the final aesthetic result of the surgery.

Does a breast with an implant change during pregnancy and breastfeeding?

Yes — exactly like breasts without implants. They increase in volume, become more sensitive, and may develop stretch marks. After weaning, the gland involutes, and the breast usually appears more 'emptied' than before. Some women need a mastopexy (lift) years later, but this is independent of the implant.

I have an implant and my milk supply is low — is it because of the implant?

Rarely. More common causes of low production: improper latch, long intervals between feedings, stress, early formula supplementation, true mammary hypoplasia (which existed before surgery). Seek a lactation consultant or pediatrician before blaming the implant. When the surgery was performed using an adequate technique, it is rarely the cause.