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Some women actually do have legitimate problems with their big breasts. They can never find affordable bras that fit well, they get back aches from carrying around all that weight, they cannot sleep on their stomachs, they cannot run because it hurts, and to top it all off they keep meeting people who insist on talking to their bosom instead of to their faces.

This seems plenty of reason to have a breast reduction done.

Breast reduction surgery can significantly impact a woman's ability to breastfeed. Few doctors are specific about this when discussing the surgery. They often say "you may be able to breastfeed" or "you should be able to breastfeed" without really understanding that "breastfeed" is an ambiguous word. Do they mean some milk will be available for the future baby (yes, some usually is) or do they mean enough milk will be available for the baby to breastfeed exclusively for about the first 6 months of life and to continue to breastfeed with additional complementary solid foods afterwards until the child is least a year old (as recommended by the AAP(American Academy of Pediatrics)? Despite improved technigues that leave an attached pedicle of tissue connected to the nipple the ability to exclusively breastfeeding after reduction is rare.

The surgical scar is the shape of an anchor; it surrounds the areola, goes down the middle of the underside of the breast and inserts into a big "U" in the inframammary fold. The areola is often very flat. The nipple shape is sometimes distorted. Some women form keloid scars or hypertrophic scars and for them the scars may be quite obvious, for others they will fade over time but not dissapear completely.

As a lactation consultant I've helped 20 - 30 women post breast reduction surgery. Only one was able to breastfeed exclusively. Almost all were able to breastfeed with some degree of formula supplementation. Problems arose from more than one source. Severed ducts, nerve damage and loss of glandular tissue all contribute to potential problems. It is hard to isolate the cause. It can be very discouraging to have to supplement while breastfeeding and some women just elect to totally bottle feed. Many women I've worked with have expressed regrets, they said they wished they had not had the surgery so young or at all. Many others have said they wish they could fully breastfeed BUT the procedure was still worth it to them. There are truely compelling physical and psychological reasons for the surgery for some women.

There is a web page http://www.BFAR.org for women who are breastfeeding after reduction. If you are thinking about this procedure and you may have children in the future please educate yourself thoroughly before proceeding. Read this web page, consider buying the book "Defining Your Own Success: Breastfeeding After Breast Reduction Surgery"; by Diana West. Give some thought to waiting until after you finish having children before having the surgery.

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