How does breastfeeding affect breasts?
The question of whether and how breastfeeding can affect the appearance of women’s breasts has been reanimated lately, due to discussions on social media.
In particular, the actress Helen Flanagan recently posted on Instagram about her breast augmentation. She said it helped boost her confidence after she felt her breasts sagged post-breastfeeding her three kids.
Significantly, research suggests that breastfeeding alone is unlikely to cause breast sagging, but changes during pregnancy, and due to ageing, can change breast appearance.
“In 2007, a joint UK and US study by plastic surgeons investigated whether breastfeeding caused breasts to sag as it was such a common complaint in breast uplift or breast augmentation consultations,” explains Mr Mark Ho-Asjoe, a breast augmentation surgeon at the leading London cosmetic surgery Karidis.
“Women wanting a breast lift or augmentation were interviewed for the study, and the researchers also assessed their medical history, body mass index, pre-pregnancy bra cup size, and whether they smoked or not. No difference in the degree of breast ptosis was found between those women who had breastfed and those who hadn’t.” Instead, it was “other factors, particularly age and whether the patient smoked that affected breast sagging."
Specifically, "ageing is typically the most common cause of breast sagging; the ligaments in the breast stretch and lose elasticity over time. This process is often sped up due to hormonal changes that occur at the time of menopause,” outlines Ho-Asjoe. “Smoking also affects breast sagging because harmful chemicals in cigarettes cause elastin to break down in the body, and its elastin that gives skin its support and elasticity. UV rays can also cause loss of elastin.”
Despite lifestyle factors and age seemingly being the most important factors in breast sagging, increased discussions about pregnancy’s effect on breast appearance are still inviting questions from clients around augmentation. For that reason, in-clinic education about how pregnancy can change the female body, especially the breasts, is increasingly important.
"Pregnancy and childbirth are nothing short of miraculous, but it is also true that they can have such a massive impact on a woman’s body that many new mothers do not feel they recognise themselves or feel comfortable with their new appearance,” reveals Ho-Asjoe. “The tummy is a key concern as the muscles and skin stretch to accommodate the growing womb, but many women often see less than welcome changes to their breasts during pregnancy, which is then compounded if they breastfeed their baby."
"After weaning, you may think that your breasts look different than before in terms of size, shape and even appearance,” Ho-Asjoe explains. This can also include the size, shape and position of the nipples. “The changes aren’t necessarily a result of breastfeeding but will have been taking place since the very early stages of your pregnancy, and even women that do not breastfeed may feel their breasts have changed.”
Hormonal changes are often the cause of these breast changes and these hormone fluctuations continue during the immediate post-birth period: “As soon as you conceive, the production of pregnancy hormones such as oestrogen and progesterone starts to increase,” explains Ho-Asjoe. “These hormones cause more fatty tissue to build up and boost blood flow to the breasts in preparation for feeding your baby after birth. The hormone relaxin is also released from the start of your pregnancy which helps your ligaments to stretch. This allows the pelvis to expand during childbirth and also affects breast tissue. In the immediate postpartum period, mothers typically experience engorgement as their body prepares itself for lactation and, if they continue breastfeeding, the breasts feel full and then empty during feedings."
These changes may also emphasise any existing breast asymmetry, meaning individuals notice it for the first time and seek aesthetic correction: "Our bodies are not perfectly symmetrical, and most women have slightly uneven breasts even before pregnancy and breastfeeding, but it’s often the case that they might only notice this lack of symmetry due to the changes to your body,” says Ho-Asjoe. “However, it is also the case that women naturally have more milk ducts and alveoli in one breast – typically the left breast – and you may produce more breast milk on one side."
With this in mind, once clients understand why their breasts may have changed during their pregnancy journey, it is easier to guide them in their options, via lifestyle changes and aesthetic treatment.
"Although there’s nothing you can do about the ageing process, there are certain lifestyle habits that can prevent breasts from sagging,” says Ho-Asjoe. “Avoid smoking and sun damage but maintain a stable weight with a healthy diet and exercise routine, as significant weight fluctuations can cause the breasts to stretch.”
If aesthetic intervention is sought, a breast lift is Ho-Asjoe's recommended option: “During a mastopexy procedure, excess skin will be removed and the tissues in the breast will be tightened, repositioning and reshaping the breasts, so it looks more youthful. The size, shape and position of the nipples can also be addressed, and if women experience loss of fullness in the upper part of the breasts along with sagging, a lift with breast implants may be advisable to create a more aesthetically pleasing breast shape."