Breastfeeding and ptosis: Study results

The joys of motherhood are many, and many women include in that category the satisfaction of breastfeeding their infants. It's too bad that breastfeeding — which has so many proven benefits — takes such an aesthetic toll on the mothers' breasts. Or does it? Some recent research seems to put that concept pretty firmly in the "old wives' tales" camp with results that disprove the theory that breastfeeding has negative aesthetic consequences.

Brian Rinker, M.D., F.A.C.S., associate professor of plastic surgery, University of Kentucky, Lexington, wanted definitive answers.

"Many patients would blame adverse changes in breast shape or size to breastfeeding. This prompted me to wonder whether or not there was a link between breastfeeding and changes in breast appearance after pregnancy," Dr. Rinker tells Cosmetic Surgery Times .

THEORY MEETS DATA Dr. Rinker notes that several international health organizations have conducted surveys which illustrate that women's concerns about changes to the physical appearance of the breasts is a chief reason why women worldwide elect not to breastfeed. "It may be even higher," he speculates, "because, as the investigators point out, many women may be reluctant to admit that that is the true reason. This notion is extremely pervasive and crosses cultural and socioeconomic boundaries." And although he says that pediatricians and groups that promote breastfeeding are very adamant that breastfeeding does not change the appearance of the breasts, surveys have shown that mothers felt their breasts changed after pregnancy — and not favorably.

In Dr. Rinker's study, researchers took a detailed medical history, including history of pregnancies and breastfeeding, from the patients via telephone. They then analyzed standardized pictures of the patients to correlate degree of breast ptosis with factors in the patients' histories. Their conclusion was that, based on the data, breastfeeding had no correlation to subsequent breast ptosis. What was positively influential, rather, were the number of pregnancies (the more pregnancies, the greater likelihood of ptosis), higher age, higher body mass index, larger pre-pregnancy bra size and smoking.

"I think most women are surprised to hear that breastfeeding isn't related to subsequent ptosis," says Dr. Rinker. "Some don't believe it! And that's fine. I'm not trying to change anyone's mind, just make sure they have all the data to make the most informed decision they can."

Edward Pechter, M.D., F.A.C.S., a Valencia, Calif., plastic surgeon and assistant clinical professor of plastic surgery at University of California, Los Angeles, believes that this study is an important first step in educating women — and physicians — about the relationship between breastfeeding and breast aesthetics.

"It's not uncommon for women seeking mastopexy with or without augmentation to state, 'I breastfed my children and they sucked the life out of my breasts.' So there's clearly a perception among women that breast feeding adversely affects breast shape and volume," Dr. Pechter says. "The benefits of breastfeeding probably outweigh any considerations about its effect on ptosis," he notes, "But if it can be proven that breastfeeding doesn't cause ptosis, it will give reassurance to those women for whom concerns about sagging keep them from breastfeeding."

Dr. Pechter also believes that tangentially, if smoking can be proven to be a cause of breast ptosis, this may give smokers an additional reason to kick their nicotine habits.