The effect of breastfeeding on breast aesthetics.

BACKGROUND The health benefits of breast milk for infants are well documented, but breastfeeding is avoided by many women because of concerns about a negative effect upon breast appearance. However, there is very little objective data to either support or refute this view. OBJECTIVE The purpose of this study is to identify risk factors for the development of breast ptosis after pregnancy and to determine whether breastfeeding has an adverse effect on breast shape. METHODS Charts were reviewed of all patients seeking consultation for aesthetic breast surgery between 1998 and 2006. History of pregnancies, breastfeeding, and weight gain were obtained via telephone interview. Degree of breast ptosis was determined from preoperative photos. Nulliparous women were excluded. Logistic regression analysis was performed to identify independent predictors of postpregnancy breast ptosis. RESULTS Ninety-three patients met the study criteria. Fifty-four patients (58%) reported a history of breastfeeding. The mean age at surgery in the breastfeeding group was 41 years, compared to 37 years in the nonbreastfeeding group. An adverse change in breast shape following pregnancy was described by 51 respondents (55%). Greater age, higher body mass index, greater number of pregnancies, larger prepregnancy bra size, and smoking were identified as significant independent risk factors for postpregnancy breast ptosis (P < .05). Breastfeeding was not found to be an independent risk factor for ptosis. CONCLUSIONS The risk of breast ptosis increases with each pregnancy, but breastfeeding does not seem to worsen these effects. Expectant mothers should be reassured that breastfeeding does not appear to have an adverse effect upon breast appearance.