Breastfeeding and breast sagging, shape

Findings from a study published in the September/October 2008 issue of the Aesthetic Surgery Journal show that, contrary to popular belief, breastfeeding is not a likely cause of post-pregnancy drooping of the breasts.

As a growing number of women turn to plastic surgeons to counteract the effects of pregnancy on their bodies, one common postpartum complaint is sagging breasts, also known as breast ptosis, which many believe to be linked to breastfeeding.

However, as this new study demonstrates, it appears that other factors, including older age, higher body mass index (BMI) and a history of smoking, are responsible for the breast sagging experienced by some women after pregnancy.

"It is widely assumed that breastfeeding will adversely affect the appearance of the breasts, and this has been a major reason cited by women who choose not to breastfeed," said Brian Rinker, MD, a plastic surgeon in Lexington, Kentucky and lead author of the study. "However, there has been very little objective data to support or deny that this is, in fact, the case. With this study, we hope to shed some light on the subject and correct any misconceptions."

The current study set out to identify risk factors for the development of breast ptosis and to determine if there is a correlation between breastfeeding and breast aesthetics using data from 93 patients who had sought aesthetic breast surgery between 1998 and 2006. All patients had a history of at least one pregnancy. The degree of breast ptosis was determined from preoperative photographs in the patient's medical charts, and ranked on a scale from zero to three. Each patient was interviewed and medical charts were reviewed to collect information on potential risk factors for breast ptosis, including age, number of pregnancies, history of breastfeeding, duration of breastfeeding, BMI, pre-pregnancy bra cup size, history of smoking and amount of weight gain during pregnancy.

Fifty-four of the patients (58%) studied had a history of breastfeeding one or more children; 39 patients did not breastfeed. Weight gain during pregnancy across both groups ranged from five to 45 kilograms and 39% reported a history of smoking. Fifty-one respondents described an adverse change in breast shape following pregnancy. BMI and weight gain during pregnancy were both significantly higher in the non-breastfeeding group.

Analysis of this information showed that greater age, higher BMI, greater number of pregnancies, larger prepregnancy bra cup size, and history of smoking were all significant risk factors in the development of sagging breasts. Breastfeeding, however, was not -- even as duration of breastfeeding increased.

"Patients need to be armed with objective data rather than broad assumptions when making important health decisions," said Alan H. Gold, MD, President of ASAPS. "While further study in larger numbers of patients is necessary to assess the effects of breastfeeding on the breasts versus other factors, this study is a good start in providing information for those who are concerned about the potential aesthetic effect of breastfeeding and is consistent with our ideal of practicing evidence-based medicine."