Dr. Devgan is featured on Mommybites- Does breastfeeding really ruin your breasts?

September 28, 2013 Lara Devgan, MD

Does breastfeeding really ruin your breasts?

This article was featured in the "Healthy Living" section of national online women's magazine Mommybites.

By Dr. Lara Devgan

Image credit therantsinmypants.wordpress.com

When it comes to feeding your baby, pediatricians and lactation consultants agree: breast is best. Breast milk gives your baby the most optimal mix of nutrients, proteins, fats, and antibodies to help him grow strong and healthy. There is even research that shows that breastfeeding decreases rates of breast cancer in women. So what is there not to love?

Well, in between feedings, diaper changes, and the chaos of childrearing, many women worry about what breastfeeding does to their breasts. Those supple curves that were once the centerpiece of feminine mystique have evolved into a combination of baby restaurant, refrigerator, and bottle warmer. They are engorged then deflated. The nipples are raw. They are covered with stretch marks.

Will they ever be the same again?

Unfortunately, the answer is no. Not completely, at least. Unless you are one of the genetically blessed among us, breastfeeding leads to some of the following physiologic consequences in women:

Ptosis. This is the medical term for drooping. You may notice after breastfeeding one or more babies that your breasts sit lower on your chest wall than they used to. The nipples might point downward. There may be more contact between the skin on the underside of your breasts and the skin of your chest. If you feel that your breasts look better in a bra, when they are supported higher up on your body, this may mean you have ptosis.
Deflation. After breasts go through the process of engorgement and deflation several times a day for weeks or months, they begin to lose their elasticity. This is manifested in the “deflated” look of the top part of the breast. You may notice that your breasts don’t fill your clothes in the same way, or that you don’t have the cleavage you used to have.
Skin changes. With weight changes of pregnancy and lactation, the skin may develop stretch marks. Sometimes these will fade over time, as hormonal levels normalize. Other times they will stay. The skin will also lose some of its elasticity– like a rubber band that is a couple of years old, it may not pop right back into a pre-maternity position.

What can you do to fix that?

Wear a well-fitting and supportive bra at all times, even when you are sleeping.

This will reduce some of the burden on your skin and connective tissue to hold up your breasts. You may need a few different bras for the various stages of pregancy and breastfeeding, when your breast size may fluctuate.

Keep your skin well moisturized.

There isn’t one “magic bullet” stretch mark cream on the market that has been proven to work in all women. However, research does show that using a hypoallergenic lotion to keep your skin hydrated can keep you looking younger. Don’t bother spending a fortune on a pricey department store brand. An unscented body lotion from the drug store will be just fine.

Try to pump or nurse on a somewhat regular schedule.

Keeping your breasts from getting maximally engorged before expectorating the milk can help limit the swing in breast size from one extreme to the other -which in turn reduces some of the tissue damage that can come with breastfeeding.

See your doctor or lactation consultant if you have cracked nipples, bleeding, or warm red breasts.

These can all be signs of a medical problem that needs to be addressed right away.

And what about after you wean your baby?

If you have stopped breastfeeding and you are unhappy with the way your breasts look, there are many options for a “mommy makeover” of your chest. These include a breast lift, breast augmentation (implants), a breast lift with implants, and a breast reduction.

Plastic surgery on your breasts is not recommended if you have breastfed in the previous six months. If you are over 40 or you have a personal or family history of breast or ovarian cancer, you will probably need a mammogram before having any kind of breast surgery. And of course, medical advice is best given by a well-trained plastic surgeon who has actually examined you and seen you as a patient.

The good news is that cosmetic breast surgery is quite safe, extremely common, and makes many women very happy. Breast implants are one of the most commonly performed plastic surgery procedures in America, and they are safe for future breastfeeding if you decide to have more kids later. Moreover, they have not been shown to delay the detection of breast cancer, which is something that women are sometimes afraid of.

If you think cosmetic breast surgery may be right for you, talk to your plastic surgeon.

Click to read Dr. Devgan's article on Mommybites

Try our new breast implant simulator

September 27, 2013 Lara Devgan, MD

If you think you might be interested in breast augmentation, this simulator is a great way to get a sense of how your unique body type might look after surgery. Adjust the settings to get a better idea of what Dr. Devgan can help you achieve.

For more information on breast augmentation you can also watch our tutorial video.

Click here to visit our Breast Augmenation page.

What every woman needs to know about breast health

September 21, 2013 Lara Devgan, MD

by Dr. Lara Devgan

Featured on Mind Body Green, a boutique online health and wellness magazine that has been featured in The New York Times and Vogue.

Breasts are part of girlhood and womanhood. They give us happiness, anxiety, pleasure, and discomfort. They make us feel sexy or athletic or insecure. Or maybe we don't think about them at all.

Regardless of your relationship with your breasts, one thing is certain: they cannot be ignored.

More than 1 in 8 American women will get breast cancer over the course of their lives. Statistically, this means that someone in your group of friends from high school or college is likely to battle breast cancer, so it's useful to educate yourself on the facts and myths surrounding this challenging disease.

THE MYTHS

Breast cancer is just an "old woman's" disease.

In my practice, I've treated women as young as their 20s who had breast lumps and masses.

It's just a Caucasian disease.

In fact, many minority women are under-diagnosed and under-treated for breast cancer. It is not just a familial disease; even if your mom and sisters are healthy, you may still develop breast cancer.

It's just a woman's disease.

Even men can develop breast cancer.

THE FACTS

Here is what breast cancer IS: it's a treatable, survivable condition for many people. Breast cancer treatments have improved dramatically, and breast reconstruction looks more beautiful and natural than ever. Breast conditions are real medical problems, and they're covered by health insurance. Breast cancer is a hurdle that can be climbed, but if it is ignored, it can kill you.

THE TIPS

What can you do to "be your breast self?"

1. Perform monthly breast self-exams.

According to Johns Hopkins Medical Centers, 40% of diagnosed breast cancers are first picked up by women who feel a lump, so doing regular breast self exams is extremely important. To do a breast self-exam, take off your shirt and bra, and use the pads of your fingers to feel every portion of your breast, first in a standing position, then in a lying down position.

Use a circular motion to press on your entire breast, including your collarbone, armpit, nipples, and the breast itself. Move from the top down, and from the outside to the inside, pressing with soft, medium, and firm pressure. Squeeze the nipple. If you notice any type of lump, swelling, dimpling, skin changes, nipple discharge, or new pain that doesn't go away, see a doctor who specializes in breasts.

2. Get screening mammograms.

In 2009, the U.S. Preventative Services Task Force recommended that all women get screening mammograms starting at age 50 and every 2 years thereafter. Some doctors want their patients tested earlier, at age 40. If you have a mother or sister with breast cancer, doctors generally recommend you get screened 10 years before that person developed breast cancer. The guidelines for mammograms can be confusing, so my best advice is to discuss this with your doctor.

3. Consider giving back to charities that support women's health.

Even if it's just a few dollars a year or a few hours spent volunteering, giving back to breast cancer charities supports breast cancer research and education.

4. See a breast specialist.

When in doubt, see a doctor or surgeon who specializes in the breasts. No question or concern is too trivial. Your health is too important to ignore subtle signals your body may be sending you. As breast cancer advocates often say, you only have two breasts and one life.

5. Share the wealth.

Don't be embarrassed to talk openly about breast cancer and breast health. Encourage the women in your life to educate themselves about screening, warning signs, and treatment. If you share this with eight women, chances are that you may help one of them battle breast cancer.

Click to read Dr. Devgan's piece on Mind Body Green

Dr. Devgan is featured on The Doctor Blog- Breast Cancer

September 7, 2013 Lara Devgan, MD

Dr. Devgan was an invited contributor to The Doctor Blog by ZocDoc, a critically acclaimed service for finding healthcare professionals that serves over 2.5 million people.

In this piece, Dr. Devgan discusses her impressions of the disparities in breast cancer (and breast cancer reconstruction) in different racial and ethnic groups.