Factors associated to breast implants and breastfeeding

Marcacine, Karla Oliveira; Abuchaim, Erika de Sá Vieira; Coca, Kelly Pereira; Abrão, Ana Cristina Freitas de Vilhena

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Revista da Escola de Enfermagem da USP

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Sumário

ORIGINAL ARTICLE • Rev. esc. enferm. USP 52 • 2018 • https://doi.org/10.1590/S1980-220X2017037803363 copy

Factors associated to breast implants and breastfeeding ^* * Extracted from the thesis: “A mamoplastia de aumento e a prática do aleitamento materno”, Universidade Federal de São Paulo, Escola Paulista de Enfermagem, 2017.

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective

To analyze the association between the surgical characteristics of breast implants, time elapsed since surgery, access route, implant placement and implanted volume and variables related to breastfeeding, type, first ‘milk let-down’, breast engorgement, pain, lesion, milk production and use of galactagogues.

Method

A prospective cohort carried out during the hospital stay (12 to 72 hours after delivery), home care (5^thto 7^thday after delivery) and telephone contact (between the 30^thand 32^ndday postpartum) of 115 postpartum women with breast implants between 2015 and 2017.

Results

The first evaluation identified more frequent use of oral galactagogues (p=0.029) by puerperal women with prepectoral implants, and of oxytocin spray by those with implants up to 270 ml (p=0.040). The second evaluation showed a higher pain score among those with prepectoral implants (p=0.046). Around the 30^thday postpartum, the presence of nipple lesion (p=0.021), pain (p=0.025) and a higher pain score (p=0.039) was more frequent among those with mammoplasty performed less than 10 years ago.

Conclusion

The presence of pain and a higher pain score, the occurrence of lesion and the use of oral and nasal galactagogues were associated with implant placement, implant size and time elapsed since surgery.

Breast Feeding; Mammaplasty; Breast Implantation; Obstetric Nursing

GROUPS	n	12 to 72 hours after delivery Type of breastfeeding (%)			n	5^thto 7^thday after delivery Type of breastfeeding (%)			n	30^thto 32^ndday after delivery Type of breastfeeding (%)

		Exclusive	Not exclusive	P-value		Exclusive	Not exclusive	P-value		Exclusive	Not exclusive	P-value
Time elapsed since surgery
≤10 years	86	93.0	7.0	0.269	62	77.4	22.6	0.999	66	59.0	41.0	0.999
>10 years	29	86.2	13.8		21	81.0	19.0		22	59.1	40.9
Access route
Periareolar	13	100.0	0.0	0.591	8	100.0	0.0	0.193	10	60.0	40.0	0.999
Inframammary	90	92.2	7.8		65	77.0	23.0		68	60.3	39.7
Implant placement
Prepectoral	60	96.7	3.3	0.076	43	81.4	18.6	0.418	47	55.3	44.7	0.658
Retro-pectoral	50	86.0	14.0		35	71.4	28.6		36	61.1	38.9
Implanted volume
≤270mL	48	93.7	6.3	0.717	37	83.8	16.2	0.254	39	61.5	38.5	0.482
>270mL	52	90.4	9.6		33	69.7	30.3		35	51.4	48.6

Population analyzed	n	Period of occurrence of the ‘milk let-down’ (%)			Breast engorgement (%)			Milk production (Mean ± SD*)

		Between the 2^nd/3^rddpp	After the 4^thdpp	P-value	Yes	No	P-value	Right breast	P-value	Left breast	P-value
Time elapsed since surgery
≤10 years	62	54.9	45.1	0.209	27.4	72.6	0.276	27.4±24.0	0.375	28.8±23.8	0.741
>10 years	21	71.4	28.6		42.9	57.1		20.1±12.6		28.1±19.4
Access route
Periareolar	8	25.0	75.0	0.065	37.5	62.5	0.682	32.6±41.1	0.979	31.7±34.6	0.999
Inframammary	65	61.5	38.5		27.7	72.3		24.3±19.8		27.4±22.5
Implant placement
Prepectoral	43	65.2	34.8	0.253	32.6	67.4	0.999	26±21	0.429	29.9±23.7	0.487
Retro-pectoral	35	51.4	48.6		31.4	68.6		24.2±24.2		26.4±22.9
Implanted volume
≤270mL	37	67.6	32.4	0.224	35.1	64.9	0.434	28.2±25.7	0.194	31.5±26.5	0.307
>270mL	33	51.5	48.5		24.3	75.7		22.1±19.1		23.3±17.4

Population analyzed	n	12 to 72 hours after delivery			n	5^thto 7^thday after delivery			n	30^thto 32^ndday after delivery

		Yes	No	P-value		Yes	No	P-value		Yes	No	P-value
USE OF OXYTOCIN SPRAY (%)

Time elapsed since surgery
≤10 years	86	28	72	0.811	62	30.7	69.3	0.166	66	3	97	0.097
>10 years	29	24.1	75.9		21	14.3	85.7		22	13.7	86.3
Access route
Periareolar	13	38.5	61.5	0.296	8	37.5	62.5	0.378	10	10	90	0.429
Inframammary	90	22.2	77.8		65	21.5	78.5		68	4.4	95.6
Implant placement
Prepectoral	60	26.7	73.3	0.999	43	20.1	79	0.311	47	2.1	97.9	0.576
Retro-pectoral	50	28	72		35	31.4	68.6		36	5.6	94.4
Implanted volume
≤270mL	48	25	75	0.656	37	19	81	0.04	39	7.7	92.3	0.617
>270mL	52	30.7	69.3		33	42.4	57.6		35	2.9	97.1

USE OF ORAL GALACTAGOGUES (%)

Time elapsed since surgery
≤10 years	86	10.5	89.5	0.448	62	19.3	80.7	0.168	66	40.9	59.1	0.804
>10 years	29	3.4	96.6		21	4.8	95.2		22	36.4	63.6
Access route
Periareolar	13	0	100	0.591	8	0	100	0.586	10	20	80	0.307
Inframammary	90	8.9	91.1		65	12.3	87.7		68	39.7	60.3
Implant placement
Prepectoral	60	8.3	91.7	0.999	43	7	93	0.029	47	34	66	0.37
Retro-pectoral	50	10	90		35	25.7	74.3		36	44.4	55.6
Implanted volume
≤270mL	48	10.4	89.6	0.734	37	16.2	83.8	0.76	39	41	59	0.999
>270mL	52	7.7	92.3		33	21.2	78.8		35	42.9	57.1

Population analyzed	n	12 to 72 hours after delivery			n	5^thto 7^thday after delivery			n	30^thto 32^ndday after delivery

		Yes	No	P-value		Yes	No	P-value		Yes	No	P-value
USE OF OXYTOCIN SPRAY (%)

Time elapsed since surgery
≤10 years	86	39.5	60.5	0.508	62	66.1	33.9	0.999	66	19.7	80.3	0.025
>10 years	29	31.0	69.0		21	66.7	33.3		22	45.4	54.6
Access route
Periareolar	13	53.9	46.1	0.232	8	75.0	25.0	0.999	10	30.0	70.0	0.689
Inframammary	90	35.6	64.4		65	67.7	32.3		68	22.1	77.9
Implant placement
Prepectoral	60	35.0	65.0	0.843	43	72.1	27.9	0.232	47	29.8	70.2	0.319
Retro-pectoral	50	38.0	62.0		35	57.1	42.9		36	19.4	80.6
Implanted volume
≤270mL	48	33.3	66.7	0.308	37	73.0	27.0	0.315	39	23.1	76.9	0.445
>270mL	52	44.3	55.7		33	60.6	39.4		35	31.4	68.6

NIPPLE LESION (%)

Time elapsed since surgery
≤10 years	86	46.5	53.5	0.286	62	83.9	16.1	0.514	66	18.1	81.9	0.021
>10 years	29	34.5	65.5		21	76.2	23.8		22	45.4	54.6
Access route
Periareolar	13	69.2	30.8	0.071	8	75.0	25.0	0.611	10	30.0	70.0	0.682
Inframammary	90	40.0	60.0		65	84.6	15.4		68	20.6	79.4
Implant placement
Prepectoral	60	41.7	58.3	0.848	43	83.7	16.3	0.567	47	27.6	72.4	0.445
Retro-pectoral	50	44.0	56.0		35	77.1	22.9		36	19.4	80.6
Implanted volume
≤270mL	48	43.7	56.3	0.554	37	83.8	16.2	0.760	39	20.5	79.5	0.302
>270mL	52	50.0	50.0		33	78.8	21.2		35	31.4	68.6

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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[1] Corresponding author: Karla Oliveira Marcacine. Rua Correia de Lemos, 571 – Apto. 84, Chácara Inglesa CEP 04140-000 – São Paulo, SP, Brazil ka_marcacine@yahoo.com.br

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Factors associated to breast implants and breastfeeding * * Extracted from the thesis: “A mamoplastia de aumento e a prática do aleitamento materno”, Universidade Federal de São Paulo, Escola Paulista de Enfermagem, 2017.

ABSTRACT

Objective

Method

Results

Conclusion

Factors associated to breast implants and breastfeeding ^* * Extracted from the thesis: “A mamoplastia de aumento e a prática do aleitamento materno”, Universidade Federal de São Paulo, Escola Paulista de Enfermagem, 2017.