Which type of breast surgery poses the greatest risk to breastfeeding success?

Free nipple graft surgery poses the greatest risk to breastfeeding success primarily due to the extensive alteration of the breast's anatomy and the potential damage to nerves and milk ducts. In this procedure, the nipple is completely detached from its original location and replanted, which can significantly disrupt the neural pathways necessary for breastfeeding. This surgery may sever important structures that facilitate the let-down reflex and the overall milk supply, making it challenging or impossible for the mother to breastfeed successfully afterward.

In contrast, breast augmentation generally involves the placement of implants without significant alteration to the tissue and milk ducts, which can allow for normal breastfeeding in many cases. Breast reduction surgery, while it involves the removal of breast tissue, is designed to preserve milk ducts and nerves whenever possible, making successful breastfeeding feasible for some women. A biopsy, being a minor procedure that usually affects only a small area of tissue, typically has minimal impact on breastfeeding capabilities. Therefore, while all surgeries can pose some risks, the free nipple graft surgery is particularly concerning regarding the ability to breastfeed effectively.