There is a section called "Breast Pumps and Massage" that has a lot of info on that and pictures. I have used a product called "supple nips" but I do not use it often. I have small breasts and I want to keep them small as I am not completely out. I do not want to have to hide them. If you "should" be pumping or using suction is a question that you will have to answer. I can only speak from what I read, but my guess is yes, it does cause enlargement that is permanent over time. Hope that helps.