When are internal bra sutures worth it in a lift? Will they make results look better or last longer?

The debate rages on as to whether dermal bra or other autoaugmentation techniques are worth performing. To be clear, I am on the "it is worth it"side of things. But I do not think it works for all people. When one lifts the internal issue, the surgeon requires an anchor point higher on the chest and also something strong to put sutures into on the tissue lower in order to elevate the internal tissue of the breast rather than just rely on the skin alone. Breasts are mostly fibrous tissue and fat tissue underneath the skin. The ratio varies significantly from one woman to another. The milk ducts and other ligaments within the breasts are strong but fat is not very strong and sutures can pull through. Also, the higher anchor point to put internal stitches relies on the covering of the pectoralis muscle which can vary in strength. Your surgeon will evaluate and try to determine although it is not always possible how much fibrous tissue is under the skin of your breast. In the dermal bra technique, skin with the epidermis removed is used to create a hammock to elevate the breast tissue. This is relatively strong. With proper postoperative care, patienst with strong tissue seems to show long-lasting results. I have a number of patients that are five or 10 years out from surgery who are still maintaining a much better shape than what I would have obtained without the dermal bra technique. This week I performed two of these procedures. One woman had very good fibrous tissue in her breasts and the other had a breast that was mostly fatty tissue. I have high hopes for the first patient. Not all surgeons agree and some feel it is a waste of time to perform this sub technique. I disagree with that and believe it helps approximately two thirds of women that I see in my practice.

Dear JeninATL,
my preferred lift is a lollipop lift when a periareolar won't do (ie greater than 2cm lift required). The lollipop technique was created by a Canadian plastic surgeon named Elizabeth Hall-Findley and treats the breast as a three dimensional structure instead of two dimensions (anchor - lift). Most importantly it does not require the horizontal component scars that the anchor-lift requires and breasts appear much more natural, lifted, and less boxy. Lastly, the lift lasts longer because the lollipop doesn't rely on the skin to hold the breast up, its actually breast tissue thats being brought together to support the breast and hence improves longevity. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

The technique I recommend is The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Hello @JeninATL, thank you for your question. The use of internal bra sutures depends on the surgical technique of the surgeon that performs the procedure. It is important to remember that in your surgical plan there are a variety of possibilities that take into account your expectations and what is possible to achieve. For more information and recommendations, it is prudent to consult with one or several board certified plastic surgeons. Best wishes! Alan Gonzalez MD, FACS. American Society of Plastic Surgery Member (ASPS), International Federation for Adipose Therapeutics and Science” Member (IFATS), Colombian Society of Plastic Surgery member (SCCP)

All breast lifts use internal sutures to help hold and shape the breasts. A skin only lift does not hold well. Sometimes, mesh is added for more inferior support until the tissues heal well.

Hello there! I hope you are doing well.As a plastic surgeon, I perform multiple breast lifts and reductions. I use the internal bra reinforcement in cases where they already had surgery and the breasts or implants dropped lower to the inframammary fold (the junction of the breast and abdomen) in order to reinforce or recreate the fold. In my opinion, I would need to examine you but based on your pictures, I believe you will have a great result with a breast lift and the internal bra is not necessary in your case.