What is the risk of complications from not using an internal bra after previous implants, lifts and weight loss?

Question

I am wondering if you can give me an idea of what the chances of a complication from not using an internal bra if you have previously had an augmentation with a lift then later had implants removed and a minor lift done then as well. Additionally I am 58 years old and recently lost over 80 pounds. I know the chances of my skin being able to support new implants is not great but just how much of a risk am I taking?

Brian K. Reedy, MD · Answer

Hello, thank you for your question! You're asking a very important and nuanced question, and it's great that you're thinking about long-term outcomes and risks.  An “internal bra” (usually using a surgical mesh like GalaFLEX or DuraSorb, or suturing techniques) acts like a scaffold, giving your implants something to “sit on” besides just skin.  It reduces stress on the skin envelope, prevents implants from drifting downward or outward, improves upper pole fullness and longevity of results.  Given your age, weight loss, and surgical history, going without an internal bra raises your complication and revision risk substantially—you are likely in a high-risk group. You could proceed without one, but only if you're using small, light implants and your surgeon sees excellent tissue quality during surgery. However, most experienced plastic surgeons would strongly recommend some form of internal support in your case. Best of luck!

Daniel Barrett, MD · Answer

Dear 81818181,

I understand your concern. It is best that you consult your plastic surgeon regarding post operative care and management (i.e including massage techniques and timing) specific to your case. Your surgeon knows your condition well and has preferences on when and what to use for faster healing and recovery. Post operative care and management depends on the type of surgery performed and the technique used during surgery among other factors.
It is best, however, that you follow your plastic surgeon's advice on post operative care management for a smooth and faster healing and recovery.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Gary M. Horndeski, MD · Answer

Unfortunately, you have not provided photographs or told us your bra size. However, if you have recently lost 80 lbs. then you will need a proper lift. The breast lift 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.

Best Wishes,

Gary Horndeski, M.D.

Ted Eisenberg, DO, FACOS, FAACS · Answer

An in person evaluation is appropriate to provide a more complete answer and guidance to your question. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Camille Cash, MD · Answer

The risk of complications of not having mesh support really depends on the elasticity of your skin and the size implants you are considering. The larger the implants and the poorer the degree of elasticity the higher the risk of complications.  For those with poor elasticity and large implants the mesh may not even be enough.  An in person evaluation is needed to determine what is right for you.

Mats Hagstrom, MD (license on probation) · Answer

When it comes to risk it’s not a black or white topic.
Getting a perfect outcome is unlikely.
Without seeing before and after pictures of your previous procedures, we can’t begin to make an assessment.
Sometimes using internal mesh is appropriate and can help and sometimes it’s not needed.
By far the most important variable is provider selection.
I generally don’t recommend people have their implants removed if they Are going to want augmentation later in life.
Each time someone has a procedure the chance of having a final quality outcome goes down.
With each previous breast procedure things become more complex and difficult.
I don’t think anyone can give you accurate numbers.
Best,
Mats Hagstrom MD

What is the risk of complications from not using an internal bra after previous implants, lifts and weight loss?

Answers (6)

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