Pocket Exchange + Internal Bra Instead of a Lift? (Photos)

Question

I’m 28 years old and had 500 cc breast implants placed under the muscle about 7 years ago. At the time, I was overweight, but I’ve since lost a significant amount of weight. Now my biggest concern is that my implants seem to fall toward my armpits when I lie down, and I have very little upper-pole fullness or cleavage. I would really like a fuller, more lifted appearance. I had a consultation with a plastic surgeon today. He does not recommend a breast lift because I plan on having children in the future. Instead, he recommends: * Converting my implants from under the muscle to over the muscle * Performing a pocket exchange * Using GalaFLEX as an internal bra for support * Increasing my implant size My question is: Do you think this approach is likely to improve the position of my breasts and keep them from drifting into my armpits, or is a breast lift ultimately the better solution? I’d especially appreciate hearing from plastic surgeons who have experience with GalaFLEX/internal bras and revision augmentation. If you were my surgeon, what would you recommend and why?

Yasemin Aydinli, MD · Answer

Thank you for sharing such a detailed history. The approach your surgeon described, a pocket revision with a GalaFLEX internal bra, converting to over the muscle and increasing size, is a recognized way to reposition implants and restore upper-pole fullness. I do want to be honest with you about a couple of concerns. A larger implant placed over the muscle carries a real risk of stretching the tissues and causing sagging over time, because the added weight gradually pulls everything downward, so a bigger implant can actually work against the lifted, fuller look you are hoping for. From what you describe, the distance from your nipple to your inframammary fold is quite long, and to me that suggests a breast lift would in fact be the more ideal way to genuinely improve the position of your breasts, rather than relying on an implant and internal bra alone. The reason a lift is being avoided is your plan to have children, which is a fair point to weigh. The key issue here is breastfeeding. A lift does carry some risk of reduced or lost ability to breastfeed; it is not a 100 percent risk, but it is real. So my honest advice is this: if breastfeeding is very important to you, I would not pursue a lift now, and I would postpone the definitive surgery until after you have completed your family. If breastfeeding is not a priority for you, a lift would likely give you a better and longer-lasting result than a large over-muscle implant with an internal bra.

Pocket Exchange + Internal Bra Instead of a Lift? (Photos)

Answers (1)

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