Will an internal bra help my breast revision? Cost? (photos)

Question

Am attending consultations with my original ps and I am also getting some other ps opinions. So far I've even told I need a donut lift and internal bra. What is permanent suturing and how much does it cost? My initial BA was about 4,000$ (With a respected RealSelf doctor) but my quoted revision cost was 9,000$ from another well respected doctor. Why is it so much more expensive? Currently 450cc saline mod plus unders 2012 Wanting 650-700 hp saline unders

Richard Baxter, MD · Answer

In general revision surgery is much more complicated than breast augmentation so fees are often quite a bit higher. There is also the cost of new implants and the material used for the internal bra. ADM materials such as Strattice have been in use for a while and have proven success, but newer materials such as SERI Scaffold and GalaFLEX are less expensive. It looks like reaching your goal will involve larger implants but also positioning them higher and closer together. The internal bra will help to maintain that. However the nipple position will probably be too low and lateral after moving the implants higher and closer so the periareolar lift would address that.

Gary M. Horndeski, MD · Answer

Your
450 cc saline implants are heavy and displaced inferiorly and laterally.Larger implants (650-700 cc) will displace further
and be more difficult to correct.I
recommend a new technique called Breast Augmentation with Mini Ultimate Breast
LiftTM.Using only a
circumareola incision it is possible to reshape your breast tissue creating
upper pole fullness, elevate them higher on the chest wall and more medial to
increase your cleavage.Your implant
needs to be plicated higher and more medial to correct the descent.Aligning the areola, breast tissue and
implant over the bony prominence of the chest wall maximizes anterior
projection with a minimal size implant.Small round textured silicone gel implants placed retro-pectoral look
and feel more natural, are more stable, less likely to ripple or have
complications needing revision.Best Wishes,Gary Horndeski, M.D.

Earl Stephenson, Jr., MD, DDS, MBA · Answer

Thank you for your pictures. I think you're goal is realistic. I do believe that the internal bra using STRATTICE® would be helpful. You may or may not need a lift. An examination with determine that. The cost difference is because the cost of the internal bra material is very expensive so that is what this cost more than a standard breast augmentation.Earl Stephenson, Jr, MD, DDS, FACS

Tom J. Pousti, MD · Answer

The term “internal bra” is not a medical term; is a term that is currently frequently used to describe procedures that provide support for breast implants. This support may include internal suture “repair” of the capsule (capsulorraphy), the use of acellular dermal matrix, the use of biosynthetic materials, or some combination of the above. These procedures are typically utilized for patients who are experiencing a breast implant displacement problem ( bottoming out or lateral displacement, for example). You may find the attached link, dedicated to revisionary breast surgery concerns, helpful to you as you learn more. Best wishes.

Darryl J. Blinski, MD · Answer

Using ACDM cost $$$s plus revision surgery is always more involved than original operation. Thus the added expenses...

Steven Wallach, MD · Answer

Implant malposition is more complex to treat than a primary breast augmentation.  That is probably why the surgery is costing more.

William G. Hart Jr., MD · Answer

Sarah, I am reminded of the old adage the enemy of good is perfection. I donut mastopexy and internal bra will require external scars some of the cost may be related to the fact that you have an excellent result out and you are risking something that may not be as promising terms of a result. I would think this over a great deal before going ahead and maybe seek additional input. Best wishes!

Francis (Frank) William Rieger, MD (retired) · Answer

Thank you for your question.  Revisional surgery is almost always more complicated than the original surgery, and if dermal substitute tissues are needed to support the breast internally, they tend to be very expensive to use.The picture of the results that you like appear to be very different than your current shape.  It may also appear that the implant location could be submammary, allowing you to have a closer approximation of the implants along the inner( medial) edges of the breasts.A proper office consultation with your local Plastic Surgeon would help to describe what may need to be done to give you the look that you desire.Good luck to you.Frank Rieger M.D.  Tampa Plastic Surgeon

Richard P. Rand, MD, FACS (retired) · Answer

The best opportunity you get is with the first operation. To try to approach your goal it will take internal pocket repair and this can be done with sutures and sometimes even needs super expensive dermal replacements  like Strattice. Going larger substantially increases the failure risk because of the extra weight you are putting on the repair. Be very careful here because you could be sitting at the top of a very slippery slope of new problems.

Will an internal bra help my breast revision? Cost? (photos)

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