Can someone explain the internal bra procedure and how it is completed? Can the internal bra be placed through the areola?

Thank you for your question.  You have clearly been doing your research.  An internal bra uses a mesh, attached to your chest muscles to help support your breast tissue and implants like a hammock or sling that runs from your breast bone, across the lower border of your breasts, and up towards your chest muscle.  In this way it mimics the cup of a bra, but the support is placed inside of the breast tissue and not on the outside.  The mesh used can vary from human tissue(alloderm) to pig skin (strattice) , to silk protein (seri).  This mesh eventually becomes incorporated by your body adding thickness and support to your tissues.  These are most commonly placed during a breast lift revision that supplies sufficient exposure to permit adequate fixation of the mesh.  

The internal bra procedure involves placement of an internal
sling of material to act as a hammock under the implant where it is exposed in
the inferior aspect of the pectoralis muscle. There are a number of different
materials that can be used ranging from human dermis, absorbable or
non-absorbable mesh. I personally rarely perform this procedure in cosmetic
situations because it significantly increases both the cost of the procedure and
leaves additional foreign body that increases the chance of infection. Consult
with your plastic surgeon that this is the best plan.

 Here at plasticsurgeryoahu I have several similar patients where I have done a  lift with an Internal Bra using mesh. The 2 options I've used most are SERI silk[from silkworms] and Strattice[from pig skin]. There are pro/cons/price differences for each, but they work similarly. Doing it thru the areola is sometimes possible, but a Vertical[lollipop] lift is often better. Going under the muscle helps, especially with small/medium implants, but larger implants may need additional long-term support.

As the other surgeons pointed to, there is really no single "Internal Bra" Procedure but instead this term is often used loosely by a surgeon to describe some type of additional support to the breast at the time of surgery.  In my practice, I use a combination approach where the breast is internally supported by a graft (such as SERI) which eventually incorporates into your own tissue as well as selective cauterization of the vertical limb of your breast to cause tissue tightening.  In my opinion, both of these procedures together may produce greater support than either one alone.I hope that helps!  Good luck on your search for a qualified Plastic Surgeon!

99% of the time a woman does not need an internal bra procedure.  This procedure utilizes mesh (Seri) or acellular dermis (Alloderm=cadaver) or (Strattice=pig dermis).  The cost is expensive, raises the complexity of the procedure, infection, fluid concerns, reaction all are increased for a perceived potential problem if used for primary augmentation. I use these products almost every week and for most of a decade.  With over 4000 implants, 2000 reconstructions, 1000 gummy bear implants....I do not recommend this but only as a last resort in breast augmentation and revision.

Not every surgeon uses the same terminology to describe different techniques, so this may be why you are having some difficulty finding out about this procedure.  Additionally, as you have noted, not all surgeons use this technique.  When I refer to an internal bra technique, I am using a material such as Strattice (pig skin that has been treated to remove all DNA and cellular components) which is sewn between the pectoral muscle and the fold on the lower part of the breast.  This is commonly done in breast reconstruction with implants to help support the implant.  The concept is that the Strattice, which grows in and becomes a part of you, works in conjunction with the muscle to hold the breast implant, and potentially the breast tissue, into place, thus creating and "internal bra".  The generic term for a product like Strattice is ADM (acellular dermal matrix), so when trying to find a surgeon to do this technique for you, you will want to inquire about their experience using ADM.  Best of luck!

The term “internal bra” 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). I prefer doing the procedure through a peri areolar incision.You may find the attached link, dedicated to revisionary breast surgery concerns, helpful to you as you learn more. Best wishes.