I've had some bottoming out since my reduction in 2007. I'd like to have an internal bra with my next reduction

Hi Dr. Fox! For patients undergoing a breast lift or breast reduction, I do utilize an absorbable mesh to create an internal support bra to maintain the shape and minimize changes to the breast over time. As far as details of the exact procedure I would recommend based on your photo, it will really depend on what your ultimate size goal is. If you generally like the size of your breasts (ie, do you like they look in clothing in a supportive bra), then you may only need a redo-breast lift (mastopexy). For patients that are happy with the volume of their breasts, I do a tissue sparing technique, which essentially an auto-augmentation, conserving all of your breast tissue, but lifting the overall breast and bringing the nipple-areola to a higher, more aesthetic position. If you would like to be smaller from a volume standpoint, then I can remove breast tissue for a reduction as well, as well as also using absorbable mesh to maintain the shape over time. Best of luck in your aesthetic journey!

Dear Dr Red Foxx,
it is hard to tell for sure without an examination. 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

An internal bra, which uses a supportive mesh or your own tissue, can help prevent this and provide additional support. It’s a good option to discuss with your surgeon for your next procedure to ensure you get the results you want. In addition, some techniques are more prone to bottoming out than others. A vertical pattern based on a superior pedicle also may be less likely to have bottoming out. Part of the discussion with your surgeon should include the techniques available and the reason why one approach may be better than another for you.

An internal bra can be added for better support, but I also recommend going some smaller to decrease the weight on your previously stretched skin.

From the provided photo you may be a candidate for a revision to improve shape. One option you may consider is autoaugmentation. This is different than fat transfer. It uses your own tissue to provide upper pole fullness. I have included a video I hope you find helpful. I welcome you to visit us in our Houston office for a consultation!

Dear Dr Red Foxx,
Although the mesh internal bra has utility in many breast revision surgeries, it is not without it's own set of risks. Consultation with an American Board of Plastic Surgery board certified plastic surgeon in your area can shed some light on your options. Good luck!

Based on your posted, photo It appears you have limited, inferior bottoming of the previous reduction. A mesh can be added in the inferior quadrant with a reduction. The mesh though quite expensive from 2500 to 3000 for the product would add to the fee for a re-reduction to be $8500-$10,500. Best of virtual consult with.

Unless there’s a good reason, I would probably avoid adding foreign material to your breast.
It’s really important that you have a clear understanding of what the procedure can and cannot accomplish as well as surgeons incorporate mesh.
The biggest problem with breast reduction surgery is that the breast tend to have very little Fullness and projection and the upper part of the breast.
The breast tends to be flat like a pancake and the volume sits low.
If you want to raise the nipple position, then generally, the skin envelope needs to be re-tightened.
This is not going to be Enhanced that much by using mesh.
Providers may have different procedures or techniques for doing this.
I suggest patient resist the temptation of making their own assessments and prescribing their own surgical treatments.
Let those who do this on a daily basis and have the proper training, make the right decisions for you.
Best,
Mats Hagstrom MD