Will an internal bra help keep implants at the apex of the breast permanently?

Question

Hey doctors! I want to have my implants remain at the apex of the breast (slightly higher than armpit level), and I know most implants drop/settle over time to be much lower than that. Is there a way to keep them high permanently, such as with an internal bra? If so, what internal bra should I get - galatea mesh, durasorb, etc? Or - what criteria should I have when choosing between internal bras? (and are there any risks/downsides?) Thank you so much!!!

Zoran Potparic, MD · Answer

We do not use any kind of support system (like internal bra, mesh) with primary breast augmentation. Implant should be placed in such a manner to bring the nipple in the most prominent position, on the top of the breast mount. Depending on the position of the breast base (footprint) on the chest wall, that position of the implant may very in relation to other lendmarks such as armpit and jugular notch, for example. It is best to discuss these issues with your surgeon ahead of surgery. Good luck.

Martin Jugenburg, MD · Answer

Hello, thank you for your question. Unfortunately there is no surgical procedure that will keep your implants that high up over time. Immediately post operatively yes they are up and perky but over time with gravity unless you have a built in shelf it will not stay up. We can not control the downward forces of gravity at least on planet earth, may need to go to Mars for that. Also introducing a mesh when not needed is additional surgery, risk factors of surgery and more foreign material in your body. Speak to your plastic surgeon to see what surgery would best suit your needs based on your physical examination. For more information check out our website.

George Bitar, MD · Answer

The best way to create upper pole fullness is with a larger and more projecting implant.  The downside is that these types of implants will have more impact on the skin and soft tissue. An excessively large implant will cause thinning and loss of support of the tissue.  In addition, when placing the implant behind the muscle, the muscle will constantly push the implant downward.  All of these factors can make the implants fall with time.  Unfortunately, there is no guarantee of a permanent solution.  Placing an internal bra or mesh aids in supporting the implant and controlling their location.  The choice of internal bra is usually made by surgeon’s preference, balancing the quality of your soft tissues, desired implant size, their experience, and the added cost.  Galaflex (from Galatea) is a very commonly utilized mesh that offers implant support with low complication rate.

Daniel Barrett, MD · Answer

Dear magicskymagic,
breast revision surgery is the most difficult plastic surgery procedure performed. Botched breast surgery alters normal tissue planes and laxity, the ability of breasts to heal properly, and leaves scar tissue that dramatically affects the level of difficulty of the corrective surgery.Many patients come in to correct poor outcomes from their initial surgeries. The most common problems are due to implant malposition, bottoming out of the implant, poor scarring, and incorrect implant size.While the type of revision required will depend on the result of the previous surgery and the desired result of the patient, some revisions involve extensive pocket repair that may or may not need specialized external bras.If you are considering breast surgery revision, you should speak with a board certified plastic surgeon and have yourself properly assessed. Only after a thorough examination you will get more information and recommendations. Also, you have to make sure that your surgeon understands your breast augmentation goals.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Camille Cash, MD · Answer

The term internal bra is a bit of a misnomer.  This technique uses bioabsorbable mesh to help support and strengthen tissue.  Your own tissue will take the place of the mesh over time resulting in stronger reinforcement for this tissue.  It will not keep the implants held high permanently, but will help keep them in place longer.  I've included a video on bioabsorbable mesh that I hope you find helpful.

Connie Hiers, MD, FACS · Answer

Nothing will keep breast implants in a permanent position unless a capsule forms. With time, tissue does sag, especially when weight and/or hormones change.

Jose A. Munoz, MD - Account Suspended · Answer

Hi and welcome to our forum!The internal bra procedure is indicated if your tissues are not strong enough to support a larger implant (e.g. stretch marks or skin thinning) of if there already is a history of previous implant malposition. The mesh is composed of an absorbable synthetic material (polyglycolic acid, polylactic acid, polydioxanone, poly-4-hydrobutyrate) which dissolves over 18-24 months. They are all very similar.It is not usually employed in breast augmentation as a primary procedure because the use of the mesh is associated with an increased infection risk. (Permanency cannot be guaranteed due to aging, pregnancy or weight fluctuation). Visit a board certified plastic surgeon for evaluation and discussion.Best wishes...

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

The only way to keep a high full look long term is if you have very tight skin, naturally small breasts, and use a high profile style implant placed under the muscle. If your tissues are at all loose or stretchy, the implants will drop over time no matter what you do.

Will an internal bra help keep implants at the apex of the breast permanently?

Answers (8)

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