Can an internal bra be added after implants? (Photo)

Question

Can an internal bra be added AFTER an anchor lift with implants without having a whole new lift/implant exchange? The lift/implants were placed 14 weeks ago and the lower skin fold is tight against my chest, but the implants are dropping over that fold causing a small "droop". 560 cc high profile/ highly cohesive and I just wanted more upper pole fullness. I have attached a before and how I wish my breast stayed in a photo combo as well as my most recent photo at 14 wks showing the drop.

Richard Baxter, MD · Answer

An internal bra with Galaflex mesh can be added any time without new implants. The lift might have to be tweaked but probably not re-done completely.

Martin Jugenburg, MD · Answer

Hello, thank you for your question. You are still very early after post op. Its normal for implants and breast tissue to drop with time even if you had an internal bra. Gravity has its force. Speak to your plastic surgeon about your concern.

Gary M. Horndeski, MD · Answer

Unfortunately, the weight of your implants and the weakness of your lift, are such that the breast implants have fallen inferior and laterally. The only way to correct this is by opening the entire wound and reinforcing the pocket inferior and laterally. The internal bra will require opening the anchor lift as well.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Carmina Cardenas, MD · Answer

You must acknowledge that 560cc implant is way to large and heavy and it does not exist a technique which will endure and support the heavy implant you have. You will always have the tendency to relapse in the saggy breast unless you change for smaller implants. No larger than 300 and become under the muscle a 100%. 
Be encouraged.
Dr. Cárdenas

Daniel Barrett, MD · Answer

Dear kfilarelli,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Sean Fisher, MD · Answer

at 14 weeks post-op you are still healing and things may continue to change. Because of this, I would not. recommended considering a secondary surgery until you are at least 6 months out from your operation. Immediate after placement, implants will always give more upper pole fullness than is to be expected with time. This is because tissues relax over time and the implants settle into a more permanent position. Whether or not an internal bra would be needed would need to be assess based on exam. This can be helpful with larger volume implants that weigh more, however this is generally only the case if there has been excess stretch on the lower pole skin (bottoming out). If the lower pole stretch is appropriate for your implant size but you are not happy with your upper pole fullness, the goal of mesh is not to keep the implants in an artificially high position, relative to your breast. Fat grafting can be considered as an alternative to increase upper pole fullness if your implants are in an ideal position. Regardless of your decision, I would recommend waiting several more months for complete healing before considering further surgery. 
Sean Fisher Aesthetic Plastic SurgeonSeattle, WA

Connie Hiers, MD, FACS · Answer

Yes, your surgeon can go back in once you have healed and add the mesh for better support. Do not go larger for your tissue may not hold any more weight.

Michael S. Kluska, DO · Answer

The results, following mastopexy with implants are very dependent upon whether your implant is on top of the muscle, or under the muscle. If your implant is under the muscle, then internal tightening of the capsule could help raise the implants up and keep them in a better position (i.e. the internal bra). That said if your implants are on top of the muscle revision vertical mastopexy will raise them temporarily but unfortunately skin has laxity that is inherent and eventually your implants will start to sag again. Implants that are 500 cc or more are somewhat heavy, and all tend to have some bottoming out as time goes on.

Jason Pozner, MD · Answer

I would let them settle a bit more and if still unhappy by say another 3-4 months then revise with galaflex mesh for support. My need to excise a little skin along the fold if they stretch but certainly can use the same implants

Mats Hagstrom, MD (license on probation) · Answer

The simple answer to your question is yes.
In order to make a good assessment requires knowing a bit more about your procedure. They have a twin size is on the large side and this is going to increase the chance of secondary undesirable side effects to some degree. Implants do drop, and the overall breast appearance changes over time after the initial outcome. This is pretty normal.
The key to keeping the implants position stable, used to create a stable pocket were the implant is placed in. Preferably sub pectorally. 
Follow up with your provider reschedule second opinion in person consultations with other plastic surgeons. For a second opinion consultations I suggest you come prepared it being with you and complete set of before and after pictures and a copy of your operative reports. These are all available of your current providers office if you request them.
Best,
Mats Hagstrom, MD

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