Underwire Bra After Bottomed out Implant Revision?

Question

I have heard of using underwire bra after a bottomed out implant revision to help support the crease while scar tissues are forming. However, I have also heard that the underwire may cause wound healing problems. Another major concern I have with underwire bras is that it may affect the final shape of the breast once everything heals. I am having the revision done on one breast and do not want it to have a different shape from the other. What are your opinions on this? Any other methods that is better than using an underwire bra?

Brent Moelleken, MD · Answer

When we revise the lower fold of the breast, we usually recommend support for the area, often through an underwire bra.  If the bra is uncomfortable or painful, we usually recommend not to use it, but rather to use a well formed sports bra.
The surgical goal after such a repair is to allow the tissues to heal to each other, rather than to succomb to the downward pressure of the breast implant.
The larger and heavier the breast implant, and the less natural resistance the patient's tissues offer, the more challenging such repairs are.
Every surgeon has his or her own protocol, so you should communicate your concerns with your surgeon.

Michael S. Beckenstein, MD · Answer

The support and pressure of the underwire on the sutured tissue can be beneficial and increase the potential for a good result. The bra must be a good fit; if not, the wrong forces can be applied and displace the implant in the wrong direction.This can cause disruption of the repair and recurrence of the "bottomed out" device.

Darrick E. Antell, MD, FACS · Answer

If you are having revisional surgery to lift a bottomed out implant, I do think that external support (an underwire bra) of some sort is helpful to hold the tissues in place until they heal internally. It's like putting a cast on a broken bone until the bone heals in place.  Obviously the bra has to fit comfortably, but to harm the wound healing, I think it would have to be extremely tight, to the point of being uncomfortable at which point you would adjust the bra.
In summary, I am a fan of a bra of some type, and in your case, probably an underwire.  You could even pad the bottom of the bra to "over correct the implant position" so that the internal sutures will not be stressed during the initial healing.

Richard Baxter, MD · Answer

Every surgeon has their own set of recommendations, but I agree with Dr. Meolleken that underwire is helpful. The key is to have it fitted well so the curve of the wire follows the curve along the bottom of the breast. that should be both comfortable and provide the right kind of support for healing.

Steven Wallach, MD · Answer

I am not a big fan of underwire bras after breast augmentation. The wire can dig into the inframammary incision or into the skin under the breast and cause irritations are even sores. I usualy tell patient to refrain from using them for at least 6-8 weeks or until the skin under the nipple to the fold feels normal.

John P. Di Saia, MD · Answer

Hello,
Follow your doctor's recommendations for support wear and let him know what you are using. You hired him. Now let him earn his money. I think most surgeons will be "pro support" in these kinds of cases, but we will all have our own ways to that end.
We all think our ways are the best too. Isn't that funny?

Stephen A. Goldstein, MD · Answer

An underwire bra may be helpful following a &ldquo;bottomed out implant revision&rdquo; surgery. This may assist in providing support to the tissue supporting the breast implant during the early healing phase. Keep in mind that scar tissue will ultimately hold the implant in the proper location. I would advise you to discuss this issue thoroughly with your treating plastic surgeon before the surgery!
I hope you find this helpful.

Andrew T. Cohen, MD, FACS · Answer

I do have my patients use an underwire bra, and I have found this to be very helpful.
Making the pocket correctly is even more important.  So in the operating room, I make sure
that my folds are equal.  If one is too low, then I raise it.
Talk to your surgeon and ask him as well.
Good luck!

Francisco Canales, MD · Answer

Hello
When we do a revision for that problem we tape the inframammary fold with silk tape and also place the patient in a non-underwire bra for support. I think most important is to discuss this ahead of time with your surgeon.  Revising the bottomed out breast is challenging. We find that supporting the repair for a full month with a bra is essential.Your level of activity should also be reduced so that you don't tear out any of the sutures that are used.  Your surgeon will be able to give you guidelines for activity.

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

The most important aspect for the control of the shape of the breast is to be sure the pocket into which the implant is placed is even in terms of the lower breast pocket on both sides.  It would seem that thise should be easy to accomplish this, but it isn't always possible to fully control this position.  For cases in which there may be doubt or concern about the fold staying even, one can use an underwire bra or tape or a tighter bra to support the lower fold.  Let your Plastic Surgeon give you proper advice about this.

	 

	Good luck to you.

	 

	Frank Rieger M.D.  Tampa Plastic Surgeon

Underwire Bra After Bottomed out Implant Revision?

Answers (11)

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