The internal bras and idea I've been working on for a long time, I know a number of other people have had the same sort of concept. The basic idea is to hold the breast up. If you think about when we do a breast lift, the breast is already sagged. But we're relying on that skin envelope to hold the shape that we create with the breast lift. The skin has already changed. It's shown that it's not up to the job and that's why we needed the operation in the first place. So, almost all versions of a breast lift, over time, lose that kind of shape and upper fullness. So the idea is to implant something that's a very biocompatible material under the skin, like a bra, to hold it up. The original kind of ideas about this came from holding implants up, using things like Strattice and AlloDerm, and breast reconstruction, and those are very good products.

They're not quite as ideal, I think, for putting under the skin for just a breast lift without an implant. The materials we're using for the internal bra with breast lift, the main ones are called SeriScaffold and GalaFLEX. They're both sort of like fabrics that are woven out of biocompatible materials. In the case of SeriScaffold, it's purified silk which is a very biocompatible material. In the case of GalaFLEX it's material that is used for sutures and they just weave it into a mesh. Both of them, over a long period of time, 18 months or so, will gradually be broken down and re-absorbed in the body. And then the body builds collagen into that sort of template in its place. So long term, the original material is not there but you should have this layer of collagen that that is serving the same purpose.

We've been using these materials already for about a year and a half now. They are FDA approved, so they are not experimental, but the companies are very interested in developing sort of best practices. So we're using them as part of clinical trials or post-approval trials. And we're getting our 18-month follow-up now on the very first patients that went into the trial. But we're also using it in a lot of different ways. Every woman has a slightly different need for revision surgery, which is where we've been using it mostly. Now we're looking at it more for just primary breast lift. I had a really interesting opportunity to go to Paris and meet with a woman named Poupie Cadolle and she has a shop there where she sells custom made bras. Her ancestors, back in the 1890's, invented the bra. They patented the idea.

The whole modern bra dates back to that original patent, and it's kind of been the family business ever since. So, there's really nobody in the world who has more expertise on bras than Poupie Cadolle. And it was fascinating to talk with her about this idea, the internal bra, how you need to shape it, whether or not you need a seam. Really, how bras need to be positioned to have optimal affect without creating a roll on the side or digging into the shoulders. I think I learned a lot about just how to shape the material when we're going to make an internal bra and she was pretty fascinated by the idea too.

The Internal Bra

Doctor Richard Baxter discusses the benefits and breakthroughs of the "internal bra" technique.