Posted December 07, 2023 in Breast

The “internal bra” procedure involves placement of an artificial mesh to support breast implants. This is sometimes used for primary (first-time) breast augmentation and very frequently used in secondary (revision) augmentation.

Why use mesh to support breast implants for a revision breast augmentation surgery?

Successful breast revision surgeries often require tightening of the scar tissues (capules) surrounding the breast implants. This allows the breast implants to be elevated to improve upper breast fullness or pushed centrally to improve cleavage. One way to address this is by placement of internal mesh, most commonly GalaFLEX, which is sutured directly to the scar tissue surrounding the breast implants. Having performed thousands of breast augmentations over the past 28 years, I can unequivocally state that this is completely unnecessary in the overwhelming majority of patients. Why?

The best way to support breast implants is to tighten the capsules (scar tissues) surrounding the implants. I do this by selectively burning portions of the capsule, which causes the capsule to shrink. (Imagine that when you put a burger on the grill, it shrinks.) This can incrementally reshape the capsule, improving breast shape and breast implant position–without the need for mesh. Placement of mesh adds complexity and considerable expense to the surgery, increases the risk of postoperative complications, and doubles the number of foreign bodies from two (implants) to four (implants and mesh).

In the vast majority of women undergoing breast implant revision surgery, strategic tightening of the existing capsules allows your own tissues to become an internal bra. Mesh is generally unnecessary.