Redefining breast surgery with internal bras

Many patients are familiar with cosmetic breast procedures such as augmentations and lifts, but fewer are aware of a supplementary aesthetic option – the internal bra. Also known as soft tissue matrices, the internal bra is used in combination with breast surgeries, such as a breast augmentation, lift or reduction, to enhance results.

We spoke with Ravi Somayazula, DO, and Peter Krasniak, MD, to get their insights around this add-on for breast procedures, the applications and the results that can be expected.

An overview of internal bras

It's important to clarify that an internal bra or soft tissue matrix is not a procedure itself, but a supplementary technique performed during a breast surgery.

"The internal bra should not be thought of as a procedure," said Dr. Somayazula. "Rather, it is a tool for a board-certified plastic surgeon who is proficient in aesthetic breast surgery to optimize lower pole soft tissue support when performing breast rejuvenation. The internal bra essentially acts as a soft tissue scaffold to support the lower pole of the breast against vertical stretch. It can be combined when an implant only is considered, in conjunction with a mastopexy (breast lift) alone, or with an augmentation mastopexy with implants as well as breast reduction surgery."

Applications for an internal bra cover the spectrum of aesthetic breast procedures and can offer wonderfully enhanced results for a lifted look.

"Your plastic surgeon may recommend using an internal bra technique when performing several different types of breast surgery," said Dr. Krasniak. "The internal bra refers to using some form of implantable scaffolding to support your own breast tissue at the same time as another procedure, such as a breast lift, augmentation or reduction. This implantable scaffolding is generally an absorbable material that your own tissue uses during the course of healing to strengthen the scar tissue and add support with the intention of giving a longer-term result."

Actual patient requests for an internal bra or soft tissue matrix are relatively rare because it is a tool rather than a procedure. Rather, these supplemental techniques will be performed at the discretion of the surgeon during an aesthetic breast procedure with the goal of providing longer-lasting results. This is often discussed with patients during their consultation, along with their aesthetic goals.

"Patients do not often make a specific request for an internal bra or soft tissue matrix," Dr. Krasniak. "More often, patients who have either already undergone a prior procedure or else who know they have loose tissue such as very low hanging and stretched breasts will instead ask about what can be done to make their result last them longer. This generally comes about in consultations when I discuss how gravity and the aging process normally impact breast tissue."

Your plastic surgeon will examine you during the consultation and recommend an internal bra if they feel it would benefit the aesthetic outcome of your breast procedure.

"In my practice, when considering a patient who is interested in breast rejuvenation, I always consider the potential benefits of using an internal bra," said Dr. Somayazula. "Most patients do not request the internal bra itself, but once they are evaluated by me during the consultation, we discuss its benefits if appropriate."

Basics of internal bra placement

Adding an internal bra or soft tissue matrix follows the same general process for each patient, with some room for customization based on patient goals and unique needs.

"The internal bra is secured to the inframammary breast crease with suture," said Dr. Somayzula. "It is then sutured and secured medially, laterally and superiorly to create various points of fixation to offload the weight of the breast tissue itself or with the addition of an implant."

Since the use of an internal bra is an add-on to the primary procedure, no additional surgery is needed. It's all done in one operation.

"The nice thing about using soft tissue matrices or an internal bra in breast surgery is that it does not require any additional incisions," said Dr. Krasniak. "It is placed through the same incisions your surgeon would normally use for the respective surgery. These devices are generally sutured in place and the placement does take some additional time and technical finesse."

Recovery and results when using an internal bra

Your healing process from a breast procedure should be the same whether or not an internal bra is used.

"The addition of an internal bra to a breast procedure does not affect the recovery time," said Dr. Somayazula.

However, patients with an internal bra need to be aware of some distinctions during recovery.

"The main differences that patients should know about is that you may have some additional pain that comes from the suturing of the soft tissue scaffold into place, and depending on how thin the patient's skin is, they may be able to feel the internal bra through their skin for a period of time," said Dr. Krasniak. "This generally lasts six to 12 months, although the material itself may not be fully dissolved until a full two years after surgery. This does not generally impact the length of the recovery time, though."

An internal bra will not affect the immediate or short-term results of the primary breast surgery. The purpose of using an internal bra is to prolong the expected result, providing lift and augmentation for longer than if patients did not have an internal bra placed.

"The goal of these procedures is that the result that you get after your surgery, whether it is a lifted or augmented result, will last you for a longer period than if you did not have an internal bra placed," said Dr. Krasniak.

Additionally, the use of internal bras will help keep your breasts lifted longer than just with a traditional procedure. Gravity will continue to take effect even after an augmentation, lift or reduction, but the internal bra adds a layer of support that keeps your bust looking full.

"The use of an internal bra will help mitigate lower pole stretch," said Dr. Somayazula. "This will improve overall breast aesthetics over time by improving upper pole fullness and cleavage."

Internal bras are a great addition to any breast procedure, whether an augmentation, lift or reduction, as they provide additional support for breast tissue, securing longer-lasting results. For patients who are interested in aesthetic breast procedures, internal bras may be one safe and effective tool in their plastic surgeon's arsenal that can be used to maximize their results.

To find a qualified plastic surgeon for any cosmetic or reconstructive procedure, consult a member of the American Society of Plastic Surgeons. All ASPS members are board certified by the American Board of Plastic Surgery, have completed an accredited plastic surgery training program, practice in accredited facilities and follow strict standards of safety and ethics. Find an ASPS member in your area.