The materials and techniques plastic surgeons use to place internal bras are evolving, and using newer technologies can enhance breast lift, breast reduction, and even some breast augmentation outcomes, according to Seattle, Wash., plastic surgeon Richard Baxter, M.D., who presented on the topic during the 2017 Vegas Cosmetic Surgery and Aesthetic Dermatology meeting, in Las Vegas.
Internal bra technologies were originally referred to as Acellular Dermal Matrix (ADM), with products including Alloderm (Allergan) and Strattice (Allergan), for support and coverage of implants, according to Dr. Baxter.
“But there remained a need for a material that could be placed under the skin, akin to an actual bra, for support of the breast shape and projection with or without an implant,” Dr. Baxter says. “SERI silk [Sofregen Medica] was the first mesh product that seemed to meet this criterion, but it had some issues. I now use Galaflex [Galatea Surgical] mesh, which seems to work very well. It slowly resorbs but leaves a layer of supportive tissue.”
There’s clinical data showing Galaflex, a bioresorbable surgical scaffold, maintains upper pole fullness with breast lifts and reductions better than without the internal support. In April 2017, Galaflex mesh became available in a 3D pre-formed shape, according to Dr. Baxter.
“The best candidates are women with larger breasts needing a lift but who don’t want implants, and women after weight loss, where the tissues that support the breasts are attenuated,” he says. “The way I see it, the internal bra is mostly applicable to breast lifts and reductions, but can also be applied to augmentation cases where implant support is needed. The combination of augmentation and lift is a compelling application, because supporting the implant and the breast tissue together helps maintain a unified shape.”