What Is an “Internal Bra” in Breast Surgery?

If you’ve spent any time online reading about plastic surgery of the breast, whether it’s a breast lift (mastopexy), breast augmentation, breast reduction, or even implant removal—I’m going to guess you’ve come across the term “internal bra” more than once. If this is true, I’m also going to guess that, like so many of my patients, you may be confused about what this procedure is and if it’s right for you. It is my hope that this blog answers some of the most common questions I hear about this technique and helps you decide if it is right for you.

The easiest way to think about an “internal bra” is just that—something that offers support to the breasts, but rather than wearing it on the outside, it’s built into the breast tissue itself. If you’re a typical Pacific Northwesterner, you’ve probably slept in a hammock at some point. The hammock was probably even fastened between two trees. And if the hammock was set up right, it held all your weight and let you swing without sagging so much that your backside dragged on the ground. Well, the internal bra does the same thing for your breasts—it cradles them and helps keep them lifted, preventing sagging over time.

As a plastic surgeon, I can tell you there are no trees in your breasts to which the hammock can be fixed. This is why the hammock is sutured to the firm tissues on either side of the breasts themselves, as drawn below:

What Is an Internal Bra Made Of? (Breast Mesh Explained)

The “hammock” itself can be made from a number of different materials. But to keep things simple, think of the hammock as a firm piece of special fabric with small holes that supports the breast as shown below. 

This special piece of fabric, or “mesh,” stays inside the breasts just long enough for all the tissues to heal together. And then the really cool part—the mesh disappears! That’s right; your body actually breaks down this special fabric over roughly three months. 

This is the point when many of my patients ask: “Well, if it disappears, then what is the point of having it?” That’s a great question! Although the mesh itself disappears, it leaves behind a very thin band of permanent scar that can’t be felt, but continues to support the breasts from the inside. If you’re still having trouble picturing this, don’t worry—I’ve come up with a drawing that shows you how it works.

Now, , fair warning: even though it’s a drawing, some may still find it a little graphic for their taste.

WARNING

As you can see, the bulk of the breast tissue is cradled by a hammock of mesh that helps slow sagging over time.

When Is an Internal Bra Used in Breast Lift Surgery?

Many patients would benefit from using the internal mesh bra. That being said, I use the internal bra technique most commonly when I am performing a breast lift (mastopexy). To understand why the internal bra can be so useful in patients looking for a breast lift, you first have to understand the concept of ptosis (pronounced “toe-sis”). Ptosis is the fancy word for breast sagging. And as plastic surgeons, we not only describe breast sagging, we also grade it—in this case, on a scale from 1 to 3.

The red line above shows the natural fold under the breast. A youthful, perky breast is shown on the far left. Notice that the nipple and all the breast tissue sit above the fold. As gravity begins to take effect, the breast and nipple start to drift downward. 

• Grade 1 Ptosis: the nipple has dropped to the level of the fold.
• Grade 2 Ptosis: there is more drooping of the breast, and the nipple falls below the fold. 
• Grade 3 Ptosis: the majority of the breast tissue sits below the fold, and the nipple is pointing downward.

The far right shows a special case called “pseudo ptosis,” where the nipple is sitting in more or less the right position, but the majority of the breast tissue has drooped below the fold.

What Causes Breast Sagging (Ptosis)?

As I tell all my patients, gravity always wins in this business. End of story. As we age, the natural elasticity of our tissues starts to go away, and like an old rubber band, it doesn’t snap back into place like it did when we were younger. As our skin and the tougher tissues that support the breast in a youthful position (ligaments) stretch, gravity pulls the breast down. While some women’s breasts may sag earlier just because of their individual genetics, some degree of breast sagging is completely normal as we age (in both men and women).

It makes sense that the more breast tissue there is and the farther it sags from its youthful position, the harder it is to keep it lifted. This is where the internal bra comes in—it not only holds the breast tissue in a lifted position while healing occurs, but also keeps it there with the help of the thin scar band that remains long after the mesh disappears.

Other Uses for the Internal Bra in Breast Surgery 

Use of the internal bra isn’t limited to breast lift surgeries. Any breast procedure that requires extra tissue support may benefit from this technique. These include: 

• Performing a lift after breast implant removal
• Fixing breast implants that have fallen out of position
• Correcting dramatic breast asymmetries
• Supporting outcomes in very large breast reductions

Internal Bra Breast Surgery: Benefits and Long-Term Results

The internal bra is any procedure that uses mesh to support the breast tissue during healing and help maintain its position long after healing has finished. This provides a more durable, long-lasting breast rejuvenation than when the same procedure is performed without mesh.

Internal Bra Breast Surgery FAQs 

Does using the internal bra add risks to my procedure? 

Although the risk is very small, the internal bra increases the risk of infection. Even though the mesh is broken down by your body over about three months, it can become infected during early healing. If this happens, you may need to be treated with antibiotics. In severe cases, the mesh may need to be removed to treat the infection. 

Does the internal bra add to the cost of my procedure? 

Yes, there is an additional cost for the mesh fabric itself (generally less than $500 per breast), as well as an increased cost due to the time and skill required to perform the procedure. 

How long do the results of the internal bra last? 

This is a hard question to answer because the internal bra technique is still quite new. Even though your body breaks down the mesh over about three months, the thin band of scar left behind stays there forever. Although results vary from patient to patient, early studies indicate that the breasts remain anchored in their new, lifted position for many years after the procedure. 

Does the internal bra technique add pain to my procedure or increase my recovery time?

Although pain and recovery vary from patient to patient, I tell all my patients that there is no increased pain from using the internal bra, and it does not lead to any increased recovery. 

Are all internal bra techniques the same? 

No, there is not one way to perform the internal bra technique. Very few surgeons are trained to perform this technique, and those who are have typically completed advanced training in aesthetic surgery. Be sure to do your research and ask detailed questions when choosing your surgeon.

Many examples of the internal bra technique can be found in my photo gallery.

Schedule Your Internal Bra Consultation in Seattle, WA

If you are considering a breast lift or want longer-lasting support and shape, the internal bra technique may be an excellent option. Dr. Alexander Gougoutas is a board-certified plastic surgeon with years of experience performing complex breast surgeries. He will evaluate your anatomy, discuss your goals, and determine whether this advanced technique is appropriate for your needs.

To learn more about your breast surgery options, call our office today at (206) 984-2964 or complete our online contact form to schedule your personalized breast lift consultation with Dr. Gougoutas.