No, an Internal Bra Lift Is Not an Actual Brassiere

Breast augmentation is enormously popular, with more than 300,000 procedures performed each year in the United States, as reported in 2018. As women seek not only to make their breasts larger but to fight the sagging that comes with age and gravity, demand for breast lift procedures is increasing—and one option is the internal bra lift.

While the procedure has recently grown in popularity, it's not actually new. Zoran Potparic, M.D., board-certified plastic surgeon, explained on his website that the concept of an inner bra has been around since the 1980s.

Surgeons have been experimenting with placing mesh products under the lower pole of the breast or around the entire breast in an attempt to stop the lower portion of the breast from sagging.

Many plastic surgeons will perform the procedure, but the internal bra lift has become a bit controversial in the plastic surgery community. Here's what all the buzz is about.

What exactly is an internal bra lift?

It's important to note that the internal bra lift is an umbrella term. The procedure looks different in each case, but the common goal of the surgery is to improve breast shape and stability.

In typical breast augmentations, your surgeon has two placement options:

• Subglandular. Your doctor will separate your breast tissue from the muscles and place an implant in that newly created pocket.
• Submuscular. The implant is placed behind the pectoralis muscle.

Some women may be unsure about implants because of the various risks that accompany them, such as rupture, the need for additional surgeries and the possibility of breast implant illness.

If you are satisfied with your breast volume but want to address sagging without an implant, you can undergo a breast lift where your surgeon will remove excess skin, raise the nipple and reshape the tissue.

While this procedure works for a time, human skin is not forever elastic and eventually, the breasts can sag again.

An internal bra lift works alongside a typical breast lift for additional support. The surgeon will insert a mesh or natural tissue, securing the material to your chest wall, in order to mimic the result of an external bra within your own breasts.

Different surgical techniques can be used, and according to Gregory Buford, M.D. FACS, a Denver plastic surgeon specializing in breast procedures for more than 25 years, an internal bra lift means something different to everyone.

The surgeon will insert a mesh or natural tissue, securing the material to your chest wall, in order to mimic the result of an external bra within your own breasts.

"For the procedure, patients can use their own tissue or a graft. Both will work [to strengthen] tissue internally," Buford said. "Having a structure inside tissue provides more structural support."

The goal of the internal bra procedure is to control the position and shape of your natural breast or implant to provide structural support to the breast internally. Some surgeons claim the procedure is better than other breast lifts and that having a mesh insert will prevent breast ptosis, where the breast skin sags, stretches and loses fullness.

However, a review looking at literature on the topic found that in spite of positive claims, meshes do not effectively prevent recurrent ptosis. There is a lack of research on how the use of mesh in the internal bra procedure compares to procedures where patients use their own tissue for support.

Risks to consider

Critics of the internal bra lift say the risk of complication outweighs the benefit. This is particularly true for patients choosing a mesh insert for their internal bra lift.

As discussed in a paper by plastic surgeon Richard A. Baxter, M.D., the use of foreign objects, such as polypropylene and mixed mesh, has the potential to cause complications in the future, including increasing the patient's risk of infection, scarring and deformity.

Additionally, inserted devices can cause potential discomfort and possible obstruction during mammograms. Researchers hypothesize that radiographers have difficulty compressing the area of the breast with implanted mesh and, therefore, the mammogram image quality suffers.

While mesh is just one of the materials used in internal bra breast-lift procedures, the other options can be significantly more expensive.

Weighing your options

Any kind of breast augmentation is a personal choice. If an internal bra lift seems like a good option for you, thoroughly research your surgeon and look at a lot of before-and-after pictures to get a sense of their aesthetic approach.

Then, consult with multiple surgeons who have experience with this procedure, as not all surgeons perform the internal bra lift. Your doctor will be able to advise you about the surgical approach that will get you closest to your goals.