Internal Bra Sydney

A deep dive into internal bras

Not all internal bras are made the same.

What is an Internal Bra?

The internal refers to support of the implant not the breast tissue.

This video outlines the 3 different techniques I use: Barbed Sutures, Composite Muscle Flaps and Mesh.

Matching the breast platform to the chest platform

One of the critical elements in getting great cleavage is matching the breast platform to the chest platform.

An often forgotten cleavage plane is the inferomedial triangle, our goals are to reduce this triangle from a large isosceles triangle to a small equilateral triangle. Whenever I do this, I double down on the need for fat grafting along with the need for internal support for the breast platform and implant using suture and muscle techniques.

Implants above 700cc

With all upsized internal bras above 700cc, I use the TILOOP MESH internal bra.

For the surgeons out there, a few tips for inserting:
1) Make the crease incision larger than you think.
2) Suture the cephalad portion of the sling to the posterior aspect of the anterior leaf of the capsule along with the caudal edge of the pec major.
3) Place the implant in the pocket after turning the mesh inside out.
4) Insert the implant and mesh and make sure the posterior leaf of the mesh is flat with no wrinkles on the chest wall.
5) Suture the caudal edge of mesh onto rib cage where you want your IMF to sit.

Case Study 1: 360cc Mini implant

360cc Mini implant combined with composite muscle flap internal bra.

If you have seen my video on chest wall anatomy, you will know there are different platforms we can create a breast on top of.
This convex slanted chest is extremely difficult. All the deforming forces are down and out, such as the slope of the chest wall, the contractile forces from the pec muscle and gravity.

As surgeons we need to do everything humanly possible to keep the implants up and in. Sometimes we win, but sometimes we lose. it's no one's fault, so don't be disheartened if your implants sit outwards when you lie on your back. Your surgeon hasn't necessarily done anything wrong, it's just the anatomy of the chest wall.

Case Study 2: Large Revision

When going this large you need a belt and braces approach especially in chest wall asymmetry cases where the chest slants laterally along with height asymmetry with the right chest wall sitting higher than the left.

Tiloop mesh internal bra combined with 3 months in a post op garment. The mesh integrates with the capsule and provides some much needed support for the implant.

Case Study 3: Capsule Plication Internal Bra

In this upsize case, the patient had a capsule plication internal bra.

This is when the preexisting capsule is plicated to itself to provide a tighter pocket for the implant. She also had a mild case of bottoming out which was also corrected at the same time. Pay close attention to her chest wall asymmetry too. The right side sits higher than the left meaning no matter what we do as surgeons we can't get perfect symmetry when the platform is uneven.

Case Study 4: Internal bra used for bottoming out and upsize

There are different types of internal bras. In this case I used the mesh technique to help with the bottoming out and provide support for the implant.

You will notice the nipple is at the same height in space (see tattoos as reference points) but now it looks more centred on the breast rather than sitting so high because the breast platform has been raised.

The key to all breast cases is securing and supporting the breast crease and implant lower pole.

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Dr Pouria Moradi - Specialist Plastic Surgeon

"I am a consultant plastic, reconstructive and aesthetic surgeon working as a visiting medical officer at Prince of Wales, Royal Women's and Sydney Children's Hospitals, and an associate lecturer at UNSW Medical School.

Having studied medicine at UNSW as a Sam Cracknell Sport and Academic Scholar, I was then awarded Membership of the Royal College of Surgeons of England in 2005 and Fellowship of the Royal Australasian College of Surgeons in Plastic, Reconstructive and Aesthetic surgery."

By contacting Dr Moradi, you will be provided with in-depth information during your consultation.

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