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Topic: Aesthetic Surgery of the Breast

Internal bra: a unifying solution for

reconstructive and aesthetic breast surgery

issues

Richard A. Baxter
Baxter Plastic Surgery PLLC, Mountlake Terrace, WA 98043, USA.
Address for correspondence: Dr. Richard A. Baxter, Baxter Plastic Surgery PLLC, 6100 219th St SW, Suite 290, Mountlake Terrace, WA 98043,
USA. E-mail: drbaxter@drbaxter.com.

Dr. Richard A. Baxter has a special interest in revision breast surgery, internal bra concepts, and ultrasound in aesthetic
medicine. In addition to his busy private plastic surgery practice in the Seattle area, he is engaged in clinical research, figure
drawing, and learning Argentine tango.

ABSTRACT
The utility of the internal bra for breast support, reconstruction, and in revision breast surgery has
been recognized and various materials have been introduced for this application. As clinical experience
has grown and new products have been developed, the roles of these materials are becoming better
defined. This paper reviews the use of the internal bra concept to date.

Key words:
Internal bra; acellular dermal matrix; alloderm; strattice; SERI surgical scaffold; GalaFLEX mesh;
revision breast surgery; mastopexy

INTRODUCTION leading to revision breast surgery. Implant malposition and
rippling are manifestations of thin tissue coverage, which
Factors leading to revision breast implant surgery include can be thought of as periprosthetic atrophy. This in turn may
capsular contracture, implant malposition, palpability, and relate to overly large implants, improper biodimensional
animation deformity with subpectoral placement. These planning, and saline implants as a result of fluid wave action.
issues often occur in combination, for example lower or Aging, pregnancies, weight loss, and prior surgeries may
[1]
lateral fold malposition with rippling or animation deformity contribute to weakening of the ligamentous support and
with fold malposition. Reoperation rates for breast implant soft tissue envelope of the breast. In combination, these
procedures are high, and even higher for previous revision patient-related and implant-related factors may multiply the
surgery. A comprehensive approach is needed if these severity of periporsthetic atrophy. Autologous material such
[2]
numbers are to be improved. as capsule flaps [3,4] and fat grafting can be useful adjuncts in
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How to cite this article: Baxter RA. Internal bra: a unifying
solution for reconstructive and aesthetic breast surgery issues. Plast
DOI: Aesthet Res 2016;3:3-7.
10.20517/2347-9264.2015.68
Received: 15-06-2015; Accepted: 12-01-2016

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