The Beauty Standard with Dr. Roy Kim
"The Beauty Standard with Dr. Roy Kim" is your ultimate guide to exploring the world of beauty, aesthetics, and both non-invasive and invasive procedures. Join renowned plastic surgeon Dr. Roy Kim as he shares his expertise, delves into the latest advancements, and engages in insightful discussions with industry experts, bringing you a wealth of knowledge to enhance your confidence and empower your aesthetic journey.
The Beauty Standard with Dr. Roy Kim
Understanding the Internal Bra for Breast Surgery
The internal bra is a revolutionary surgical concept providing long-lasting breast support through an internal framework placed beneath breast tissue. This technique creates an enduring lift by countering gravity with strategically positioned supportive materials that help maintain breast position closer to the collarbone.
• Various materials can be used including patient's own fascia, synthetic dissolving polymers, purified sheep gut (Ovitex), or acellular dermal matrix (ADM)
• Ideal candidates include those considering larger implants, needing significant lifts, or who've experienced sagging after previous procedures
• Functions as "insurance" for surgical outcomes, providing long-term benefits rather than immediate improvements
• Potential considerations include additional cost and possible awareness of the material during healing
• Consultation with a board-certified plastic surgeon is essential to determine if this approach suits individual anatomy and goals
For those interested in seeing results, check websites or social media profiles of board-certified plastic surgeons who specialize in breast surgery using internal bra techniques.
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Welcome to the Deep Dive. Today we're looking at something really quite fascinating in breast surgery the internal bra. And we're not talking about lingerie here?
Speaker 2:No, definitely not. This is a surgical concept, a support structure that surgeons can actually place under the skin.
Speaker 1:Right under the skin.
Speaker 2:Yeah.
Speaker 1:To sort of bolster the breast tissue.
Speaker 2:Exactly. It can be used alongside breast implants or even just with natural breast tissue to give a lift that well. The aim is for it to last longer.
Speaker 1:Okay, so providing more enduring support. Fighting against gravity.
Speaker 2:That's the core idea. You're trying to create this internal reinforcement, if you like, to keep the breast tissue position higher up on the chest, you know, closer to the collarbone, for a longer time.
Speaker 1:So who is this really for? If someone's listening and thinking about, say, augmentation or maybe a lift, or perhaps they've had surgery before and experienced sagging again?
Speaker 2:Yeah, recurrent mitosis.
Speaker 1:Why would this internal bra idea even come up? What's the fundamental thinking?
Speaker 2:Well, it really comes down to the longevity of the results. We know gravity is a constant force, right Always.
Speaker 1:And the weight of the breast tissue itself, especially if you add implants which increase the weight, inevitably leads to some stretching and sagging over months and years. So the internal bra is conceived as a proactive measure. It's about building in support from the get-go, hoping to preserve that surgical lift and shape for well, significantly longer.
Speaker 2:Okay, so it's future-proofing almost.
Speaker 1:In a way, yes, it becomes a really relevant conversation for people considering larger implants or those needing quite a substantial lift or, as you said, individuals who've unfortunately seen sagging return after a previous procedure.
Speaker 2:Right, so planning ahead Now. Now this internal bra. What is it exactly? You said a structure, but what kind of materials are we talking about? How does it actually work under the skin?
Speaker 1:okay. So the basic principle is creating this sort of supportive layer, almost like a mesh or a hammock maybe a sling is a good way to think of it a sling.
Speaker 2:Okay, yeah, position strategically beneath the breast tissue. This is what provides that upward support holding things in place, and what's interesting now is the variety of materials sturgeons can beneath the breast tissue. This is what provides that upward support holding things in place, and what's interesting now is the variety of materials surgeons can actually use to build this internal framework A variety.
Speaker 1:Okay, so it's not just one thing. What are some of the main options people might hear about?
Speaker 2:Well, one approach, maybe less common now, involves using the patient's own tissue, specifically their fascia.
Speaker 1:Fascia, that's the connective tissue right, like the white layer on muscle.
Speaker 2:Exactly that. It's strong fibrous tissue. A surgeon could potentially harvest a strip of this from nearby, like the abdominal area or chest wall, and use it to create a supportive sling.
Speaker 1:Using your own body's material sounds good. Presumably no rejection issues.
Speaker 2:Correct. The advantage is it's your own tissue, but the drawback and it's a significant one is often the limited availability. You might not be able to get a piece that's large enough or strong enough right there in the surgical field to create a really robust, long-lasting support.
Speaker 1:Ah, okay, practical limitations, so that makes it less popular maybe.
Speaker 2:Generally, yes, compared to some of the other options now available. What else is out there, then? We're seeing a lot more use of specially designed materials. Some are man-made synthetics designed to dissolve over time.
Speaker 1:Dissolve like stitches.
Speaker 2:Very much like absorbable sutures. Yeah, One example is called GoFlex PH4B, that's polyphorhydroxybutyrate. It's a polymer. Surgeons can cut it to shape or it might come in preformed sling shapes.
Speaker 1:Okay.
Speaker 2:Another similar one, sometimes known as DORB, uses PDO and PLLA threads Again the same kind of materials in dissolving stitches. Both of these provide support for a period, then gradually break down. The body absorbs them.
Speaker 1:So they act like a temporary scaffold while the body heals and maybe builds its own support around that area.
Speaker 2:That seems to be the thinking. Yes, they provide that crucial support during the initial healing and maturation phase maybe 12 to 24 months, and then they're gone.
Speaker 1:Interesting Any other types.
Speaker 2:Yes, there's also Avitex. This one is actually biologically derived. It's made from purified sheep gut. Well, it's known for having a very soft kind of natural feel once it's in place, while still providing pretty significant support and lift. It also gets resorbed by the body over time.
Speaker 1:So another dissolving option, but from a biological source.
Speaker 2:Correct. And then there's another category called a cellular dermal matrix, or ADM.
Speaker 1:ADM I think I've heard of that used in other types of reconstruction.
Speaker 2:You likely have. Yeah, it's often derived from animal sources like porcine or bovine dermis, which has had all the cells removed to prevent rejection. It comes in sheets and the surgeon cuts and shapes it to form the sling.
Speaker 1:How does ADM fit in? Is it also dissolving?
Speaker 2:ADM actually integrates into the patient's own tissue. The body's cells grow into it so it becomes a permanent part of the support structure. It's soft pliable.
Speaker 1:Sounds good. Any downsides?
Speaker 2:Well, one potential nuance with ADM in aesthetic breast surgery, compared to some of the newer synthetics or Avatex, is that its final long-term position can sometimes be a little less predictable.
Speaker 1:Yes, predictable, how so?
Speaker 2:The surgeon places it precisely, of course, but as it integrates and remodels with the patient's tissue over months it might stretch or settle in a slightly different way than initially intended. Think of it like a biological graph that becomes living tissue but might shift a bit.
Speaker 1:I see so the newer synthetic options like the GoFlex or Dorb and maybe the Abatex. They offer more control over exactly where that support stays long term.
Speaker 2:That seems to be the advantage surgeons are finding. Yes, the way these materials are engineered or processed allows for very precise placement, and they tend to maintain that position more reliably as they function and eventually dissolve. Predictability is key in aesthetic outcomes.
Speaker 1:Makes sense, and you mentioned surgeons might even combine things.
Speaker 2:Absolutely. A surgeon might use one of these sling materials, but also reinforce it using the patient's own tissues where possible, perhaps tightening the existing ligaments or using specialized long-lasting internal sutures to create an even more robust and durable support system. It's about layering techniques.
Speaker 1:Okay, quite sophisticated. Now, thinking about the patient's experience, you said the main goal is long-term support. Does an internal bra make a difference right after the surgery, or is it really something you only appreciate, you know, years later?
Speaker 2:Its primary value is definitely geared towards the long-term. Immediately after a breast lift or augmentation, the initial results, the improved shape, the lift that comes from the primary surgical techniques. The internal bra isn't really needed for that day. One result oh, okay. Its real job is to help maintain that result against the forces of gravity and time, To minimize the recurrence of sagging, particularly, as we said, in cases with larger breasts, heavier implants or where a very significant lift was performed initially.
Speaker 1:So it's like insurance for the surgical outcome.
Speaker 2:That's a pretty good analogy. Yeah, An investment in the durability of the result.
Speaker 1:Okay, so if someone's considering this, what are the potential downsides or things they really need to weigh up?
Speaker 2:Well, there are a couple of key considerations. Firstly, cost Adding an internal bra usually increases the overall expense of the surgery.
Speaker 1:Right. The material itself costs money.
Speaker 2:Exactly, whether it's synthetic or biological. These are advanced materials and there's a cost associated with them which typically gets passed on in the total surgical fee.
Speaker 1:OK, so budget is a factor. What else? What about actually having this thing inside you? Can you feel it?
Speaker 2:That's a really common question and a valid one. It is possible, especially during the healing period, say the first year, maybe even two, that some individuals might be aware of the material.
Speaker 1:Aware how Like feeling an edge or just a different texture.
Speaker 2:It could be a sense of firmness or maybe feeling an edge if they press deeply. This is probably more likely if someone has larger implants pushing against it or if they have naturally quite thin skin and less fatty tissue covering the breast area.
Speaker 1:Does that mean something's wrong?
Speaker 2:Not necessarily. In fact, many surgeons might say, feeling it subtly, particularly early on is actually a sign that the support structure is there and doing its job, holding things firmly. It usually softens and becomes unnoticeable as healing progresses and the material integrates or dissolves.
Speaker 1:But it's something to be aware of, potentially.
Speaker 2:Definitely. It's crucial to discuss this possibility with your surgeon beforehand. If you're worried about the sensation, have that conversation. They can explain what to expect based on the specific material and your anatomy. Open communication is key.
Speaker 1:Always. Now you know people listening will probably be curious to see what this actually looks like, the results.
Speaker 2:Understandable Visuals are powerful.
Speaker 1:Can we show any photos or point people somewhere?
Speaker 2:Unfortunately, because of the content guidelines on many platforms regarding medical images, especially before and afters and cosmetic surgery, we can't directly display them here in our deep dive.
Speaker 1:Great restrictions.
Speaker 2:But what I absolutely recommend is, if you're interested, go look at the websites or perhaps the social media profiles, like Instagram, of board certified plastic surgeons who specialize in breast surgery and mention using internal bra techniques.
Speaker 1:OK.
Speaker 2:Many reputable surgeons do share anonymized before and after photos of their work there, including cases where internal support was used. That's probably the best way to get a visual sense of the potential outcomes.
Speaker 1:Good advice Look for surgeons who actually perform this. So, wrapping this up, for someone listening who thinks, hmm, this internal bra sounds interesting, maybe it's for me. What should their next step be?
Speaker 2:I think the first step is always education. Learn more about the different types of breast procedures available lifts, augmentations, reductions, combinations. Understand what your specific goals are, what bothers you, what are you hoping to achieve long term?
Speaker 1:So self-reflection first.
Speaker 2:Yes, Then, armed with that knowledge and your personal goals, the crucial step is to schedule a consultation with a board certified plastic surgeon not just any doctor, but someone properly Right and in that consultation be open, discuss your goals, your concerns about longevity and specifically ask about the internal bra. Ask if they think it would be beneficial for your specific situation, your anatomy, your tissue quality, your implant choice, if any.
Speaker 1:So it's very personalized.
Speaker 2:Extremely. There's no one-size-fits-all answer. A good surgeon will assess you individually and explain the pros and cons of using an internal support system in your specific case, helping you decide if it aligns with getting the lasting result you want.
Speaker 1:That makes perfect sense. Arm yourself with knowledge, then seek expert personalized advice. Well, this has been genuinely fascinating, digging into this concept of internal breast support.
Speaker 2:It really is an evolving area. It's quite remarkable how surgical techniques keep advancing, offering surgeons, and therefore patients, more sophisticated tools to aim for not just good results, but enduring results, tailored results.
Speaker 1:Absolutely. It really makes you think, doesn't it, how these kinds of innovations might shift our whole perspective on cosmetic procedures, moving towards really personalized solutions designed for the long haul Something definitely to consider. Thanks for taking this deep dive with us today.