The Beauty Standard with Dr. Roy Kim

Beyond The Lift: Internal Bras and the Future of Breast Surgery

• Dr. Roy Kim

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We explore breast lift procedures (mastopexy), unpacking different surgical techniques, when implants or fat transfer may be needed, and how new innovations like internal bra technology can improve long-term results.

• Changes in breast appearance over time are normal due to aging, pregnancy, and breastfeeding
• Nipple position is key - if it sits above the breast fold, just adding volume might be enough
• Donut lift (Benelli/circumareolar) offers minimal scarring but only modest lifting capability
• Lollipop lift adds a vertical incision for more substantial reshaping and lifting
• Anchor/inverted-T technique provides the most dramatic lift with strategic scar placement
• Implants or fat grafting can be added when volume enhancement is desired alongside lifting
• "Internal bra" mesh technology creates internal support that improves long-term results
• Recovery typically takes 1-2 weeks initially, with complete healing over 6-12 months
• Scar care is essential throughout the healing process for best aesthetic outcomes
• Consultation with a board-certified plastic surgeon is crucial for individualized recommendations

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Speaker 1:

Welcome to the Beauty Standard with Dr Roy Kim.

Speaker 2:

Welcome to the Deep Dive. Today we're getting into a topic that seems to be on a lot of people's minds breast lift procedures.

Speaker 1:

That's right.

Speaker 2:

We've got some great material here from a plastic surgeon's YouTube channel really detailed stuff and we're going to, you know, break it down for you.

Speaker 1:

Yeah, and it's probably good to start by just saying look changes in how breasts look over time, sagging, drooping, whatever term you use, it's completely normal. Totally you know, aging, having kids, breastfeeding it all contributes. It's just part of life.

Speaker 2:

Absolutely yeah. So our mission here, our deep dive today, is really to clarify the different surgical techniques. Mastopexy, that's the medical term. Yep surgical techniques Mastopexy that's the medical term Yep mastopexy. We want to help you understand which options might make sense depending on the situation. Maybe uncover a few surprising details along the way.

Speaker 1:

Exactly. We'll look at the different kinds of incisions, how implants or maybe fat transfer fit in and this really interesting idea of an internal bra and what that means for you know long-term results okay, let's get started.

Speaker 2:

Then the surgeon in the video they first talk about when maybe just adding volume, a breast augmentation could be enough on its own yeah, that's a key point.

Speaker 1:

So if the issue is mainly just a bit of looseness, sort of predominantly at the top of the breast, okay, and this is the critical part the nipple is still clearly above the top of the breast. Okay, and this is the critical part, the nipple is still clearly above the fold, underneath the breast, that inframammary fold.

Speaker 2:

Right the crease.

Speaker 1:

Exactly, then sometimes just adding volume with an implant or maybe fat transfer can actually give a little bit of a lift. It sort of fills things out and pushes things up slightly.

Speaker 2:

Makes sense. So volume can sometimes create lift, but only in those like milder cases where the nipple hasn't dropped too much. The surgeon really stresses that nipple position is key.

Speaker 1:

It's the main indicator, yeah. So then the discussion moves to when you really do need a proper lift, the mastopexy itself. What are the signs then?

Speaker 2:

Well, the video says it's pretty clear Right, if the nipple is right at the level of that breastfold, or especially if it's dropped below it, at that point just adding volume probably isn't going to get you the aesthetic result you're looking for.

Speaker 1:

And the goal of the lift typically isn't just about hoisting things up, it's about repositioning the nipple and the areola, the darker skin, so it sits more centrally on the breast mound the darker skin so it sits more centrally on the breast mound, Often aiming for a more natural sort of gentle slope appearance, not necessarily, you know, a perfectly round super high look.

Speaker 2:

Right, aiming for natural. Okay, so we know when a lift is likely needed. Let's dive into the actual techniques. First one mentioned is the Benelli or donut lift. Sounds minimal.

Speaker 1:

It is, relatively speaking, also called circumareolar. The incision is literally just around the border of the areola, like drawing a donut.

Speaker 2:

Okay.

Speaker 1:

The big advantage the scar is usually the least noticeable of all the lift types. Plus, it's great if you also want to make the areola smaller. At the same time Kills two birds with one stone, kind of.

Speaker 2:

Okay, very discreet.

Speaker 1:

Yeah.

Speaker 2:

But I'm guessing there are limits.

Speaker 1:

Definitely stone kind of. Okay, very discreet, yeah, but I'm guessing there are limits. Definitely the amount of actual lift you can get is well limited, maybe about one to two inches or like two to five centimeters upwards, it's not dramatic.

Speaker 2:

So less scar, less lift.

Speaker 1:

Pretty much, and the surgeon also points out a couple of potential downsides. Sometimes it can lead to a bit of a flatter look right around the nipple area and if you try to get too much lift with just that circle, the scar itself can stretch out, maybe become more oval-shaped over time.

Speaker 2:

Okay, so not ideal if you need a really significant change.

Speaker 1:

Exactly, which leads us to the next option, the vertical mastopexy, sometimes called the lollipop lift Lollipop right because of scar shape. Precisely you have the incision around the areola, just like the donut, but then you add a vertical line going straight down from the bottom of the areola to the breast fold.

Speaker 2:

Okay, so an extra line down.

Speaker 1:

Yeah, and that vertical component. That's what allows for a more substantial lift upwards. It also gives the surgeon more access to actually reshape the internal breast tissue.

Speaker 2:

Ah, okay, so you can do more internal work.

Speaker 1:

Exactly, you can kind of rearrange things inside to get better fullness, especially in that upper part of the breast which often deflates a bit.

Speaker 2:

And the source mentioned. This can be done with or without adding volume, right like with implants or fat.

Speaker 1:

Correct. You can combine it if volume is also a goal, or you can just do the lift itself if the person has enough volume already but just needs repositioning. It's more versatile.

Speaker 2:

Makes sense. So for even more lift, there's the third main type, the inverted T or anchor incision sounds like most involved.

Speaker 1:

It generally is. It includes the circle around the areola, the vertical line down to the fold and a horizontal incision hidden right along that new lifted breast fold.

Speaker 2:

Okay, so three parts to the incision. Why the extra horizontal part?

Speaker 1:

Well, the thinking is you could just make the vertical lollipop scar longer and longer if you need a lot of lift, but a really long vertical scar isn't always the most aesthetically pleasing result. Right, so that horizontal incision along the fold lets the surgeon remove the necessary amount of skin for a big lift, but hides a significant portion of that final scar in a natural crease.

Speaker 2:

I see. So it's about managing the scars while still achieving a major lift and reshaping A trade-off basically More scar initially, but potentially better hidden for a more dramatic result.

Speaker 1:

That's a good way to put it. It allows for the most significant repositioning and removal of excess skin.

Speaker 2:

Okay, that clarifies the main techniques. Let's switch gears slightly to the filler materials in plants and fat grafting. When do they usually come into play with a lift?

Speaker 1:

So the video makes it clear Fillers are mainly about restoring lost volume or adding fullness. Often they're considered right alongside the lift procedure. But not always essential Not always, it really depends on the patient's starting point. If you already have, you know, decent breast volume, or maybe you wouldn't mind being slightly smaller after the lift.

Speaker 2:

Like half a cup size or something.

Speaker 1:

Yeah, something like that. Then a lift on its own might be perfectly fine. You might not need or want the extra volume.

Speaker 2:

But if you feel deflated or want more fullness after the sagging is corrected, then implants or fat are the options.

Speaker 1:

Exactly and the video touches on implant placement. The common spots are either under the chest muscle or above the muscle, but still under a layer called the fascia, sometimes directly under the breast tissue. But the first two are more typical. And choosing the implant itself is not the patient's breast width, the profile, like how much it projects forward, fitting their body frame and, of course, the desired final look. It's quite personalized.

Speaker 2:

Right, tailored to the individual. What about fat grafting that uses liposuction?

Speaker 1:

yeah, that's right. Fat is taken from somewhere else on the body, maybe the abdomen or thighs, using liposuction. Then it's processed, purified, basically, and carefully injected back into the breasts.

Speaker 2:

Adds volume that way.

Speaker 1:

Adds volume and can also help with smoothing contours sometimes. But as the surgeon notes, you have to remember there's recovery involved for the areas where the fat was taken from too.

Speaker 2:

Good point. Techniques, volume what about making it all last? The surgeon talks about existing tissue quality, but then this internal bra thing that sounds important for longevity.

Speaker 1:

It really does. It's essentially a piece of supportive mesh material, usually synthetic, designed for medical use, though apparently there's a type derived from sheep tissue too Less common though.

Speaker 2:

Okay, a mesh, and how does it work?

Speaker 1:

It's placed inside during the lift surgery. And how does it work? It's placed inside during the lift surgery. It acts like a little sling or hammock, basically creating extra internal support for the breast tissue itself and for the implant. If one is used, think of it like internal scaffolding.

Speaker 2:

Wow, okay, so it's helping hold everything in that lifted position long term.

Speaker 1:

That's the main idea. Yes, the real benefit, according to the surgeon, shows up down the line six months a year, even longer.

Speaker 2:

It helps maintain the shape and fight against gravity, reducing the chance of sagging coming back. So you might not see a huge difference, right?

Speaker 1:

away? Apparently not. The surgeon mentioned that even in the operating room the immediate difference might be subtle. It's really about improving the long-term stability of the result.

Speaker 2:

Interesting, so it's recommended, especially for heavier implants or just anyone who wants the best shot at long-lasting results.

Speaker 1:

Seems that way, especially if you want maximum support over many years. They also mentioned it doesn't add a huge amount of time to the surgery itself and the cost is, you know, reasonable given the potential payoff and durability.

Speaker 2:

Definitely sounds like something worth asking about in a consultation, for sure. The video also gives some general info on the payoff and durability. Definitely sounds like something worth asking about in the consultation, for sure. The video also gives some general info on the procedure and recovery. It's usually outpatient right Go home the same day.

Speaker 1:

Typically yes. The surgery itself takes well several hours, depends on exactly what's being done the technique implants or not. Internal bra.

Speaker 2:

And recovery involves pain meds. Oh yeah, technique implants or not.

Speaker 1:

Internal bra and recovery involves pain meds. Oh yeah, expect prescription pain relief and often surgeons use long-acting numbing medicine during the surgery to help with those first hours afterwards.

Speaker 2:

How much time off work are we talking usually?

Speaker 1:

Generally plan for about one to two weeks for that initial recovery period. Enough time to rest and let things start healing.

Speaker 2:

But the final result takes longer to see, much longer Full healing, but the final result takes longer to see Much longer Full healing, swelling finally going down completely.

Speaker 1:

That can take 6 to 12 months and the surgeon stresses scar care during that whole time is really important for how the scars ultimately look.

Speaker 2:

Right Got to be patient and diligent with the scar treatments.

Speaker 1:

And they also mention you know that initial super full look right after surgery. Some of that is swelling, so expect it to settle down a bit over time. If you have implants, there might be recommendations for massage, maybe meds to help prevent scar tissue tightening around them. That's capsular contracture, okay. And, like we said, if you had fat grafting, there's specific care for the lipo areas too.

Speaker 2:

It's definitely encouraging, though, to hear about these advancements like the internal bra tech. It sounds like results are potentially better and longer lasting than maybe they used to be.

Speaker 1:

Absolutely. It feels like the field is constantly evolving, looking for ways to improve not just how things look right after surgery, but how satisfied patients are years later.

Speaker 2:

So, wrapping up this deep dive, we've really unpacked a lot about breast lifts. Drawing straight from that surgeon's explanation, it's clear there's no one-size-fits-all answer.

Speaker 1:

Not at all, but hopefully, understanding the different techniques you know the donut, the lollipop, the anchor, and thinking about volume and this internal support idea, it gives you a much better foundation.

Speaker 2:

It's that first step, right Understanding the options, before you even talk to a surgeon.

Speaker 1:

Exactly which leads to the next step. If you're considering this, take this info, think about your own goals and then definitely have a thorough chat with a qualified, board-certified plastic surgeon.

Speaker 2:

Absolutely essential. They can assess your specific situation and give you the best advice.

Speaker 1:

And maybe a final thought to leave you with Considering these surgical advancements and these options for better long-term support, like the internal bra, how is this changing how we think about cosmetic surgery results? You know their predictability, their longevity.

Speaker 2:

Hmm, that's interesting. Does it make these kinds of procedures feel well, maybe more reliable in the long run than people previously thought? What new questions does that raise for someone thinking about it?

Speaker 1:

Exactly Something to ponder. Thank you for listening to the Beauty Standard with Dr Roy Kim. Make sure to follow for future topics and episodes.