Understanding Internal Bras: A Guide to Enhanced Breast Support

When considering a breast augmentation or a combined lift with implants, patients often have questions about how to maintain their results over time - especially if they’ve experienced weight changes, pregnancies, or skin laxity. One option Dr. Rau may recommend to enhance support and longevity is an internal bra. Despite the name, an internal bra is not a separate procedure. Instead, it’s an advanced surgical technique used during breast augmentation or breast lift surgery to strengthen internal support and help maintain beautiful, long-lasting results. 

In this guide, we’ll walk through what internal bras are, why they’re used, and which patients benefit most from them. 

What is an Internal Bra? 

An internal bra is a supportive material placed inside the breast during surgery that acts like internal scaffolding. Instead of relying solely on the skin to support the weight of implants, the internal bra helps reinforce the breast structure from the inside. 

Two Types of Internal Support Materials

Internal bras can be created using: 

• Dermal Matrix: A medical-grade material derived from deeper layers of human or animal skin. 

• Biosynthetic Mesh: A lab-engineered mesh that gradually dissolves over time while encouraging new collagen formation. 

Both materials integrate with the patient’s own tissues and slowly absorb as the body builds natural internal support. 

How an Internal Bra Works

Dr. Rau places the internal bra by securing it to deeper structures - usually the chest muscle and a sturdy layer over the ribs - the wrapping is partially around the implant. As the mesh dissolves, the reinforced collagen helps maintain the implant’s ideal position, especially in patients with weaker tissue support. 

Why Use an Internal Bra?

Internal bras offer several important benefits, particularly for patients who are at higher risk of experiencing implant malposition or sagging after surgery. 

Key Benefits of an Internal Bra

• Maintains Implant Position

  Helps prevent implants from sliding downward (“bottoming out”) by giving them a secure internal foundation. 

• Enhances SymmetryIdeal for patients with uneven breast shape or tissue differences - allowing the implant to rest in the correct position on each side. 

• Supports Larger, Heavier ImplantsLarger implants naturally place more weight on breast tissue. Internal support significantly reduces strain on the skin and improves long-term shape. 

• Reduces Rippling and Skin StretchingBy relying less on the skin envelope, internal bras minimize stretching, thinning, and visible implant edges. 

Without an Internal Bra

If an internal bra is not used, the implant is supported primarily by: 

• The patient’s natural skin envelope

• The underlying muscle (depending on placement)

• The internal scar capsule that forms after surgery. 

For many patients, this is sufficient. But for those with weaker tissue or higher risk of implant drop, additional internal support makes a meaningful difference in outcomes and longevity. 

Who Is a Good Candidate for an Internal Bra? 

During your consultation, Dr. Rau will evaluate your skin quality, anatomy, medical history, and aesthetic goals to determine whether internal support will improve your results. 

Internal bras are especially helpful for patients who: 

• Have experienced massive weight lossThe skin may be stretched or thinned, increasing the risk of implant descent. 

• Have had multiple pregnancies or breastfeedingThese changes often weaken the skin envelope and breast support structures. 

• Are choosing larger or heavier implantsAdded weight increased the likelihood of bottoming out over time. 

• Have significant breast asymmetryInternal support helps the implants sit in the most symmetrical position possible. 

• Have already experienced bottoming outAn internal bra can help correct implant displacement and prevent recurring issues. 

What Does “Bottoming Out” Mean? 

Bottoming out occurs when an implant gradually slips downward on the chest. Patients may notice: 

• A fuller, elongated lower breast pole

• Nipples sitting unusually high on the breast mound

• Nipples appearing to point upward

• Loss of the balanced, youthful breast shape created by surgery. 

Using an internal bra dramatically lowers the risk of bottoming out by providing reliable internal support that skin alone may not achieve - especially over time. 

Internal Bras and Breast Lifts

Internal bras play a critical role during breast lift procedures with implants. When the skin is being tightened and reshaped, the internal bra ensures that the implant stays in its ideal position while the skin envelope is draped and sutured around the lifted breast mound. This separation of responsibilities - internal support for the implant, external shaping for the skin - results in improved longevity and aesthetic symmetry. 

Is an Internal Bra Right for You?

Not every breast surgery requires an internal bra, but for the right patient, it can be a powerful tool for long-term success. During your consultation, Dr. Rau will examine your anatomy, evaluate your goals, and determine whether internal support would improve your surgical outcome. 

If you have concerns about skin laxity, are considering larger implants, or want to ensure your results stay beautifully lifted for years to come, an internal bra may be an excellent addition to your procedure. 

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