When complications arise after breast augmentation, such as implant displacement, bottoming out, or asymmetry, patients often seek revision surgery to correct the issues and restore the desired appearance. With advancements in surgical techniques, there are now several options for addressing these complications, each with its own set of advantages.

One of the most innovative and effective solutions is the Internal Bra technique, pioneered by Dr. Don R. Revis, JR., MD, FACS. But how does this technique compare to other breast augmentation revision methods? In this article, we’ll explore the Internal Bra technique in comparison to other commonly used revision approaches, helping you understand which solution might be best for your unique needs.

The Internal Bra Technique: Overview

The Internal Bra technique is an advanced solution designed to provide structural support to breast implants, particularly in cases where the natural breast tissue is weak or the implant has shifted out of place. This procedure involves reinforcing the implant pocket with biologic or synthetic mesh, creating an internal “scaffold” that holds the implant securely in its correct position. By adding this extra layer of support, the Internal Bra prevents future complications such as bottoming out, lateral displacement, and implant sagging.

Traditional Revision Techniques for Breast Augmentation

Before diving into a comparison, let’s briefly examine some other common revision techniques used to correct complications after breast augmentation:

1. Capsulorrhaphy (Internal Sutures)

Capsulorrhaphy is a common revision technique that involves stitching the internal breast pocket to adjust its size and shape. The goal is to reposition the implant and prevent it from shifting again. Capsulorrhaphy can be performed to correct bottoming out, symmastia (where implants drift toward the center), or lateral displacement (where implants move to the sides).

2. Pocket Change (Submuscular Placement)

In some cases, surgeons may opt to change the implant placement from subglandular (above the muscle) to submuscular (below the muscle). This technique is often used when the initial implant placement caused complications, such as visible rippling or bottoming out. Submuscular placement offers greater support, as the muscle helps hold the implant in place and reduces the risk of implant migration.

3. Fat Grafting

Fat grafting, also known as fat transfer, is a procedure that involves harvesting fat from one area of the patient’s body (such as the abdomen or thighs) and injecting it into the breast to enhance shape and fullness. While primarily used to improve the appearance of the breast’s contour, fat grafting can also provide additional coverage for the implant, particularly in cases where there is thin tissue or visible rippling.

4. Strattice/ADM (Acellular Dermal Matrix)

Acellular Dermal Matrix (ADM) products, such as Strattice or AlloDerm, are biologic grafts used to reinforce the breast tissue and provide additional support for implants. These materials are often used in complex revision cases where the tissue has weakened, and they act as a scaffold for new tissue growth. ADM is commonly used in cases of capsular contracture, implant displacement, or for patients undergoing breast reconstruction after mastectomy.

Comparing the Internal Bra to Other Techniques

Now that we’ve reviewed the most common breast augmentation revision methods, let’s compare how the Internal Bra technique stacks up against these approaches in terms of effectiveness, support, and long-term results.

1. Support and Longevity

• Internal Bra: The Internal Bra provides unparalleled support by reinforcing the implant pocket with mesh, which integrates with the surrounding tissue and creates a permanent structure to hold the implant in place. This long-lasting support reduces the risk of future complications like bottoming out or displacement, making it an excellent choice for patients seeking durable results.
• Capsulorrhaphy: While capsulorrhaphy can help reposition implants, it relies on sutures to tighten the pocket, which may not provide enough long-term support in cases of thin or weak tissue. Over time, the sutures may loosen, and the implants may shift again, particularly in cases where large implants are involved.
• Submuscular Placement: Changing the implant placement to a submuscular position can provide better support than subglandular placement, as the muscle helps hold the implant in place. However, this technique may not be suitable for all patients, particularly those who already have implants placed under the muscle or those with limited muscle coverage.
• Fat Grafting: While fat grafting can improve the appearance of the breasts and add volume, it does not provide structural support for implants. It is typically used for aesthetic enhancements rather than corrective purposes for implant displacement or bottoming out.
• ADM Products (Strattice/AlloDerm): ADM products, like Strattice, offer excellent tissue reinforcement and are often used in complex revision cases. Like the Internal Bra, these grafts provide long-term support by integrating with the body’s tissue. However, the Internal Bra offers a less invasive option while still delivering significant structural support.

2. Prevention of Future Complications

• Internal Bra: The Internal Bra is specifically designed to prevent future complications by providing a secure foundation for the implants. The mesh reinforces the breast tissue and implant pocket, significantly reducing the likelihood of complications such as bottoming out, lateral displacement, or implant sagging in the future.
• Capsulorrhaphy: While capsulorrhaphy can correct existing complications, it doesn’t provide the same level of future prevention as the Internal Bra. If the tissue remains weak or if large implants are used, complications may recur over time.
• Submuscular Placement: Submuscular placement can reduce the risk of future complications by offering additional support from the muscle. However, this technique does not address issues related to weak or stretched tissue, and further displacement or bottoming out may still occur.
• Fat Grafting: Fat grafting alone does not prevent future implant complications, as it does not reinforce the tissue or provide internal support for the implants.
• ADM Products: ADM products offer excellent long-term prevention of complications. They are particularly beneficial for patients with weak tissue or those who are prone to issues like capsular contracture. The Internal Bra, however, provides a similar level of prevention but without the need for biologic grafts, making it less invasive.

3. Customization and Versatility

• Internal Bra: The Internal Bra technique can be customized to meet each patient’s specific needs, whether they are undergoing revision surgery for complications like bottoming out, displacement, or simply seeking preventive support for larger implants. The versatility of the mesh material makes it a highly adaptable solution.
• Capsulorrhaphy: Capsulorrhaphy is a straightforward technique that can be used to adjust the implant pocket, but it may not be as effective for complex cases where additional tissue support is needed.
• Submuscular Placement: While changing the implant placement can provide added support, this technique is limited in its ability to address all types of complications. It’s not a suitable option for every patient, especially those with submuscular implants or thin tissue.
• Fat Grafting: Fat grafting can be used to enhance breast shape and contour, but it doesn’t offer the versatility needed for correcting implant displacement or other structural issues.
• ADM Products: ADM products are highly versatile and can be customized to meet the needs of complex revision cases. They are commonly used in breast reconstruction and cases involving weak tissue. The Internal Bra offers a similar level of customization with fewer complications.

Choosing the Best Option for Your Needs

Ultimately, the best breast augmentation revision technique will depend on your specific circumstances, including the type of complication, the strength of your breast tissue, and your desired outcome. While each revision method has its benefits, the Internal Bra technique offers a unique combination of support, durability, and prevention that sets it apart from traditional methods.

Whether you are dealing with complications from a previous augmentation or simply want to ensure long-lasting, stable results, the Internal Bra may be the right choice for you.

Take the Next Step with Dr. Don R. Revis, JR., MD, FACS

If you’re considering breast augmentation revision surgery and want to learn more about the Internal Bra technique and other options, schedule your consultation today with Dr. Don R. Revis, JR., MD, FACS. With his expertise and innovative approach, you can trust that you’re in the best hands for achieving the beautiful, lasting results you deserve.

Your confidence begins with the right support.