Sub-Fascial Breast Augmentation with an "Internal Bra"

Board-certified plastic surgeon Dr. Steven Sigalove is excited to bring the “internal bra” sub-fascial breast augmentation technique to Scottsdale Center for Plastic Surgery. This approach to one of the world’s most popular cosmetic procedures allows qualified patients with a minimally invasive, muscle-sparing breast augmentation that reduces both post-operative discomfort and recovery time.

Unlike standard submuscular (dual plane) breast augmentation, where the pectoralis major muscle is partially divided and elevated, this technique is based upon creating a pocket by carefully dissecting the pectoralis fascia (tissue covering the muscle) off of the pectoralis major muscle. The implant is then inserted into the pocket created underneath the fascia and breast tissue and is supported by a piece of bio-resorbable mesh which functions as an “internal bra.” It is important to note that this mesh is very safe, completely reabsorbed, and replaced by your own tissues over time. It is totally unrelated to the vaginal mesh that is often seen in lawsuit commercials. The procedure maximizes the aesthetic outcome by ensuring a beautifully shaped breast, and Dr. Sigalove or Dr. Cohen can help determine if the sub-fascial approach is appropriate for you.

The resorbable mesh provides stability, and over time the mesh is replaced with your own collagen, which is stronger than the natural tissues. This mesh is the key to success with this procedure as it reduces the incidence of malposition, bottoming-out, and rippling, which can be common problems with traditional “over the muscle” breast augmentation. No drains are needed with this type of mesh.

Sub-fascial breast augmentation is ideal for women who exercise regularly, do yoga or Pilates, lift weights, or perform body building and want to return to their regular routines as early as possible following their operation. By avoiding dissection of the pectoralis major muscle, patients can resume normal activities within a few weeks following their surgery. Compared to standard breast augmentations, the recovery time and time back to work tends to be faster, and patients rarely require medications stronger than ibuprofen or Tylenol. Additionally, by not placing the implant below the muscle, the unwanted side-effect known as “hyper-animation” or “flexion deformity” is avoided. Finally, in patients with wider-spaced chest muscles, this technique can allow for a narrower cleavage spacing because placement of the implants is independent from where the muscles insert on the sternum.

The Sub-Fascial Approach: Are You a Candidate?

The sub-fascial augmentation with an internal bra approach is popular thanks to its reduced recovery time; however, each patient must be evaluated to determine if sub-fascial is the right approach for their unique anatomy. A detailed assessment by Dr. Sigalove or Dr. Cohen is critical to ensure that this procedure is appropriate, and in patients with unfavorable anatomy for this approach (for example, those with very thin soft tissue coverage), a dual-plane breast augmentation is an excellent alternative option.

sub-fascial breast augmentation diagram

During the surgery, Dr. Sigalove or Dr. Cohen creates a pocket between the fascia of the pectoralis major muscle and the breast tissue. He places your preferred implant within this pocket and supports it with the resorbable mesh.

Like traditional breast augmentation, sub-fascial breast augmentation is performed under general anesthesia with a board-certified M.D. anesthesiologist in our ultra-modern, state-accredited surgical center. Both surgeons typically use the inframammary (breast crease) incision to place the implant, which allows them to both precisely control the dissection of the pocket and minimize the risk of capsular contracture. The implant is inserted using a Keller Funnel for a “no-touch technique,” which further reduces risks of infection and capsular contraction.

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What to Expect After Sub-Facial Breast Augmentation

Within a few days following surgery, most sub-fascial breast augmentation patients are comfortably back to work and other normal daily activities. An additional week is required before getting back to light exercise such as yoga and Pilates.

If a rapid recovery after breast augmentation sounds appealing to you, request your consultation online, or call Scottsdale Center for Plastic Surgery at (480) 423-1973 to schedule a detailed and customized evaluation with Dr. Sigalove or Dr. Cohen.

Modern Beauty

See Dr. Cohen on Modern Beauty, a series on the Style Network.

See Dr. Cohen on Modern Beauty, a series on the Style Network.
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