Isn’t a breast lift forever?! Sometimes patients figure out that a breast lift doesn’t last as long as they expected, and after several months or years the shape of the breasts start to change. This is because…GRAVITY comes into play and takes the perkiness away! Basically, the perky breast becomes flatter and more concave in the upper pole and more convex and saggy in the lower pole.

Plastics surgeons have been faced with this fact, and have been trying to find a solution to improve it for over 50 years. Every year, there are over 100,000 breast lift procedures performed in the U.S. A breast lift is a very popular and frequently performed procedure, as a single procedure or in combination with breast implants. For longer lasting results of a breast lift is to place a breast implants while performing breast lift surgery. This preserves upper pole fullness for a long time; however, it doesn’t prevent breast tissue to descend due to gravity. The implants will stay in place, but in time, the breast tissue will end up sagging.

So, we ask Dr. Zoran, who has been performing breast lift procedures with different techniques for over 30 years, how do we prevent this? “Due to the process of aging, breast tissue, elasticity of the skin, and other soft tissues become weaker as a support bra. As we know gravity pulls everything down. This gravity effect doesn’t include just patient’s breasts, but also face, neck, abdomen, thighs, and buttocks. One way to diminish breast sagging after a breast lift (mastopexy) is to reduce the amount of breast tissue, in other words, to do a small to moderate breast reduction. Removed breast volume is then replaced with an implant; remaining breast tissue serves as a cushion and preserves natural breast shape and feel. However, this is a very demanding procedure, which requires good pre-operative evaluation, experience and surgical skills.”

When researching other breast lift options online, some may find the Internal Bra Lift. This is the recommended solution to prevent breast ptosis (sagging) after a breast lift. There are different forms of “internal bra,” including fixation of “internal bra” to the ribs and collar bone with screws? This may sound unpleasant, so we ask Dr. Zoran is this dangerous?

Dr. Zoran explains that “the inner bra concept has been around since the early eighties. Surgeons were experimenting with surgical absorbable mesh products, which can be placed around the entire breast or around lower pole of the breast to maintain shape and position. The goal was to prevent lower pole from sagging. However, these are foreign materials and some of them have shown in time to create serious complications similar to synthetic meshes used for abdominal hernia or pelvic floor repair.  Recently, after good experience with human and animal dermal grafts in reconstructive breast surgery after cancer, we started using acellular grafts in the form of a support bra for cosmetic breast surgery. In time graft material is replaced with patient’s own tissue. The resulting scar-like structure increases the thickness and overall support to the lower pole of the breasts.  This additional support is likely to reduce and/or slow sagging of the lower breast pole. However, these materials are very expensive and cost around $3,500-$7,000 per patient. It is still unknown whether this is a better alternative than one which includes breast reduction/lift and implants.”


Although the Internal Bra Lift may be an appealing concept to the patient who wants very large breasts to stay perky, there is no evidence that this procedure actually works and what is a complication rate. Placing foreign materials in your body beside breast implants, increases chance of infection, scarring and deformity, especially if more economic synthetic mesh materials are used for internal bra. Scientific literature does not support this concept, yet. Before making  decision about” Internal Bra Lift”, take a time to consult 2-3 board certified plastic surgeons with good reputation in  breast lift procedures.