Many have been considering the internal bra as a means of improving the shape and positioning of the breasts. The techniques and materials used in the augmentation have been evolving since the introduction of the concept in 1981. Here is an excerpt from a professional article with matters which you may wish to consider. Italics here, are mine. At the end of the article I offer you the link to the full article which if considering the process, you should read in full.
The internal bra technique involves the placement of mesh inside the breast pocket as a means of replacing the compromised ligamentous suspension system. In the case of synthetic mesh, the induction of fibrous tissue then serves to support the breast parenchyma (the functional tissue of an organ) for a long-term, more stable aesthetic outcome.
Although the internal bra technique has the potential for improved cosmetic outcomes, there are also concerns about the increased risk of postoperative complications with the use of matrices, including infection, seroma formation, and skin necrosis. Additionally, the cost of mesh is not insignificant, although synthetic meshes are a more cost-effective option than the acellular dermal matrix (ADM).
Concerns have also been raised about the impact of mesh placement on the visualization of the breast parenchyma with various breast cancer screening modalities as well as the impact on rates of cancer recurrence. In addition, radiation therapy has been found to be an independent predictor of complications with higher rates of implant loss and capsular contracture in patients who underwent implant-based reconstructions with the use of mesh. Although there are increasing data on the use of mesh in breast surgery, this application of ADM or synthetic mesh is considered off-label use by the Food and Drug Administration.
Although the use of mesh for soft-tissue support in breast surgery has become increasingly common over the last 2 decades, there is a lack of strong data supporting its use. This systematic review and meta-analysis aimed to further elucidate the potential risks and benefits of using the mesh internal bra system by analysing the safety data and complication risks, and summarising qualitative and quantitative evidence regarding cosmetic outcomes.
Mesh is commonly used across surgical specialties with a generally well-demonstrated favourable safety profile; however, there is a deficit of high-quality studies regarding safety and rates of complications of mesh in breast surgery specifically. Despite myriad reports of improved breast shape and/or decreased incidence of ptosis (downward droop) and pseudoptosis, there are insufficient data to support these claims.
Another important consideration is the optimal type of mesh to be used in breast surgery. There are a wide variety of different types of mesh, including biologic and synthetic (absorbable, nonabsorbable, and mixed, partially absorbable). There are too few studies with small sample sizes and a deficit of data in this selection of studies to adequately compare the rates of complications or cosmetic outcomes between different types of meshes, especially considering the lack of reliable data to make generalised conclusions regarding long-term cosmesis with the use of mesh.
However, the question of optimising the type of mesh for breast surgery is an important one. The literature suggests that there are relatively similar rates of complications between synthetic and biologic meshes, although ADM has been shown to have higher rates of hematoma formation. With respect to cosmetic outcomes, mesh with rapid absorption is unable to provide appropriate long-term support to the breast tissue, but the efficacy of materials with longer absorption times has not been proven, despite its relatively common use. It has been theorised that resorbable meshes leave behind a collagen scaffold that can support the breast tissue or implant, but there is insufficient evidence that absorbable meshes can provide long-lasting cosmetic results.
The use of the mesh internal bra system has become increasingly popular in practice. Although there does not seem to be a significant difference in risk profile compared with breast surgery without the use of mesh, the current data, albeit limited, do not support the claims of improved cosmetic outcomes. Further well-controlled, quantitative studies are necessary to objectively evaluate the cosmetic benefits of using mesh in breast surgery.
The above is not my own work! The above excerpts are taken from (and I suggest you should read in full, if considering an internal bra):
Williams, Sonya BS; Shauly, Orr MD; Menon, Ambika MD; Jolkovsky, Eliana BA; Gould, Daniel J. MD, PhD; Losken, Albert MD†. Efficacy of Mesh Use in Breast Surgery: A Comprehensive Review of Complications and Aesthetic Outcomes. Plastic & Reconstructive Surgery-Global Open 13(2):p e6537, February 2025. | DOI: 10.1097/GOX.0000000000006537
Division of Plastic and Reconstructive Surgery, Emory University, Atlanta, GA. Department of Medicine, University of California Los Angeles David Geffen School of Medicine, Los Angeles, CA Private Practice, Beverly Hills, CA.
Original Published online 11 February 2025.
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