Getting longer lasting internal bra breast lift results without absorbable mesh [Austin Hayes, MD, Portland]

Dr. Hayes (00:00):
My name's Austin Hayes. I'm a plastic surgeon in Portland, Oregon.

Eva Sheie (00:04):
How is the double bra different or similar to the internal bra technique that is probably more well known or emerging at this point?

Dr. Hayes (00:13):
My impression is, is that when people hear internal bra, they think of mesh. And it's not mesh, it's just an absorbable suture that's meant to last about six months. But the repair that we're creating, the shelf that we're creating is meant to be permanent. And so I would say when people think mesh, that's not it. It's not mesh, it's natural tissue. So that's really the difference. And then mesh doesn't necessarily mean that the crease has actually been secured. You could use mesh and not secure the crease, and I don't know how well that works because I just don't use mesh for my breast lifts.

Eva Sheie (00:48):
Do you ever use the internal bra mesh, that typical GalaFLEX for anything?

Dr. Hayes (00:54):
All the time. All the time, yeah. I probably use it for, oh man, it's hard to say, maybe 50% of my breast augmentations. But that mesh is securing, is actually holding the implant. So when I do an augmentation, it's implant in, fold is sewn, and then mesh is placed. So I'm essentially recreating an entire bra. So I'm securing the fold and that recreates the wire of the bra. And then by putting in a mesh cup, I'm creating the cup of a bra. And then, as you know, GalaFLEX absorbs over the course of about two to three years and leaves behind a layer of tissue that's five times stronger than natural. So the implant has support. But when I do a breast lift, there's no place for me to put in mesh. I'm reconfiguring the tissue, creating a hammock for the breast tissue, double sewn fold, so mesh doesn't have a place for me because it doesn't provide any support from those cases for me.

Eva Sheie (01:53):
In the lift, you're really talking about just a lift without an implant.

Dr. Hayes (01:58):
Totally. But the double bra actually, so it's kind of a little bit of a side note, but when people get a breast lift with implants, those operations are commonly performed together, but also commonly performed separately. For people who have significant sagging, thin tissues, desire real, the most braless look possible, you might lift them first. So you can do a double bra breast lift first, let them heal, wait six to nine months, and then come back and augment them with mesh. So there are times where I do everything. And even a single stage breast lift with implants, when I do that, it's everything. It's double bra, it's mesh. Yeah, it's really cool.

Eva Sheie (02:37):
You said earlier you use the mesh in 50% of your breast augmentations. Why don't you need it in the other 50%?

Dr. Hayes (02:45):
Great question. One of your podcasts that you did was with a plastic surgeon named Steve Sigalove in Phoenix.

Eva Sheie (02:53):
I knew you were gonna say him.

Dr. Hayes (02:53):
Yeah, I know you did. Yeah, so that was an awesome episode. I had seen him talk about that before. Sientra does essentially like a weekend conference, and he came to speak, I was at the conference in Phoenix and he came to speak and basically was talking about how he was converting a lot of his augmentation to subfascial with mesh. And so I kind of began journey and I've been really happy. Adam Oppenheimer is another friend of mine, plastic surgeon in Orlando, and he and I go back and forth and talk about technique, and he was converting a lot to subfascial. And so that was another impetus to start. And for people who are good candidates, lovely. So when I do an on top of the muscle augmentation, all of those get mesh. And when I go submuscular, I think probably most patients benefit from mesh, but not everyone chooses that route. And so it ends up coming out to maybe 50/50.

Eva Sheie (03:53):
Where can we find your Instagram? What's your handle?

Dr. Hayes (03:55):
At Dr. and then my name Austin, A-U-S-T-I-N. Hayes, H-A-Y-E-S. That's my Instagram. That's the best place to find me

Eva Sheie (04:04):
On this podcast, we bring you directly to the doctors who are where before meets after. Links to our guest's website and contact info are in your show notes. Follow us on Instagram @wherebeforemeetsafter. Where Before Meets After is a production of The Axis, the podcast agency for aesthetics, theaxis.io.