The next generation of the internal bra technique for breast lift surgery [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):
What kinds of procedures are most people coming to see you for these days?

Dr. Hayes (00:08):
Well, I do breast and body, and I do labiaplasty, so people come for the whole spectrum of what falls into that category. So breast lift, breast reduction, tummy tuck, breast augmentation, and labiaplasty, which is decreasing the size of labia minora, but probably I've been on this journey to try and make my breast lifts and my augmentation, but it started mostly with breast lift and then jumped into augmentation, but I've been on kind of maybe like a four year journey of trying to create the best breast lift that I can. So to make a long story short, the thing that people come and ask me about most now is breast lift and reduction cuz I created an operation that's pretty unique, and I did that about a year ago, and the word starting to spread, which is really cool.

Eva Sheie (00:55):
Does that operation have a name?

Dr. Hayes (00:57):
I didn't know what to call it, so I called it the double bra. Unfortunately, now it's actually three bras, so it's totally

Eva Sheie (01:05):
The triple bra breast lift.

Dr. Hayes (01:06):
I named it too early, but essentially it's an exceedingly meticulous way of securing the fold. And the fold of the breast is one of the most important parts of the breast lift and the reduction. And if you can get that right and figure out how to secure it properly, it completely changes the way it looks. And from, I'll tell you a funny story, I was at, I can't believe I'm admitting this, but Taylor Swift's first concert, I think it was in Arizona, was going on or had gone on, and my wife came home and said, oh, the concert's apparently amazing. It's 30 something songs. It's more than 15 outfit changes. And I was like, okay, we have to go for sure. So book tickets for that upcoming weekend, which was in Las Vegas, so flew down to Las Vegas. We had gotten off the airplane and we were sitting having breakfast and it was like a light bulb went off. And got a napkin from the waiter and a pen and just started drawing and just drew out this operation that had just popped into my mind, and that's the double bra. And then did the first one on Monday, two days later.

Eva Sheie (02:16):
I don't even know where to go with that, Austin.

Dr. Hayes (02:20):
Yeah, so it's funny. I would say that most of the cool innovations I've had in my career have kind of come like that. Think on it, you know you think about something for a long, long time, and then eventually you can't exactly pinpoint the origin of where the idea came from, but it kind of popped in, which is so cool.

Eva Sheie (02:38):
When you went in on Monday, did you have to tell the patient, here's what I'm going to do, or did you?

Dr. Hayes (02:44):
No, I think I told them. It's not like it was taking a big new risk. They already knew how I thought about breast lift and how I thought about reduction, and that I thought that securing the fold was supremely important and the way that I was planning to do it. And so it was a major, but a minor twist on that theme. And so however, I do think that I told them, but yeah, we did the first one and it was incredible how different it was. It wasn't even close. And you could tell on the table, and then those results continued. So that was just super gratifying.

Eva Sheie (03:22):
What did she think of it?

Dr. Hayes (03:23):
She thought it was great. I mean, the first three patients were women who had relatively small to medium sized breasts. So to be able to do what we were, so by securing the fold properly, the way you can tell that it's working is that the scar is truly in the fold. If the most, or I should say many, I can't say most, I don't know what every surgeon does, but many breast lifts, the majority of breast lifts, the breast tissue falls below the weakened crease. When you do the lift, you typically make an anchor shaped incision, and that incision that lives in the fold weakens the fold. And many people do nothing to support it, I would say that's most, but again, I don't know what other surgeons do. And then some surgeons sew it, and then there's again, the double bra, which is kind of that double sewn layer.

Dr. Hayes (04:15):
But to know that it's working, you look at the scar position, and so when the scar is riding up onto the breast, and this can happen up to an inch, an inch and a half, the breast is sliding down their torso. They're losing volume out of their breasts, and they're losing fullness at the top. And so the first three were small to medium sized breasts. So to be able to accomplish it was not the true test. A single sewn layer can do that. But when we were doing larger and larger patients over the subsequent months, and it was still holding, that was where it really starts to shine. And really the difference becomes noticed.

Eva Sheie (04:49):
When someone has a double bra breast lift, what is the recovery like? Is it typical, similar to, I don't even know what to compare it to.

Dr. Hayes (04:58):
It's different, but it's not. So because their fold has been sewn, it's sore, but usually that's what they notice. But surprisingly, operating on the breast, at least in my experience, is not that painful. So many patients will take pain medicine, but many will not. I mean, it might be Tylenol, and then a few days after surgery, then I let them start taking ibuprofen. But the big difference is feeling soreness and tightness at the bottom. And that's because it holds everything so tight, and that's why it works. That's why it has the result that it has. But that's the main thing they notice. But other than that, probably for the first two to three weeks, then I think the trajectory becomes very similar for the two recoveries.

Eva Sheie (05:41):
Where can we find your Instagram? What's your handle?

Dr. Hayes (05:43):
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 (05:52):
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.