SURGERY JOURNAL - 03/25/2026
Breast Lift After Implant Removal & Internal Dermal Bra Breast Lift

Happy Wednesday, everyone. Today we are doing implant removal and a breast lift. Our patient has had breast augmentation that was performed 17 years ago. She has saline implants. This one has clearly leaked, so she wants both of them out. What you'll notice is the fact that she has a good amount of breast sagging over the implants. Implants don't sag, but breast tissue continues to sag over it as we age. Another issue is the fact that placement of the implants has lowered her breasts on her chest and made them wide. You see how wide this breast is. So in the process of lifting it, performing an internal dermal bra breast lift and repositioning the breast higher on her chest, I'm also going to try to make them narrower so that Not only the width problem is corrected, but also the height problem is corrected, and then the breast sagging itself is corrected. And then we're going to shape it and create projection using her own breast tissue. You ready? Ready. Thank you.

So I wanted to take this opportunity to show you what we've accomplished so far. We took her deflated saline implant out, which was this. This one is not deflated, but what you'll notice is that this breast is this wide, probably about seven or eight inches, and this one isn't wide anymore because I just narrowed it. Not only I've made it much narrower, By bringing the whole outer chest tissue forward and recruited that tissue to give this breast projection and volume, but also have repositioned the breast higher on her chest. Look at this inframammary fold versus this one. You see how much higher it is? So we've raised the inframammary crease. By raising that, we've repositioned the whole breast unit higher on her chest like that. Then we've made it narrower, and then we've reshaped it. Obviously, it's overcorrected, and obviously this is gonna settle, but it's better for it to settle from up here than your standard breast lift, which is down here, which is this. So a ton of difference. These procedures take a lot longer to do. They take a lot longer because there is no Dead space inside, meaning that the tissue of the breast is sutured appropriately as per plan of surgery. This is a structural breast lift. Every part of this breast is lifted, repositioned, and sutured, and that's what's gonna give you longevity, rather than a standard breast lift that relies on skin closure to hold the breast in place. Also the problem with skin closure only is not only the fact that the skin will relax and you lose your correction, the skin cannot create projection. The skin cannot reshape the breast. And if you want reshaping, I mean this and narrowing and control, we have to essentially put all of those elements inside the surgery. Otherwise it's not gonna happen. And if you look at this side, you see how wide it is? All of this breast tissue was utilized on the other side to create volume and projection.

So we are now finished with our surgery and just look at what we've been able to achieve for our patient. Beautiful round breasts. We started with breast asymmetry given the fact that the right breast had a 380cc implant still within it and on the left side that implant had deflated so she had a less wide, smaller breast compared to the right side which had more skin. Today we removed the implants and performed an internal dermal bra breast lift what you what is clear from this angle is the fact that with the internal dermal bra we recruit a lot of the breast tissue and suture it at a higher position so we have more upper pole fullness and you can clearly see that from this angle This over correction obviously is necessary so that as the breasts settle in the future you still have a good amount of upper pole fullness another thing that we did for our patient is reposition is to reposition the breast higher on her chest by lifting her inframammary 01:11 --> 01:42 fold crease and you can see that in the prior surgical Video that we posted i also pulled all of her outer chest fat and breast tissue and recruited that and added that to her breasts so this is a true breast lift using the internal dermal bra technique and breast reshaping this procedure almost took me five hours and if i had done a standard breast lift would have been done in two and a half hours the difference is the fact that we do a structural lift lifting every element of the breasts from the inframammary fold to the breast tissue and we do a ton of suturing in order to create these beautiful round high-profile breasts.

Are you happy with your results? I am. I feel healthy. I feel lighter. I feel that everything can fit now. It feels perky, and I can walk around without a bra. And you have no implants anymore, right? No more. No more. All natural. All natural. So we removed 420 cc implants and used all of her own breast tissue to restore her breasts’ fullness, shape, roundness, and look at the quality of the scars. You see how beautiful they look. One thing that I want to emphasize is this incision is perfectly placed at the inframammary crease. And for it to stay like this, we actually suture the incision like that. So it’s not that it’s gonna end up doing that. You actually have to plan for it, and you have to reconstruct the inframammary crease, and then you have to make sure that the incision ends up correctly at that place. Time and time, I see patients who are here for breast lift revision, and one of the issues that they have is the fact that the incision and the inframammary creases are two different lines. As you come to her side view, you see she’s got a beautiful upper pole fullness. And as she said, she’s got a nice projection. This projection was built into this surgery using her own tissue. If we had removed tissue from her, she would have been flat. To create projection, you have to pull everything. You see what’s happening like that. This creates projection. So we do this internally using the internal dermal bra and also lots of suturing that goes internally. Hours get spent on each breast. So if I was doing a standard breast lift, one hour here, one hour here. When I do an internal dermal bra, this takes two hours, this takes two hours. So it’s twice longer for me to do the internal bra. But then again, it gives you profile, projection, and beautiful results. We also tighten her outer chest. Our incision goes perfectly. Yes, I could have put a shorter incision here, but then she would have had dog ear. I could have extended the incision, but then you go towards her back, so it’s perfectly placed at the junction between the front and the back. She has no dog ears after chest tightening. So again, as I always emphasize, it’s not just about the breasts. The breasts are part of the bigger picture. The bigger picture is her front, her chest, and the breasts are just part of it. So when you do surgeries that only take care of one element, neglect the others, then it doesn’t look amazing. And what we try to do is not only do the breasts, but also attend to the surrounding tissues so that our picture becomes even more beautiful. Anything else? No, that will do it. Thank you.