I was embarrassed to walk around without a bra, even lounging at home,” Lisa, 48, says. “My breasts were sagging, and one drooped even more than the other.” Lisa, a 36C and an avid runner, didn’t want larger breasts or implants. “I just wanted them restored to where they used to be.” Until recently her options would have been limited to a traditional breastlift that might not offer long-term results. But Lisa’s plastic surgeon presented her with the opportunity to become one of the first patients to try a new technique: the insertion of a bioresorbable mesh called GalaFlex, which acts like an internal bra, holding the girls up. “My breasts look perkier now,” Lisa says. “They’re symmetrical with a nice round shape, and they don’t bounce around when I run.”
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Breast sagging can be caused by a number of factors, including genetics, changes in weight, pregnancy and breast-feeding, high-impact exercise, aging, and menopause (basically, life for most women). These same factors may also cause the surrounding skin to weaken along with the breast tissue. “With a traditional lift, you take out skin and pull the rest back together,” says Caroline Glicksman, M.D., the plastic surgeon in Sea Girt, New Jersey, who performed Lisa’s surgery. “That will look great for a year or two, but most women who come in have poor skin quality, and when the skin starts to stretch, even if the nipple stays high, the bottom part of the breast will begin to fall.” (Doctors refer to this as “bottoming out,” an expression that, alas, makes perfect sense.)
The idea of adding some form of internal support—basically scaffolding beneath the breasts—to help traditional lifts last longer is not new. In the past, though, it took the form of silk or permanent synthetics, both of which often had a high risk of complications, like infection and prolonged inflammation. GalaFlex mesh is made of P4HB (officially known as poly-4-hydroxybutyrate), a polymer that the body breaks down naturally into carbon dioxide and water, much like absorbable stitches, though at a slower rate. “GalaFlex is a game changer,” says Ashley Gordon, M.D., a plastic surgeon in Austin, Texas. “While the mesh dissolves over 12 to 18 months, collagen and elastin enter into the scaffold and create a network that is three to four times stronger than native tissue.” The procedure doesn’t change cup size but does result in higher, fuller breasts. And unlike previous forms of implants or meshes, the GalaFlex is undetectable to the touch, Glicksman says: “There are no edges, and it makes a traditional lift last longer.” Because the procedure is still new, there aren’t studies to determine how long results will last, but doctors using the mesh have observed that there is no droop for at least one year.
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“I just wanted them restored to where they used to be.”
The outpatient procedure adds approximately one hour to a traditional two- to three-hour breastlift and is done under general anesthesia. (Breast-lifts range from $6,000 to $9,000; the mesh is an additional $500 to $1,000.) The surgeon places the mesh beneath the breast like a hammock and stitches it to the sides of the chest wall. “The scarring isn’t any different from a regular lift because all of the stitching is done internally,” explains Glicksman. “Most external scars heal nicely with massage and the use of scar gel.” As with any surgery, risks include infection and bruising. Recovery time is usually a few days at home, and while you can resume normal activity within a week, high-impact exercise is verboten for up to six weeks. Lisa was back to work within days.
Not all doctors are quite so enthusiastic about the procedure, though. Adam Kolker, M.D., a New York plastic surgeon who has lifted some of the most celebrated breasts in town, is unconvinced. “With a proper lift, you do more than just tighten skin; you also reposition tissue, and it should last about 10 years. It’s debatable whether mesh will make it last longer.” Kolker is also concerned about screening for cancer. “We don’t have enough long-term data about breast cancer detection with mesh,” he says. “You will have some scar tissue, and that may interfere with mammograms.” When Lisa had a mammogram eight months after her surgery, the radiologist was concerned about scar tissue. However, it hasn’t been an issue with subsequent mammograms, and Lisa remains thrilled with the results, three years after her surgery. “I know gravity will catch up with me eventually, but for now I have one less thing to feel self-conscious about.”