This also bothered Dr. Rowe, who responded to my initial consultation with multiple surgical plans. “One of the key things I try to ascertain when examining a patient: what are their actual expectations, and more importantly, are they realistic for the patient?”
When Dr. Rowe first opened his private practice in 2004, routinely implanting 500 and 600cc implants—for reference, the size of a cup is about 250cc. With larger implants falling out faster, creating sagging, she says women have been trending smaller over the past five years. Fat transfer enhancements, popular with those seeking natural-looking breasts, can calcify into hard lumps and be mistaken for cancer during a mammogram—resulting in additional surgery. Complications and lifespan associated with implants have also increased well known: subsequent surgeries to remove or replace implants after 10 years or earlier and implant ruptures must replaced in up to 17.7% percent of patients after 6 or 10 years (the rupture rate after revision augmentation is between 2.9% and 14.7%). Breast implant disease is a controversial topic—it’s a patient-coined term, rather than a medical diagnosis. There is a lack of data on the subject. and there’s no real agreement on what the symptoms are, although patients tend to name elusive symptoms like fatigue, joint pain, brain fog, rash, memory loss—but the FDA and many doctors agree there are still many to learn, Grant Stevens, president of the American Society for Aesthetic Plastic Surgery (ASAPS) and clinical professor of plastic surgery at USC’s Keck School of Medicine, previously said to Allure.
Still, the promise of built-in cleavage was enticing. I wanted to go bra without insecurity. Wear plunging dresses without experimenting with endless sticky chops. I didn’t want to lift my chest in tight t-shirts. At the same time, I didn’t want to get bigger and I didn’t want to have multiple surgeries on my breasts as I got older. My heart just wasn’t in implants.
“Whereas I used to do a lot of breast implant mastopexies – where you put the implants in at the same time – nowadays I probably do more mastopexies [breast lifts] alone,” he says.
After the consultation, the options Dr. Rowe offered me were a mastectomy with a small implant or a mastectomy with an inner bra. The inner bra is a lesser-known procedure that started in the ’80s and has gained wider awareness more recently, Rowe says, with the help of a rebrand and big marketing push. Originally, the inner bra was a kind of cone shape (Madonna image) created from a Gore-tex mesh. Over time, there were claims that mesh could obscure the mammogram, and insurance companies began denying mammogram claims if the patient wore an underwire bra. That’s where Galaflex came in. First a new inner bra material was implemented circa 2016, best described as absorbable mesh sewn to the chest wall.
