Breast mesh implants are surgical mesh products placed inside the chest to create a supportive scaffold that integrates with natural tissue over time, most often in breast reconstruction surgery and certain cosmetic procedures.
In breast reconstructive surgery and implant-based breast reconstruction, surgeons may use an internal bra mesh implant or acellular dermal matrix to reinforce thin tissue, define the lower breast pole, or help control implant position.
Similar techniques are sometimes used in cosmetic breast surgery involving mesh, including augmentation-mastopexy and breast lifts, when the surgeon believes tissue alone may not provide adequate long-term support.
Despite this growing use in breast surgery involving mesh, the FDA has stated that the safety and effectiveness of surgical mesh in breast surgery has not been determined.
The FDA has not approved any surgical mesh products specifically for use in breast surgery, including breast augmentation and reconstruction, and it has warned that no surgical mesh products are cleared or approved for use in breast augmentation or implant-based reconstruction.
In 2021, the FDA warned about differing complication rates among acellular dermal matrix products used in implant-based breast reconstruction, noting higher risks of major complications with certain ADMs compared to others or no ADM use at all.
In 2023, the FDA issued a letter to health care providers reiterating that no surgical mesh is cleared or approved for breast augmentation or reconstruction and that the benefit–risk profile for this use in breast surgery remains undefined.
Many internal bra and breast mesh devices reached the market through the 510(k) clearance process, which requires a showing of substantial equivalence to an existing device but does not independently prove safety and effectiveness in breast-specific applications.
Why and how breast mesh is used in internal bra surgery:
- To provide internal support when breast tissue is thin or weakened after mastectomy or prior operations
- To reinforce the lower breast pole and define the implant pocket in breast reconstruction surgery
- To help support the weight of an implant and reduce the risk of downward migration or “bottoming out”
- To contour the breast shape during healing, particularly in combined breast augmentation and breast lift procedures
- To bridge tissue gaps or provide soft tissue support where native tissue is insufficient after cancer surgery or trauma
- To stabilize revision surgery when prior implants, scarring, or radiation have compromised local tissue
For some patients, these techniques may help achieve or maintain an initial cosmetic or reconstructive result, but they also introduce foreign material into a delicate surgical field.
The FDA has highlighted that, in some settings, use of acellular dermal matrix and other mesh products has been associated with higher rates of complications such as infection, implant loss, and repeat operations compared to certain alternatives.
As a result, breast surgery involving mesh is now the focus of increased medical and legal scrutiny, and patients are encouraged to discuss the potential risks and benefits of mesh use in breast surgery with their health care providers before consenting to an internal bra or mesh-assisted procedure.
Types of Mesh Used in Breast Procedures
Breast procedures that use an internal bra technique can involve different internal bra mesh products depending on the goals of surgery, the quality of the tissue, and the surgeon’s preferences.
Biologic mesh materials are derived from processed human or animal tissue and are designed to integrate with the body more permanently, which is why they are often used in breast reconstruction and some complex revision settings.
Many synthetic mesh products used in breast lift surgery and reconstruction are made from bioresorbable polymers that gradually dissolve, allowing the body to replace the scaffold with its own collagen over time.
Different mesh brands and designs exist because surgeons need options that balance strength, flexibility, absorption rate, and tissue compatibility for specific procedures and patient needs.
Common types of mesh used in breast procedures include:
- Biologic mesh materials made from processed human or animal tissue (for example, acellular dermal matrices)
- Bioresorbable synthetic mesh designed to dissolve over time and be replaced by the patient’s own collagen
- Hybrid or biosynthetic mesh that combines synthetic structure with biologic-like behavior
- Permanent or long-lasting synthetic mesh used more selectively in certain reconstructive settings
- Brand-specific internal bra mesh products marketed for use in breast reconstruction, breast lift surgery, or revision procedures
