The Surgeon Minute

An Internal Bra with GalaFLEX Mesh

An Internal Bra with GalaFLEX Mesh

Imagine what it would be like to walk around with an internal bra that was constantly lifting, supporting and shaping your breasts. Pretty fabulous, right? This is what GalaFLEX provides.

GalaFLEX is a biologically-derived mesh that plastic surgeons are now using to create an internal scaffold for soft tissue support. Dr. Bruce Van Natta of Indianapolis discusses the many ways that surgeons can use GalaFLEX, as well as the new GalaSHAPE and GalaFORM, in their breast surgeries.

Who is the GalaFLEX Patient?

GalaFLEX is an internal support mesh, or scaffold, that Dr. Van Natta says he’s been fortunate to be using in his breast surgeries for the last 3-4 years. It’s job is to provide soft tissue support, and it, “has really been a game changer.” Thanks to the success that he’s had using it with both his breast list and breast reduction patients, he has begun to apply the technique to other cases. For example, pocket stretch.

In the past, when a patient came to him with a pocket that had stretched, he would simply go in and stitch the pocket closed. Now, however, he uses the mesh to provide lasting reinforcement. “[It acts] kind of like suspenders and belts to put some added support there,” he shares.

Van Natta also uses the mesh with what he lovingly calls his, “911 breast augs”. These are patients who are an A minus, minus cup size. They are often fitness fanatics who have almost no breast tissue, many without even a distinct fold to the breast. In the past, the only option would have been to offer them a “pediatric sized implant” because he would have been worried that their tissue couldn’t support anything bigger. With materials like GalaFLEX, surgeons can now put in a big gal implant to give them a more natural looking result.

How GalaFLEX Works

GalaFLEX mesh is made of poly-4-hydroxybutyrate (P4HB), a biologically-derived material designed for minimal inflammatory response. When placed beneath the breasts, the mesh tricks the body into doing what it does naturally: it sees the polymer mesh as an intruder or foreign body and encases it with collagen or scar tissue. After 12-18 months, the mesh is naturally broken down into CO2 and H2O and eliminated, but the collagen that has formed around the mesh remains, continuing the support.

GalaFLEX internal process.

GalaFLEX 2.0: GalaSHAPE

At the end of the day, there is a fundamental problem with the original GalaFLEX mesh, it’s flat, 2D shape. With a two dimensional shape, wrapping it around a curved surface like a breast is not easily done. GalaFLEX 2.0 or GalaSHAPE, has since been released as a polymer that can be heated, as well as having a 3D out of the box. Surgeon can then take the GalaSHAPE and wrap it around the breast, utilizing tabs that can easily be fixed to the tissue.

GalaFLEX - GalaSHAPE 3D.

GalaFLEX 3.0: GalaFORM

Another recent offering from the company is called GalaFORM. It is the same 3D shape as the 2.0 version, only this one has a rim which gives it even more definition. Patients who see this one have no problem getting the concept because it looks so much like a bra.

GalaFLEX - GalaFORM 3D.

Why do females wear bras? They lift, support and, most importantly, shape the breasts into something that looks pretty. The GalaFORM in particular works really well with revisions and breast reconstructions because these are instances where the surgeon wants to try and define the shape of the tissues. With the advent of GalaSHAPE and GalaFORM, surgeons have more options for fine-tuning the look and shape of the breasts.

Patient Satisfaction High

Breast lift and breast reduction patients are historically some of the happiest patients around. They were happy even before the advent of the GalaFLEX mesh, but in order to achieve an ideal, natural, and long-lasting outcome, surgeons would often have to over lift the breasts because they were dealing with damaged skin caused by:

  • pregnancy
  • weight loss/gain
  • aging
  • combination of the above

Even though the surgeon would remove some of this damaged skin during the procedure and tighten things up, the surgery did not magically make the remaining skin more elastic. To compensate for this, the surgeon would over lift in anticipation that, “gravity was going to take back some of the result,” explains Dr. Van Natta. When you really talked to the breast lift and breast reduction patients long term, they would say that they loved their breasts, but they missed that extra fullness and lift that they had in the first month or two. It was a problem without a great answer until mesh products like GalaFLEX. The mesh helps to ensure a maintainable result so that surgeons no longer need to over lift.

In theory, the mesh should also help with scarring. If you have better support of the tissue and you don’t have that weight and stretching and pulling, “it would seem to follow that we would have a little nicer scar,” says Dr. Van Natta. Overall, the new tools significantly add to the toolbox that is creating better, more natural breast augmentation and reconstruction results than ever before.

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