Understanding GalaFLEX (P4HB) and the “Internal Bra” in Modern Breast Surgery

By the Pittsburgh Center for Plastic Surgery Team

Advances in aesthetic breast surgery continue to introduce new tools that help improve support, enhance shape, and promote long-lasting results. One of the most exciting innovations in this space is GalaFLEX, a fully absorbable poly-4-hydroxybutyrate (P4HB) scaffold—often referred to as an “internal bra.”

At the Pittsburgh Center for Plastic Surgery, we use GalaFLEX in both primary breast augmentations and revision breast surgeries. When thoughtfully applied, it reinforces soft tissue, stabilizes implant position, and supports long-term aesthetic outcomes—all while being gradually replaced by your body’s own collagen.

What Is GalaFLEX (P4HB)?

GalaFLEX is a soft, flexible mesh scaffold designed to provide temporary internal support during the healing process. Made from P4HB, a biocompatible material with a long track record in medical use, it functions as an internal bra by:

• Supporting the lower pole of the breast and implant position
• Reinforcing tissue that is naturally soft or more elastic
• Assisting with shaping and symmetry
• Gradually being replaced by the body’s own collagen over 18–24 months

Over time, GalaFLEX completely dissolves into natural byproducts that the body safely eliminates—leaving no permanent foreign material behind.

How We Use GalaFLEX in Our Practice

Primary Breast Augmentation

In select cases, GalaFLEX can provide valuable internal support for patients whose:

• Breast tissue is thin or naturally lax
• Desired implant size places extra demand on the lower pole
• Anatomy carries a risk of early stretching or implant descent
• Results would benefit from enhanced lower-pole structure

By reinforcing the tissue from within, GalaFLEX helps stabilize the implant pocket and promotes durable, natural-looking results over time.

Revision Breast Surgery

GalaFLEX is also a powerful tool for revision or secondary procedures, including cases involving:

• Recurrent implant malposition (bottoming out or lateral displacement)
• Stretched or weakened lower poles
• Pocket modification or implant plane changes
• Reduced tissue quality after prior surgery

It’s also frequently used when treating capsular contracture, helping to strengthen the soft-tissue envelope and potentially reduce recurrence risk once the contracture is corrected.

Importantly, we don’t use GalaFLEX in every case. Each patient’s anatomy and goals are carefully evaluated to determine whether internal support will meaningfully enhance the outcome.

Is GalaFLEX Safe?

Yes—GalaFLEX has an excellent safety record and has been used safely for years in multiple surgical specialties.

A 2025 systematic review in the Aesthetic Surgery Journal found P4HB scaffolds to be safe, well-tolerated, and effective across a variety of breast surgery applications—with high patient satisfaction and strong tissue incorporation.

Why We Trust It:

• Fully absorbable—no permanent implant
• Does not interfere with imaging
• Low infection risk
• Soft, flexible, and conforming—not rigid
• Replaced naturally by your own collagen

These features make GalaFLEX an attractive option for patients seeking added support without permanent materials.

Who May Benefit From an “Internal Bra”?

You may be a candidate for GalaFLEX if you:

• Have soft or more elastic breast tissue
• Desire fuller implants relative to your natural anatomy
• Want to minimize the chance of early stretching or implant descent
• Need revision for prior stretching or implant malposition
• Have experienced capsular contracture
• Are undergoing implant pocket or plane changes
• Want the most structurally stable result possible

During your consultation, our surgeons will help determine whether internal support could benefit your specific goals.

The Takeaway

GalaFLEX (P4HB) is a versatile, absorbable internal scaffold that functions as a temporary internal bra, reinforcing soft tissue and supporting long-lasting, stable results in both primary and revision breast surgeries.

Because it is safe, biocompatible, and naturally absorbed, it provides structural integrity during healing—without leaving anything permanent behind.

If you’re considering breast augmentation or revision surgery, our experienced team at the Pittsburgh Center for Plastic Surgery can help determine whether internal support with GalaFLEX is right for you.

Schedule a consultation to learn more about your options and how we personalize every surgical plan for natural, lasting results.