Has anyone had micro fat grafting?

hope123108

CrunchyPood,

May i ask you for the number for Dr.Khouri's surgeon training program?  I would like to have the procedure done also, however don't have much money.  What a wealth of information on this site,all the sites for that matter.

Thanks,

Hope

CrunchyPoodleMama

I'm composing a list of questions to ask Dr. Namnoum... just posting here in case anyone feels like chiming in with any other ideas... otherwise, just ignore me!

• 1. How many reconstruction patients have you done ONLY Brava + micro-fat-grafting? Request before/after photos and/or testimonials (Be clear that I do NOT want an implant; I want this to be done exactly as Dr. Khouri does it)
• 2. Why did Dr. Khouri's office say you've discontinued training?
• 3. Can you do this procedure at the same time (same day) that I have the mastectomy? What breast surgeons do you recommend? (make sure one of them accepts Aetna)
• 4. Can I do the procedure without general anesthesia? What if I get pregnant during the course of treatment-can the later procedures be done while pregnant?

CrunchyPoodleMama

Sure, Hope - it's 305-642-4263. When you call, ask for Rosie (the training coordinator). Just FYI, if you get her voicemail, you may want to hang up and try again later. I had left her a voicemail which she didn't return, but when I reached her in person, she was very helpful. (I'm sure it's the general fact of his office being completely slammed these days!)

makingway

crunchy-I was quoted between $5470.00-$7970.00, and this is for a pair. I only want reconstruction on one, so it might be even cost less. My PS wanted to charge me @$15,000.00 for one!

makingway

crunchy-I was quoted between $5470.00-$7970.00, and this is for a pair. I only want reconstruction on one, so it might be even cost less. My PS wanted to charge me @$15,000.00 for one!

CrunchyPoodleMama

Oh yikes! Just so I know, did those numbers include the cost of the Brava system itself (I'm guessing not)?

makingway

I'm not sure if this included the device. I think that is @$750.00. It just pisses me off that my PS is trying to take advantage of me-again. Implant surgery here in Newport Beach, CA costs @ $28,000.00 and the best local PS didn't take my insurance, so, I had no choice but to have my surgery done by the only PS willing to take my insurance. I asked to see some before and after pics. He told me he'd have to dig them up. I forgot about it... Until after I suspected he didn't know what he was doing. When he finally showed me the pics there were only 2 patients! And one was from 10 years prior!!!I

NotMyTime2Go

I started to write a post asking why you ladies weren't planning on insurance covering this. I think maybe makingway is saying that she's not using one of her plan providers? Coverage for mastectomy patients is required by law, but that does assume you stay within your network. And of course the BRAVA itself still isn't considered a medical device so that's not covered. Is there any other reason to be worried about the coverage? 

CrunchyPoodleMama

Dr. Namnoum will be considered an out-of-network provider for me, but insurance will still pick up a good chunk of it. (I do want to know what his base price is, though, because my portion of out-of-network is a lot higher percentage than in-network!)

whippetmom

Dr. Namnoum would have no reason to credit Dr. Khouri for the fat graft transfer procedure.  Dr. Khouri is not the inventor or pioneer of fat graft transfer for breast augmentation - he is only the inventor of the BRAVA suction system.  Fat graft transfer for breast augmentation, has been performed here and in other countries for over fifty years. Probably over a hundred years, if you count the patient for whom breasts were created out of fatty lipomas - back in the late 1800s.  But the procedure has enjoyed, obviously, a relatively obscure presence here in the US, because of regulations and restrictions imposed by the federal government and secondary more than likely, to insurance coverage and liability issues. Far more reports of fat graft transfer for breast augmentation come out of Europe - and even Japan. There was a bit of a moratorium over the use of fat graft transfer for breast augmentation in the 1980's, when the American Society of Plastic Surgeons reported that fat graft transfer to the breast could be problematic for mammography purposes. But thereafter - in the mid to late 1990's, the safety and efficacy of the procedure gained renewed acceptance and advancement. Fat graft transfer to augment and enlarge the breasts has been done long before Dr. Khouri began performing this in conjunction with his BRAVA device.  There are other doctors who have far more experience and expertise in performing fat graft transfer than does Dr. Khouri, simply by virtue of "time in the field".  Dr. Khouri was a hand surgeon long before he became interested  - ten years or so ago - in plastic surgery referable to the breast. 

Deborah

alexandra-aaa

I struggled a bit with replying, at the risk of a very, very informative and helpful topic turning into a "my doctor's better than your doctor" tiff.

However, there seems to be a bit of misinformation that if I had come upon while researching prior to my procedure, may have unnecessarily negatively influenced my decision.

No one has said that Dr. Khouri pioneered the fat graft transfer procedure. What he did pioneer (aside from inventing BRAVA) was using BRAVA to create a fertile scaffold for micro injections of fat. Pre and post surgical use of BRAVA provides not just the space for more fat, but a matrix for tiny droplets of fat throughout multiple planes of the breast, which insures a far greater success rate of fat survival.

Traditional fat grafts, the very ones performed for many years, typically injected large amounts of fat into a very small space. The fat could not survive very well. Traditional rates of survival were somewhere around 40-50%.

Dr. Khouri's pioneered procedure (as evidenced by a 5-year, 50-patient study, along with many, many other patients since) ensures a survival rate of on average 90%.

Also, the information that Dr. Khouri was a hand surgeon who just became interested in breast reconstruction ten or so years ago is patently incorrect.

"He is a Plastic Surgeon with more than 20 years of experience with breast reconstruction. Roger K. Khouri, MD, FACS Khouri is a leader and innovator in natural, no implant, breast augmentation and post-mastectomy breast reconstruction. Twelve years ago Roger K. Khouri, MD, FACS Khouri published, what was then the largest experience in the world with breast reconstruction using microsurgery & TRAM flaps."

I'm not certain if the study referenced above is this: "Simultaneous bilateral breast reconstruction with the transverse rectus abdominus musculocutaneous free flap", but regardless it should shed light on his breast reconstruction background.

I find it interesting that other surgeons who have worked with and learned from Dr. Khouri have no problem acknowledging BRAVA's role, as well as the technique of micro grafting, such as Dr. Daniel Del Vecchio in Boston and here.

And Dr. Sydney Coleman in NYC.

Yet Dr. Namnoum only states: "...Then Davies met Dr. Namnoum. Dr Namnoum, also a assistant clinical professor at Emory University School of Medicine,  suggested a pioneer procedure involving fat transfer. The procedure would take liposuctioned fat from Davies thighs and then re-implant them into her chest wall. This, in conjunction with skin stretching therapy, would revitalize the tissue on Davies’ chest, making it healthy and pliable enough for breast reconstruction using implants...." I also could find no before/after photos of any fat graft reconstructions. (However, I do have to say that his traditional augmentations and reconstructions are quire beautiful.)

On my forum I have a sub-forum for patients of other surgeons who have undergone this procedure. So far only Dr. Khouri's patients have joined (except for one woman who used another surgeon first, then went to Dr. Khouri to correct the result of some complications that she suffered). But I would love to see a sharing of helpful information as opposed to what appears to be more confrontational interactions. It's hard enough finding the little information that there is so far on this method without giving proper credit to all of the doctors providing this procedure.

leeinfl

Let me take my place in the vain and shallow line as well!  Dr. Khouri is doing touch-up work on my breasts in 2 weeks.  I have silicone implants that I'm basically happy with, but a dent on one side and boney areas above.  I can't help but look at these areas all the time.  It might be shallow, but I want my breasts to look as perfect as they can possibly be.  The PS that did the reconstruction says fat grafting wouldn't work, but Dr. Khouri says his method will.  He is so enthusiastic which makes me feel much better after coming to the conclusion that my other surgeon is "done" with me and my boobs.  I've heard from so many women now who are very pleased with his work, and like me, wish they had heard about him and his technique earlier.  The only options I was given was no reconstruction, lat flap or implants.  It would have been nice to know that there is the possibility of reconstruction using micro fat grafting and the BRAVA device.  Knowledge is power ladies.

makingway

leeinfl-Boy, I know what you mean when you say you wished you would have known about this sooner. When I went to see my PS after my implant exchange, I said to him, with totaly disgust I might add, "I can't believe this is where we are at with reconstruction. Our only options...after all this cancer research money etc. Why hasn't somebody made a breast using only fat?" He said someone has, but he discounted it as anything worthy of doing. I wish he would have elaborated on the topic. It would have spared me a lot of pain, grief and self loathing.

Are you keeping the implants?

Knowledge without money can't get me this operation. I will get it one way or another...

CrunchyPoodleMama

"Boy, I know what you mean when you say you wished you would have known about this sooner."

You're NOT kidding!! And can I just vent for a second? Every day, right here on BC.org, I read new replies to posts where women here are telling other women (with an air of complete authority and finality) that if they do a mastectomy with reconstruction, they will have sensation loss and there's no way around it. Helloooo, people, there is another way, and you DON'T have to lose all breast skin sensation!

For a while I would pipe in and mention Dr. Khouri's technique. Now, I'm thinking, maybe I shouldn't keep mentioning him until after mine is done. LOL (Every time I find a store, vendor, etc. that I love, I sing their praises all over the Internet... and then when I need to use them again, they're sold out or booked for the next two years!! I don't want that to be the case with my boob reconstruction!!!!)

makingway, the first plastic surgeon I met with (who is very highly respected here) has never heard of this technique. Before I knew about Dr. Khouri, I joked with him that I wish there were a way to create a breast with just liposuctioned fat. He laughed and said dismissively, "Oh, that would be nice, wouldn't it." UGH!!!!!

Knowledge without money can't get me this operation. I will get it one way or another...

Heh heh heh, I hear ya, sister!!!

leeinfl

Makingway - Yes, I'm keeping the implants (for now....).  Dr. Khouri offered to take them out and do fat grafting with a smaller implant, but even he said I've gone so far down this road, that we should work on making what I have better.  I'm alright with that.

CrunchyPoodleMama -  I agree with you and your frustration (Alexandra? ditto, I'm sure!).  The possibility of reconstructing a breast with your own fat should be listed more prominently on this site.  Everyone has to make their own decision, but here is where most women end up for answers once they get that devastating diagnosis.  If not here, where?  It's an option and we need to make sure more women know that's it out there.  It would be nice if the RECONSTRUCTION forum could be redesigned to list ALL the choices and options.  That way, we can learn about all of them and make informed decisions.  Just my 2 cents worth! 

mradf

Let me preface by saying I'm glad I had fat transfers done, and that my PS was able to make the case for coverage by my insurer, however, I don't think this site would list so prominently a procedure that is still, by all accounts, being investigated.  In all the literature I can find from medical insurers, the ASPS, and other sites, there are one or more quotes like the following:  "based on a review of the current literature and a lack of strong data, the task force cannot make specific recommendations for the clinical use of fat grafts".  And; although Dr. Khouri cites his clinical trial on his site:http://www.miamibreastcenter.com/breast-reconstruction/5-year-50-patient-study.html there are no results on clinicaltrials.gov, and, in fact, the most recent update still says it's recruiting participants.   http://clinicaltrials.gov/show/NCT00466765

He may well be the answer to your prayers, but be careful to do your homework first. You can only make an informed decision insofar as the information is available.  Buyer Beware. 

Be well,

Maria

CrunchyPoodleMama

Well, I met with Dr. Namnoum today. It was... interesting. He's quite a character. He didn't strike me as very keen on the procedure and made it sounds like if you lose weight after you have it done, your entire breast can go down to nothing. Mmmkay. Then he started talking about having my mastectomy with a tissue expander put in, to keep the skin from shrinking down... will skin really shrink down THAT much in just a month or two (however long after the mx before I start the fat transfer/Brava stuff)?

erika54

Thank you Alexandra -- Dr. Khouri is very good at what he does. Yes, he is a hand surgeon as well and does breast too. I see nothing wrong with a physician have a specialty for both. Don't usually participate on forums but want to thank you for letting others know that Dr. Khouri is good at what he does. I know first hand as I have seen several women he actually has performed surgery on. They look fantastic and are so happy. Not only that, he has a fun personality and truly cares about all his patients.

Best to you,

Eriak

mormor1

CrunchyPoodleMama,

As much as I long to hear of other MD's who can do this fat grafting reconstruction in addition to Dr. Khouri (and I think he does have some surgeons in training), I don't get a good feeling about what ou heard at your appointment.  I know of a woman who went to someone else and ended up with nothing after two surgeries, now just did it with Dr. Khouri and seems to be having great results.

 I started my fat grafting six months after my mastectomy.  It still works.  I don't think you've had your mastecomty yet, right?  Another woman I know had her surgeon for the mastectomy consult with Dr. Khouri before her mastecomy and he took the fat, but left the fold definition and did some skin sparing.  I think that is really helpful in maybe not needing as many procedures.  If your MD is willing, this might be a good option.

praying for the best path for you to become clear,

wisconsin randi

CrunchyPoodleMama

Thanks, Randi - right, I haven't had my mastectomy yet. It will be nipple-and-skin-sparing. Dr. Namnoum said that if I wait too long to have the initial procedure, the extra skin will shrink/wrinkle up. I don't get why I'd need to wait so long to start the Brava thing! Maybe 4-6 weeks to make sure the incision is perfectly healed, I would think?

Dr. Namnoum said (after I grilled his nurse before making the appointment to make SURE he's done this procedure) he's only done micro-fat-grafting + Brava with an implant. Well, I don't want an implant, and I know Dr. K doesn't insist on an implant... *sigh* I don't know what to do. I can't fly to Miami because of a family problem.

Oh, Dr. N laughed when I mentioned Dr. K's training program. He said he doesn't have a training program... that it's all marketing. Grrrr!!! (and yet he claims to be good friends with Dr. K and is going to call him about my case!!!!)

I just have no idea what to do now. I'm tempted to say "screw the mastectomy" and just get pregnant.

makingway

Crunchy-Dr Khouri might not have 'training' but he does do seminars for docotrs. I know this because my PS went to one. I think they are weekend seminars were he teaches other PS how the tecnique is done. I want only Dr. Khouri-the best to do mine!

I think if you live in Florida and have the MX there, you can have the fat grafting done at the time of MX. But, if you don't live there, I think you might need a tissue expander to keep the skin from adhering to the chest wall. I'm not certain about this. Email Rosie with that question. She should be able to ask Dr. Khouri and give you an answer. It might take a few emails or calls to get a response.

mormor1

Just had a friend do skin sparing mastecomy (not in Miami) and she started on the Brava a few weeks afterwards (did not have expanders/implants).  Just had the first fat grafting surgery (by Dr. Khouri) after about five weeks on the Brava and was told she might not need to have any further fat grafting surgeries (or maybe one more)!  That was a much better course than I had starting the micro fat grafting process six months after the mastectomy!

 Have you checked into karenhurd.com yet??  Might resolve your early stage estrogen positive cancer without needing the mastecomy:D

CrunchyPoodleMama

Thank you, makingway and wisconsinrandi!

makingway, I would give anything to be able to travel to Miami and have "the original and the best" do it... you have no idea. I was tossing and turning all night last night, depressed about it. Because of a certain family situation, it just isn't possible... it KILLS me but there's nothing I can do.

wisconsinrandi, that is great to know that your friend was able to start using the Brava after a few weeks... Dr. N. seemed to think I would have to wait a long time to make sure my incision didn't pull apart or something. And just five weeks after that she had the first fat grafting - that is SO encouraging!

You know what... I'm going to do this with Dr. Namnoum. He's willing to do it even though he obviously doesn't believe in it the way Dr. K. does. Maybe after I'm his first success story with it he'll change his mind about it. (He's done it, but only in conjunction with implants.) I'm going to see if I can have an initial fat graft done at the same time as the mastectomy. (I'd have to have a completely different plastic surgeon do that because my breast surgeon and Dr. N. don't operate in the same hospital.)

About karenhurd.com, I am a HUGE believer in the diet and lifestyle changes she promotes. I've been doing just about everything she recommends for about a year now. Although the DCIS has not spread any further, unfortunately, these few little DCIS microcalcifications didn't go away... and I want the DCIS completely out of my body before I try to get pregnant. I'm definitely doing prevention of any future recurrences through diet/lifestyle... no Tamoxifen for me!

Kitchenwitch

I met Dr. Christina Ahn yesterday (she is a PS in NYC). I thought she was wonderful. Caring, experienced, very open to a patient who asks questions and goes online for info (I always hate when someone kind of cringes when I say I found out something online, and they act as if I can't possibly tell the difference between some fruitcake site and something reputable). "I love those patient forums!" she said. "I'd do the same thing myself!"

 I still don't quite have a treatment plan, but if I have another excision and I get the clear margins and then go through radiation, Dr. Ahn will do micro fat grafting to restore my breast to more or less oiginal size (it is 34DDD, but I've had two excisions and it's looking different). 

She can do nipple-sparing mastectomy, even on my size - apparently it has too do with the distance from something near your collar bone and the nipple. I'm short, so maybe that's working in my favor. At least she said she would try. My BS just doesn't even do that. So if I do turn out to need a mastectomy at some point I will go to her for it.

 Anyway, for anyone in the NY area I would highly recommend Dr. Ahn.  

mradf

erika54:

I am wondering how you posted this yesterday morning on another thread:

"I am new to forum and wondered if anyone can refer me to someone good in the Miami area who is experienced in performing breast reconstruction with fat grafting. Interesting in doing this with the BRAVA domes. I am 10 years out from bilateral breast mastectomy and currently have saline implants in now for 5 years. If anyone can refer me to a good plastic surgeon that would be wonderful."

And then, followed only hours later on this thread with:

"Dr. Khouri is very good at what he does. Yes, he is a hand surgeon as well and does breast too. I see nothing wrong with a physician have a specialty for both. Don't usually participate on forums but want to thank you for letting others know that Dr. Khouri is good at what he does. I know first hand as I have seen several women he actually has performed surgery on. They look fantastic and are so happy. Not only that, he has a fun personality and truly cares about all his patients."

It just seems odd to me.  How did you come to find out so much in such a short time, first hand, no less? 

Early on, Dr. Khouri's staff began posting here.  It wasn't right then - and it isn't right now - if anyone is posting on his behalf. 

Be well,

Maria

lago

I posted my feelings about the brava system elsewhere but I feel I should also post here. This is not to discourage anyone from moving forward if this is what they want to do. It's just my feelling and why I don't think brava is right for me even if my implants fail:

--------------------------------------------------------------

I have been reading posts about the Brava system for a while. Personally for me it sounds a bit too new. I want some long term info.  I also don't want to be treated by a celebrity surgeon. While I'm sure Dr. Khouri cares for his patients many times "celebrity" physicians have very limited time which means long waits to see the doctor or having to never really see/talk with them for follow ups (deal with nurse pratictioner etc) ... that concerns me.

Another thing that some folks may not realize. There is a commitment on the patient side of wearing the system for 10 hours a day. That might not be as easy as you think.

Beesie

Maria and lago, I've been reading this thread for a while but haven't posted here before.  My reconstruction is done and I'm not planning any revisions so my interest is purely educational and as such, I didn't think it was appropriate for me to comment.  But I think it finally is time for me to speak up.

Maria, I agreed with your earlier concerns about the posts from Dr. Khouri's office (sorry I didn't post with my support) and I agree with you now about the inappropriateness of people posting on Dr. Khouri's behalf.  It seems that there are quite a few people on this thread whose only posts on this discussion board have been on this thread.  This isn't to suggest that what they are saying isn't a true representation of their experience or that it isn't being posted with the best of intentions, but honestly this thread reads a lot like a paid promotion for the Brava system and Dr. Khouri.  If any women are making their reconstruction decisions based on what they read here, that worries me.

lago, I agree with you too that, for me, this system seems to be just too new.  Most of what I read about it refers to breast augmentation patients; there is little information available at all about breast reconstruction patients.  Will breasts reconstructed via this method "last" forever?  Are there any potential problems with the system in that it may spur the growth of the tiny amounts of breast tissue that remains after a mastectomy.... does this create an increased recurrence or new primary BC risk?

When I look on the internet, almost all the information that I find about the Brava system is written by the company that makes the system or by the few doctors who sell it.  Where are the unbiased perspectives?  Where is the medical research on the safety of this method for breast cancer patients?  Where is the information that shows that this method works over the long-term?  I'm pretty good at digging through the internet to find the information I'm looking for and so far, I haven't been able to find any studies or research articles or unbiased reports on this system, specifically related to reconstruction.  If anyone has this information, please share.

I think it's great that there are women who are willing to try new methods of reconstruction; your experiences will be very valuable for those who follow.  But for the sake of all the women who are reading this board and making their reconstruction decisions, we need to be careful to present the Brava system for what it is - a new, seemingly untested system that so far has been used primarily for breast augmentation, and that seems to have no long term data to support it.  The long term results may be wonderful, and this may be the way of the future, but it's too early to say this.  Anyone making a reconstruction decision today should know this.  Then, if you want to go ahead with this method of reconstruction, I applaud you, wish you the best of luck and hope that you get the results that you are looking for.

alexandra-aaa

To Beesie, Maria and lago,

I respect your protectiveness of the forum and its members, and perhaps I should back away from posting if what I've shared it unneeded or unwelcome. In light of one - the recent posts by Erika54 - which I noticed the contradiction in the 2 posts yesterday as well, very odd, and two, of a couple of others who just kind of came by to say how great this was then disappeared, I thought I'd explain (again) why/when I made my first post here vs when I first found the forum.

My profile explains my family's history with bc - related to that I first found bc.org a number of years ago. I'm very concerned for my daughter (again, see my profile) and try to read now and again in the appropriate section of the forum.

HOWEVER, I first began researching fat grafting in general late last year. As I've also explained, I do not have cancer. I had two biopsies, and a lumpectomy (for a more suspicisous? tumor than the others) 18 years ago. The net effect from the lumpectomy was the same, malignant or not. I actually had scheduled a consult with Dr. Coleman in NY in January (I live in NJ) because I knew he did fat grafting. When I called to schedule, the receptionist asked if I was going to part of the BRAVA study. While I knew what BRAVA was for many years in terms of breast enhancement  (my breasts never developed beyond that of an eight year old child), I never heard of it connected to fat grafting. I hung up the phone, went to clinicaltrials.gov, saw Dr. Khouri's name, google'd away, found his site and scheduled a consult. The premise behind why BRAVA increases the fat survival rate by almost double made sound logical/medical/scientific sense to me.

That was back in January. I could find NO ONE on the entire darn internet who had done this. I began posting about it on an implant forum I had joined in December, because I'd had enough of how I looked and felt. I posted on a support group forum for ladies who did not develop breasts (a "flatsy forum") that I've owned for SIX YEARS - google my user name if you care to and you'll find it - I didn't just pop out of the woodwork to rah-rah anyone. I was desperate to find someone to share this with. It IS a crazy procedure, no matter how genius. No one in your "real" world is supportive because they take one look at you in the ginormous domes and no longer take you seriously.

Someone mentioned wearing the domes for 10 hours. Well, my consult was in January. Dr. Khouri had no surgery dates until April. I wore the domes for 12-14 hours/night for the ELEVEN WEEKS until then. Then wore them another SIXTEEN WEEKS post-op. I probably googled the terms +Khouri +brava and +fat a million times over. Back in May I found this thread. Never intended to post. Never felt it would be my place.

BUT then someone asked how the process worked with a lumpectomy. Well, I was just a couple of weeks post-op, still in the post-op BRAVA wear period, still only had a handful of interested observers that I was talking with on the several forums that I had been. I knew how desperate I was to find anyone going throught this that I could talk to, that I thought maybe my experience with the lumpectomy reconstruction might help someone.

By mid-summer, the four or five different forums that I was talking to ladies on were getting bigger, I'd run into a few who were considering it, a few who'd already met Dr. Khouri. I couldn't keep track of everyone I was talking to, so I temporarily opened a sub-forum on my "flatsy" one FOR MY OWN SANITY and as a way to stay organized.

After thinking about the diverse group of ladies that I'd been talking to - mastectomy reconstruction, tubular deformity reconstruction, an implant removal, one with pectus excavatum, a couple with true hypomastia (complete lack of breasts), a "regular" augmentation patient, I decided that I would create a separate forum for all of us. I felt to limit the patient-to-patient discussions to each individual type of patient was doing us all (the current ladies talking) a disservice. While what brought us to this surgery were pretty diverse and varied conditions or desires, the overlap of the nitty-gritty details of this process was huge. It's turning into a pretty-cool cross-over of support from the ladies, while at the same time becoming a pretty informative pool of the very lacking detailed "stuff" we as patients want to know.

My first post here I was told that it came off as an advertisement. Funny, because quite the opposite - last January I actually ASKED Dr. Khouri why there was so little information and if he MINDED if I posted about it. (I know of more than one plastic surgeon who has had patients sign that they would NOT post anything derogotory, and another anything at all, on the internet!)

My opinion on MiamiBreastCenter's posts in the beginning are mixed. Sure, it initially came off as odd (I know if I had someone come on my flat-chested forum advertising implants or whatever, it would rub me the wrong way), but it never seemed they were advertising. It read to me the same way I feel when seeing some of the posts with absolute incorrect information (such as the one saying Dr. Khouri was a hand surgeon, more or less just getting interested in breast surgery, where he'd actually been doing TRAM flap surgeries for 20+ years) -  I feel a need to at least correct it.

None of MiamiBreastCenter's posts said, hey why don't you schedule a consult, this would be great for you, etc. They pretty much only corrected info, and after the first post really only spoke when spoken to.

A few others since, certainly come off as odd - especially when no accompanying info as to who they are is shared (unlike the volumes you all probably wish I'd keep to myself!!). Anyway, this certainly was a long winded reply, but I felt like I did a TON of research before committing to it. I feel like there's more than enough long-term data out there. And I honestly don't know the answer to this one - WisconsinRandi might - whether Dr. Khouri began this on reconstruction or augmentation patients. However, I do believe that most of his long-term data IS on reconstruction patients.

Well, sorry for being so wordy. Hope I explained myself marginally. And if my input is not wanted/needed/appreciated, I get that and won't post. As I said, I run two forums and understand - no hard feelings

lago

alexandra-aaa I'm not sure why you are addressing me. I just posted my feelings on why brava is not for me. I am not encouraging anyone not to go this route. I am glad you are happy with your decision but you need to allow people to post alternative points of view without getting defensive.

alexandra-aaa

Lago, I apologize. I did get kind of defensive. I guess I kind of lumped together the last few posts that I read, combined with feeling like I really shouldn't post here, yet needing to explain why I felt compelled to. I'm sorry if any of that was offensive (in addition to being DEfensive, LOL!!).



(I am curious tho what you meant by "celebrity" surgeon? I never got that feeling. To me Dr. Khouri comes off as humble/highly, very highly excited about his work. Just my impression.)