Has anyone had micro fat grafting?

makingway

I am extremely dissapointed to find that Dr. Khori's prices have risen. Last year when I found out of his surgery using the Brava device I was so hopeful. I contacted his office and received a quote of $5,000.00-$7,500.00. I was unclear if this was for each surgery or just the first one because it is more involved, with removal of the implant etc. I thought possibly because I had a unilateral MX the cost would be less to do only one side. My insurance wont cover it. I didn't know how I would come up with the money for the surgery, but I want it so badly. Fate stepped in and brought me hope.

I spoke with Cindy from his office recently. She told me that each surgery operation is $10,000.00 and that I would need at least 2, possibly more. Hope just flew out the window. There's no way I can see of coming up with that amount of money. I've heard Dr. Khouri helps those in need. I've written to him. I don't know if he read my letter, but Cindy did. I'm still considering using the money I have to fly to Florida for a consultation, and BEG him to do my surgery for the original price I was quoted. What do you think? Is it worth a shot?

GointoCarolina

Makingway,are you sure your insurance won't cover it?I know it has to be submitted a certain way and is probably out of network,but I have found you have to be persistent.Have you asked Dr.Khouri's office if there is anyone closer to you,there are surgeons being trained in this every day.Texas would be closer for you and I know there is a talented doctor there,someone posted here about him and I contacted him with questions.Even though he knew I was not going to be his patient,he very kindly answered my questions.I can give you his name if you want.I hate that women have to be stressed out over financing recon.

Anonymous

Hi Ladies,

Had my appt with Dr. Khouri, and wanted to report back what I've learned.

The first thing he told me was that, since I have TE's in, that's actually a step backward when it comes to the type of recon that he does.  He was adamant that there was no way for him to use the TE's, it's BRAVA or nothing.  So, some hopes dashed there.

Because I've had one side radiated, he felt that I need a minimum of 5 procedures on the radiated side, 3 on the non-radiated side to get to a B/small C (his goal). He would first remove the TE's and inject a small amount of fat.  I would be very flat for a minimum of 3 months.  I would then use the BRAVA and go back for subsequent FG 3 mos apart, 3 times total on the non-radiated side, at least 5 on the radiated side.  We discussed anesthesia, he didn't seem too fond of the idea of not going totally under, but said I could discuss it with his anesthesiologist.  He did find enough fat on me for the size mentioned above, but I wasn't really worried about that!  We also discussed the approval status of BRAVA.  He told me it was approved for reconstruction in Canada and Europe, and that he's been in discussions with FDA for some time, but it appears that they've asked for more patients and longer follow-up. He told me that 100 patients have been reconstructed using this technique, with 5-10 years of follow-up, and no evidence of increased recurrence.  He does not feel that the introduction of fat into the breast is any different whether it's via lipo or flap surgery when it comes to the issue of stem cells contained in the graft. 

Cindy showed me the BRAVA domes, but I did not get to try them to see how they feel, probably because they'd want me to do the first stage of removing the TE's first.  Although, it would have been nice to try it, to see if I could even tolerate it before deciding to go that route.

I have to add that Cindy was very nice.  In addition, I waited only an hour to see him, and he spent a good hour talking to me and my DH and answering our questions.

GointoCarolina

pinkbutterfly,I am not sure where you are located,but there is a doctor in Texas who does fat grafting with tissue expanders.

Anonymous

Dr. Kishinevsky does as well, but none of these places are near me (I live in GA).

 Who is the Dr. in Texas?

GointoCarolina

He is Dr.Michel Saint-Cyr, in Dallas.His website is www.drsaintcyr.com It does not tell about the fat grafting on his site,another woman here referred me to him for information.He did her recon and she raved about how great he and his staff were.He may know of someone closer to you.

bher

pinkbutterfly- I had my first stage fat grafting done two weeks ago and my implants were taken out with some fat grafting done.  My situation is similar to yours except I had permanent implants instead of TEs and I am a unimx.   I will probably need at least three more procedures on my radiated side.   It has been a tough postop two weeks for the radiated side.  No problems with the lipo or my native side.  I am very tight(rads side) and it is painful to wear a bra. My skin feels like I am going through radiation again.  I think it may be slowly improving though.  I can see this is going to be a process and hopefully I will make it to the end.  The TEs, exchange surgery and the radiation was hard for me too with the tightness so this is nothing new.  My exchange surgery was a complete disaster so if the fat grafting/brava works then in the end, it is all worth it. I am willing to see it through but I can see already this is not going to be easy. Good luck with your reconstruction decision.

Anonymous

Thank you, pandazankar and bher.

I have to admit, the thought of going through 5 procedures over more than a year does not appeal to me, and even less so if I have to coordinate travel for surgery. I have 2 small children, and it's not easy. Let alone wearing the Brava for a year. A big part of me is thinking to just go with implants, and hope that they work for me. Bher, do you mind sharing your story of post-radiation exchange?

tedwilliams

Pinkbutterfly:



I have posted before about my dr. In New Orleans and the banking of my fat. I will travel to New Orleans and have the second grafting on Aug. 5. This will be done at the surgery center with light sedation. My sister and I plan to be shopping that afternoon. I believe I saw the the Dallas surgeon in a piece my dr did on fat grafting and fat banking. This was in conjunction with a fat grafting symposium held by my surgeon and attended by Dr. Khouri and others from around the world.



I too am dealing with radiation damage that has created issues with reconstruction and this seems to be the least invasive at this time. I do not have an implant nor TEs.



Jana

agada

Oh, yeah, I did have liposuction in my tummy to fill up the foobs and make them look a bit more normal.  I did have lots of bruising from the liposuction but the pain is something you can handle. I woke up to an almost flat tummy and nice foobs.  The tummy got flatter as the swelling went down.  Not a bad trade off for bruising.

Agada

Anonymous

Hi Jana,

Sorry if you explained it before, but what do you mean by fat banking?

tedwilliams

http://www.wwltv.com/news/local/Using-your-own-body-fat-for-cosmetic-procedures-121419979.html

Here is a link to my surgeon showing him performing a fat graft with storage of the fat. My fat is stored in Dallas like eggs or sperm.  The cost was around $1700 for storage.  My fat and I will arrive in New Orleans at the same time and I will have the fat grafting under mild sedation at the surgical center.  He collected enough fat for 4-5 procedures....thus only one session of liposuction.

Jana 

bher

Pinkbutterfly,

My exchange surgery was about 3 months after I finished radiation and even though my skin looked pretty good at the time, maybe it was too soon.  I have read here on the boards that the longer you wait to heal after radiation the better the result.  My permanent implant was as tight and hard as the TE.  It really looked no different than the TE plus it was very asymmetrical with the other side.  I had some healing issues as well.  My ps indicated to me that I may need a lat flap so I decided to go the fat grafting/brava route instead because I did not want to do such an invasive surgery.

 I can't even imagine how hard this must be going through surgeries and reconstruction with small children. That is rough and my heart goes out to you. My children are grown and it has been hard for me.  

Anonymous

Thanks bher and Jana for sharing your stories.

My breast surgeon told me that I should wait 12-18 mos before recon, but I don't know if I can, just want to be done. I guess it's something to consider. My PS told me that beyond 6 mos, time doesn't really matter...bher, I would do the same thing if I needed to have a lat flap. My PS is waiting to see how my skin reacts to the expansion. And if it doesn't go well, I know he will recommend that for me, as he only does lat and tram flap, and already told me I can't have a tram.

mormor1

makingway   awww...feel for your disappointment with the price change!  I would make very sure about the insurance.  We were so surprised that Dr. Khouri and the hospital I had it in were both in network for us!  They know how to code things, so we had no problems with insurance covering on any of the procedures we had in Miami (4).  That is something to be very careful about with each MD you check out.  We had problems in WI because they didn't have coding they could use to get it paid even though we had coaching from Dr. Khouri's office that it should be breast reconstruction-other and make sure they don't put in liposuction. 

When you compare costs, there could be a lot of variables...how many procedures (which is hard to totally estimate); if you get the results you want (Dr. Khouri does seem to ge better results than most MD's...but imagine others will be growing in experience and catching up).  It is an art as well as a medical procedure.

 Interesting update on the Brava, Pink Butterfly..was really hoping that was going to come through and be covered soon.  Glad the office experience was so good!

bher and Pink Butterfly...think it is important to just take things one day at a time.  For me, it was nine months on the Brava, but I never knew it would be that long.  Just took it one procedure to the next.

Agada   I agree...fat redistribution is SO sweet!!

Jane  thanks for the link...so interesting!  Things will keep changing.  I know Dr. Khouri mentioned in one of the training conferences that he prefers not to use the jet washing of the fat, so that no natural "goodies" are lost...not sure if that is essential to storing fat.

makingway

pandazankar-My insurance definately won't cover Dr. Khouri's procedure. My insurance is provided by the County I live in. It is for indigent, the homeless etc. it's the worst insurance one could have. With this insurance you don't get a choice of who you are referred to for a 'specialty' such as reconstruction.

dustylady

pandazankar....just wondering...how long since your MX?  I am wondering about your chest sensitivity.....after my BMX, I went through a period of time when I couldn't have anything touch my chest....I could hardly wear a loose piece of clothing...anything that touched my skin....HURT!  That did pass....so now, I am thinking it was just the nerves dying after the surgery.  Do you think any of your pain could be transitory?

GointoCarolina

Makingway,that just sucks about the insurance,it enrages me that we do not all have the same rights when it comes to recon.And it all boils down to money....Here in central New York we are blessed to have a surgeon who accepts Medicaid for flap surgeries.                                                                Dustylady,my last surgery was April 21,so three months ago.I still had a lot sensitivity from my original mast back in 2008.My PT thinks it is because my nerves are just raw from the fibro and having no cushion there makes it worse.I am just a weird case!                                                          I'm so sad when I read about others having trouble,whether with insurance or pain or just wanting it all to be over.I hope I live to see the day when there is no more breast cancer.

emtca

Hi I am new to here but I just had fat grafting with Dr Khouri last week (life saver for me) I was a implant failure) but anyway my brava cost me for 550 for first set and 300 for size increase. I will not be starting my brava tell post op 3 weeks or whe it gets here it is back ordered right now. I am worried how I am gonna hide them thew the airport securty prior to my next surgery as I understand u need the on 24 hours on prior to surgery . My sister and I were already thinking of pet names for the brava domes instead of of madonna cones maybe lady gaga domes..  Need humor when u see these domes ,, I have four teenage boys in the house...  eek

Anonymous

emtca- You might want to join fatgraftpatients.com.  There are a lot of members on there that have done the Brava/fat grafting and could give you some tips on traveling with them.  There's a whole section on there regarding Brava.

mormor1

Agree with pandazankar...so sorry to hear about your insurance, makingway and all the struggles of breat cancer and other ills of this life.  Those are thoughts I have struggled with alot.  The concepts in The Problem of Pain by C.S. Lewis has helped me gain perspective.  There is Hope in each person's situation step by step, but sometimes the way is very hard...sorry to get off on a tangent but if anyone wants to talk about that PM...feel free.  Still hurts to hear of your situation and frustration though.  I wouldn't give up...maybe there will be a way.

 welcome emtce!  Wow...just a week out!  You are so right about a sense of humor!!  Especially with four teenage boys!!  I agree with Kate33, the forum is full of kind supportive women and great tips!  I had a long black dress that seemed to hide about as well as anything could.  Did get someone trying to "hit" on me once with it though!!  I did have to go through airport security at least once.  Had a note from Dr. Khouri.  They are getting more and more strict though, so would check with those who have gone more recently.  

GointoCarolina

I wish we could organize some kind of fund raising and have the money go to women who need help with recon expenses.I think recon is kind of forgotten,everyone is looking for a cure and new and better treatment and that is great,but in the meantime,women are diagnosed every day.Many embrace being flat,but I think more do not.Sometimes even a small amount of money could make a big difference,like paying for meals or hotel or a caretaker.I know what I plan to do when I hit the lottery!

alexandra-aaa

Makingway....

I'm not sure when you've last been on the forum, but a few weeks ago I posted about an organization I learned of called "Gateway to Hope" (<---link) for un- and under-insured. They are for Missouri residents only, but when I contacted them I received a reply from "Cyndi Stotler, RN - Program Nurse Manager". She recommended contacting The American Cancer Society to see if there are similar programs in other areas. It couldn't hurt to try....

And honestly, if more surgeons learned this procedure, it would actually be more cost effective for them, less invasive, therefore less complications for their patients, and honestly a much simpler procedure than flap surgeries. For surgeons who are donating their time and skills such as these are, this would be a win-win for them to offer.

 

dustylady

emtca....

 I did wear the domes through security on the way back from my first surgery.  I flew out of Fort Lauderdale and they have one of those new, see all screeners....well...they saw ALL of my BRAVAS!  I just explained to the TSA rep that I had just had surgery and was wearing external expanders....I'm sure they are all still laughing at me...but they treated me very respectfully as I went through...of course, it helped that I was still on pain meds!  All the other times, I timed it to get to Fl. so I could wear them a couple of days non-stop before the surgery and then Dr. K normally asked me to wear them 24/7 for 3 days after, so I usually completed this before I flew home.  Depending on the length of your flight....you could just take them off as you arrive at the airport for departure and then put them back on when you arrive in Florida.  I never actually wore them on the plane.

IrishLuck

Pinkbutterfly, thanks for posting about your visit with Dr. Khouri.  Sorry to hear that some of the news was dissappointing.  Five surgeries is a lot especially with two little ones at home.  I have two little ones as well so I know what you mean.  Have you thought about having Dr. Khouri put in small implants with fat grafting around them like some women on here have done?  That would make the process go faster and you still get the great benefits of the fat grafting.

Really too bad about BRAVA not being FDA approved yet.  I guess I will be part of the ongoing study participants.  My surgery is scheduled for this Saturday. 

IrishLuck

Welcome emtca and I hope you will join us over on the fatgraftpatients.com site.  Love the idea of calling the domes "Lady Gaga Domes."  Have been referring to them as my future Dolly Parton getup but Lady Gaga Domes is so much more hip and up to date.   Know your teenagers will appreciate that!

Anonymous

IrishLuck,

We talked about that, but Dr K said it would be better not to. And in any case, I'm still looking at a minimum of 5 procedures over 1-2 years. Just don't know if I can handle that right now.

There is a link on one of the exchange threads to an article where FG was used at the TE stage, then at exchange, to improve outcomes in women who have had rads. I am planning to ask my ps about it when I see him next...

Chicago1018

Am I the only one who finds the fatgraft site hard to navigate?  I can't seem to find my way around for some reason. 

Saw this article online while obsessively googling fat grafting and thought you ladies might find it interesting:

http://digital.miinews.com/article/Autologous+Fat+Transfer+Review/326624/32276/article.html

leeinfl

Chicago - the best thing is to click on patient stories and just start reading.  Start on the first post and you can read that patient's whole journey from start to finish.  There are also quite a few photo posts that correspond to the stories.  Just click around and you'll get the hang of it. 

tedwilliams

Chicago:



I agree with the difficulty. The revisions/ updating has made it even harder.





Jana