Has anyone had micro fat grafting?

goodrhue

http://www.miamibreastcenter.com/

I saw Dr. Khouri on Tuesday for a consultation.  The procedure of BRAVA with fat grafting looks really promising, but it would be a long process (5-6 procedures) for me because of my radiation and my very thorough surgeon who removed ALL breast tissue.  I'm still thinking about it - no hurry (4 years since RB Mast). 

Anonymous

goodrhue, you are in GREAT hands if you choose Dr. Khouri. Good luck!

Meekone

Hi Ladies

I scanned this topic for a little bit but I have not seen anyone on here post their opinions on the results long term.  I am intersted in potentionally having my implants replaced with smaller ones and making up the difference with fat grafting in hopes of making them softer.  I have researched and it seems like 50/50 that the fat will get absorbed by the body over a short period of time........anyone have a different experience?

Meek

EileenKaye1

I am in the process of having fatgrafting--first round completed.  Recommend the fatgraft website--from Dr. Khouri--a number of doctors across the country are now doing quite a bit of fatgrafting.  Eileen

kareenie

Just to clarify -- the fatgraftpatients website is not sponsored by Dr. Khouri or any other doctor. It is a forum of patients of many different doctors.

Anonymous

Meekone- I had exactly the procedure you described.  I had my 375 implants replaced with 225 and had fat grafting done over the top.  I ended up the same size as before the procedure (same size bra) and have retained almost all of the fat 18 months later.  The fat grafting made everything look and feel more natural.  I used to have a big "step off" which is gone.  I always could feel the implants under the skin before, and the skin over them was colder than the rest of me, but that has been eliminated, too.  My implants do feel so much softer.

The 50% reabsorption rate really depends on the technique they use.  With some of the older techniques the rate was 50% and there was a higher risk of calcification.  The new techniques, using either BRAVA or by just replacing implants with smaller ones therefore creating space for the fat, has a rate more like 85%.  You really want to make sure you're going to someone with a lot of experience in where to place the fat and where to take it from in the first place.  Not sure what part of the country you're in but I had a few consults with some PS's in the southern CA area and have heard of some great ones in the NY area as well. 

mormor1

Hi Meekone,

Kate33 gave a great response!  I agree with everything she said and just wanted to affirm that the breasts obtained from Brava enhanced microfat grafting with a qualified PS are "for keeps".  My fat grafting was completed Jan '09 and I have retained the same size for over 3 1/2 years now (36B/C).  I think the 15% approximate loss occurs within the first few months and after that everything seems to be stable.  Important question!

eine

I am also researching the fat grafting procedure and would love to hear the success stories from both the Brava procedure and fat grafting alone, or with a smaller implant.  I had a lumpectomy and rads and failed recon with te's and implants, so I am no longer a good candidate for implants alone due to the damage caused by radiation.  I had a consult with Dr. Renee Burke in Chicago who suggested fat grafting that will hopefully improve the radiated skin and, eventually, accomodate a small implant.  I am very, very small breasted and have a major defect from the surgery and rads.  Hoping to make some decision before the end of the year for insurance purposes.  Does anyone know of any other dr. who does uses the Brava?  This is a very exciting alternative and I look forward to learning much more!  Thank you to all of you who are willing to share your stories!

Anonymous

I nave implants but they had to be smaller due to an infection I had after bmx. I had fat grafting once, with extensive lipo to my abs ( out of pocket on my part). I did not absorb too much. I would say 20 percent maybe. I still felt they needed some more oomph in the upper pole area, so just had some redone ten days ago.



I hope it holds because they look great now! And they are very soft. I never noticed the cold thing that others have mentioned. Mine have always felt warm to me, even before fat grafting.



Sherry, unless something has changed in the last two years, the brava unit itself is not covered, as it isn't yet considered a tool for reconstruction, however, all the fat grafting procedures are as that is an accepted form of reconstruction.

kriserts

actually, regarding insurance, my doctor's assistant told me (last week) that another patient got 50% covered. I'm certainly going to submit the Brava to insurance.

Anonymous

It seems that it should be time for it to be covered, given the number of people utilizing it now. There wasnt anyone in Indianapolis doing it, and I talked to Dr. Khouri several times. I was my first choice, but I settled on the implants as I didn't want to have to travel for it.

I am hoping by the time I have to have these replaced, they can just put fat in instead of implants. Although, now that I have had my abs lipod twice, I am not sure where they will pull the fat from. LOL. Idon't have much in other places.

EileenKaye1

kriserts--I was covered --50 percent for brava.  Yet--BC/BS gave me a difficult time approving the second round of fatgrafting.  No way to know--how it goes with insurance coverage.    Hoping I will not have difficulties moving foward.  Eileen

ReadingMama

Hi, I had DMX with DIEP recon.  Previous chemo and rads.  My left (cancer/radiated side) did not take well to the DIEP and became red and shrunk.  It is 1/2 - 1 cup size smaller than right side.  Right side is small B probably.  Did Phase II, lipo and fat grafting and again left side shrunk, basically lost most of the fat.  Right side retained well.

Was thinking about Brava to maybe improve fat retention.  Am curious to see some of you post about wearing it for shorter periods of times.  I am concerned about the 10 hours for 10 weeks.  I would need to wear it at night, but am not always home for that many hours, sometimes need to work late -for those that wore it for shorter times, was this dictated by your doctor or just what you could manage? And how were results?

I also saw someone mention Ebay?  Can you buy BRAVA from there or other places? My PS is not trained in it, so I don't know if Brava would sell to him and I know they will not sell direct to me b/c of cancer history. 

lane4

Hi, all - I posted this question on the "fat grafting questions" thread, but no one has replied. I thought I'd try this question here since it seems a little more active. Thank you for sharing your experiences and wisdom! 

I have a question for those of you who have had fat grafting: What does the grafted fat feel like after 9 months? I had some fat grafted last December into the area where I had a partial mastectomy. This is also the area where the radiation boost was (tumor bed), so there's a lot of scar tissue. The area looks much better and appears to be filled out, but the fat is palpable under the skin. It feels firm, but not rock hard like the fat necrosis I had biopsied last year. I'm really hoping that doesn't mean that fat has died. My BS did a clinical exam this past week and I mentioned that, but he didn't comment. I should have pushed for his opinion, but the conversation went elsewhere and before I knew it, the visit was over (imagine that). I will see my PS in November and of course I'll ask him what he thinks. My recent mammogram was fine. Just wondering if the grafted fat can feel firm for a while and still be viable.

Beckers

I'm having some fat grafting to even my left DIEP flap. My doc said I have to purchase the Brava part. Is anyone done with theirs? I have no idea what it is or does but that's a lot of $ at Christmas time on my disability pay. :-/. My stage II surgery is Dec 27th.

lalove55

Hi ladies - there are a number of you with BRAVA & fatgrafting questions.  I have been doing a ton of research on BRAVA & fatgrating for the last 6 months due to pain & complications from Lat Flap reconstruction.  I have been very intrigued with the whole concept of fatgrafting, and I truly believe that once the insurance companies quit footdragging on this "new procedure", the number of doctors doing it will increase, the costs will come down, more improvements and breakthroughs will be made, and we will see fewer women choosing to get all cut up to try to get some semblance of a breast.  I have done a lot of reading on the fatgraftpatients.com site, which, of course involves a much smaller group of women, but it might be worth checking out because you can see a lot of women tell of their experiences with BRAVA and fatgrafting.   I think we all need to get very vocal on having other less invasive options for breast reconstruction. 

lalove55

kriserts - did I read that you wrote a letter to your insurance co. to get them to pay for fatgrafting?  Did you post that letter?  I would like to do the same thing, and want to be pretty thorough!  Any advice would be appreciated!

kriserts

lalove55, I can send you a draft of the letter. Send me an email: kriserts [at] gmail [dot] com.

newbe6

lane4:

I finished reconstruction after BMX. in July 2012, & went to my PS yesterday to let him take his pictures. He did a little fat grafting when he gave me the silicone implants. I asked him about having further fat grafting to provide more contour. In discussing the pros and cons, he pointed out that one of the risks of fat grafting is lumps. They do not result in any medical problems, but may interfere with perceived satisfaction with the outcome. The PA also advised to continue doing breast exam after the complete reconstruction, due to the possibility of reoccurrence. If there is a lump, to check for changes. It is unlikely that there would be a reoccurrence in the skin, but it could happen. It sounds like you're lump is the fat, which is what my plastic surgeon said could happen from the graft.

kriserts

My surgeon warns me about the same thing, lumps in the fat that might need to be tested to make sure they're not tumors. My PS for this sort of minimizes that, she says an experienced technician can tell the difference between fat and tumor lumps.

dancetrancer

I've had two lump scares post fat grafting and both turned out to be fat necrosis.  They used mammo's and verified via ultrasound that they were benign.  So yes, these are scares that likely will happen - good to be aware and know so you are less freaked out if it happens.   

kriserts

Dancetrancer, does a mamo on FG breasts hurt the same as on a real breast?

dancetrancer

It feels the same to me, except when they are trying to get a magnified image - b/c I am a bit smaller than I was pre-surgery - so they really have to get in there which is not comfortable.    However, it is not anything I freak out about.  Just discomfort, and then it is done and over with.  The non-magnified mammo's don't hurt at all. 

lane4

newbe6, kriserts, and dancetrancer: Thank you for your replies! I just hope this lumpiness is not more fat necrosis. The fat necrosis that I had before caused a deep dimple and a really hard lump. My PS broke that up when he did the fat grafts last December. I can live with lumpiness, but I don't want the dimpling or the unneccesary biopsies.

nanblaine

eine, I noticed you were asking if there were any other doctors that do the brava.  It looks like you are in Illinois.  Is that right?  I am going to the Cancer Treatment Center of America in Zion Illinois and they have been FANTASTIC to my family and I.  The PS that did my mastectomy and is doing my fat grafting is Dr. Stephen Ray.  I have done a lot of research on him and he is one of the best at this procedure.  If your insurance covers the CTCA I would highly recomend checking them out.  I have only had my first fat grafted at the time of my mastectomy because I turned out to be HER2+ and now I have to wait until after the herceptin treatments before he will continue with more grafting.  I'm not sure why but I'm trying to be patient which is not easy because I just want to be normal again.  But I have been very happy with CTCA.  You will feel the genuine warmth and caring from the minute you walk into the place.  I feel safe and important when I go there and they have a whole team to work on your personal case and each doctor spends as much time with you and your questions as you feel necessary.  I will be happy to answer any questions you may have if you want.  Good luck in your search!

Galsal

I'm so very excited to have a consult appt with Dr Khouri in late November!

Oracle

Hi Galsal:

You will be in the best hands with Dr. Khouri. To learn more about Brava + AFT (autologous fat transfer), be sure to visit: www.fatgraftpatients.com



Have you seen Dr. Khouri's recently released book?

http://www.amazon.com/Your-Natural-Breasts-Augment-Reconstruct/dp/0615695809/ref=sr_1_1?ie=UTF8&qid=1352769519&sr=8-1&keywords=Khouri+breast

goodrhue

I'll send you an email also - would appreciate a copy of the letter.  Thanks!

goodrhue

I had my consult with Dr. Khouri in July, am getting ready to order my BRAVA, and my first procedure is scheduled for January 24.  Dr. Khouri's office put me in touch with a woman who had a similar experience  (radiation, 4 micro fat-grafting procedures) to mine, and it was really helpful to talk with her, so I'd recommend that any of you thinking of going to Dr. Khouri use that resource.  4.5 yrs since RB mast...now I'm looking forward to bathing suit shopping in 2014!  I'll post my experience with the procedure and with insurance (BC/BS).  Any advice from those of you who've gone through the procedure is much appreciated!

Galsal

Thanks...just got the book today when their office called to let me know I was out of network for insurance.  It gets worse - I have no out of network coverage.  So will need to change my plan since it's open season and pay a lot more in premium in order to have that coverage.  At least I'll have seen him by the deadline of our open season.