Microfat grafting or BRAVA doctor recommendations

dustylady

hi robo47: 

You were wondering if fat grafting could be done on BMX...Yes.  I had a BMX 6/10.  I went to Dr. K in Miami...I was about a small B originally...he completed my R in two sessions...now a large B or small C...The left was irradiated years ago..so is coming along slower.  I believe my surgery on 9/21/11 will be the last for the left side (hoping).  I was amazed at how much feeling returned.  They feel very comfortable and just like my originals...except the left still has a couple of numb areas.  I imagine this next round of fat will change that.  I am not a really large person, so was worried about the fat supply...has worked out great so far...I'm 5'2" and about 110-114 lbs.   

kareenie

Squishon - This lady was in training with Dr Khouri last week -- Dr. Lauren Greenberg in Palo Alto.  She already has a post in her blog telling how excited she is about fat grafting.

Please let us know if you talk to her and what she says.

pixelsupply

Dr. Otto Placik, Chicago IL

Went to see him and liked him alot. He knew of all the current procedures, had already done some procedures and said he liked to find the best fit for what the client needs.  His office is not very medical and more spa like which is different from my care at UCH. He discussed everything thoroughly, was very knowledgeable and forthcoming even about costs! And they do take insurance for reconstruction despite what the receptionist and website say.  I have to wait a few months after radiation and if I don't like what my current PS suggests I will be going to Dr. Placik.

Chicago1018

Pixel -

I am shocked!  They all but told me that I couldn't schedule an appointment.  I wonder if the receptionist acts as a 'gatekeeper' or something.  I am so glad you got in and he was helpful. 

Chicago

pixelsupply

Chicago

Great article! Thanks for posting.

pixelsupply

Chicago,

I actually scheduled an appointment via email. And the consult is free! I don't know why they didn't talk to you. Maybe try the website? Weird!

Anonymous

This was posted on the fat grafting thread by whippetmom-

A Beverly Hills plastic surgeon who is using the BRAVA method...http://www.drtrott.com/breast-augmentation-without-implants.html

whippetmom

Bump

chatsworthgirl

I was diagnosed with breast cancer on June 9th.  I had a lumpectomy then a re-excision and then was told that the cancer was multi focal or multi centric and that a bi lateral mastectomy was the best option.  I had cancer in the sentinel lymph node.    I will be having the bi lateral within the next two weeks.  I have done a lot of research and have read many discussions on this web site which has enabled me to learn things that otherwise I would not have known.  Among them was the cold for chemo including the caps, vitamins etc. and most importantly the fat grafting for recon.

 I was going to have recon at the time of mastectomy but when I read so many women's reports, on other sites as well, of the terrible problems with implants and flap procedures I decided to cancel my appointment with the plastic surgeon who would be performing the implant surgery.

I have been in contact with Dr. Khouri's office and am in the process of getting all the insurance data to them in preparation.  Since I live in Los Angeles I was interested in finding a local PS who would do this procedure as I learned that he had trained some.  It happens that Lauren Greenberg in Palo Alto had trained with Dr. K and on her website talks about her excitement and her training.  I will be callilng her today to find out if she is able and willing to do the total reconstruciton with fat grafting technique since this would be much easier for me to travel to Palo Alto.

Also if possible I would like to speak to one of the women here who have had the fat grating with Dr. K.  I can give you my email and then phone number.

leeinfl

Sorry that you've joined out little "club" - but glad that you are armed with more imformation than most of us were.

There are several of us who have had fat grafting with Dr. Khouri.   Just click on the member name and then send us a private message.  I'd also recommend you drop in on fatgraftpatients.com for loads of info as well as patient stories.  There is a member on that site who is several weeks out from bi-lateral mastectomy with immediate fat grafting.  Her photos are nothing short of amazing!  

We are here to help in any way we can!

Lee

chatsworthgirl

leeinfl

Thank you for your reply.  I have tried the fatgraftpatients site and registered but it was not possible to even view anything. 

Since I am in Los Angeles and have already going through a lumpectomy then the re-excision I am locked in to the insurance covering the mastectomy.  Although it would be nice to have immediate fat grafting it is not possible because I will be having some radiation under my arm per Dr. K and per Dr. Greenberg. 

I spoke to  Dr. Lauren Greenberg this morning.  She is setting up to do the procedure and will be receiving her centrifuge shortly.  Although she has not yet done this she is extremely positve and said she will be doing it exactly the way she was taught by Dr. K.  She sent a friend of her's to Dr. K for the procedure prior to her being able to do it herself.  I am more than willing to be her first but she said she has patients who are already being scheduled. 

 So to anyone who is on the West Coast, Dr. Greenberg is the only one that I have found so far doing the total reconstruction using BRAVA and fat grafting.

I will try clicking on a name and doiing a private message.

 Feeling hopeful.

Kathy

Anonymous

chatsworthgirl- There is a member on here, who is also on the fat graft site, that just had her NSM and then FG with Dr. Khouri.  Her screen name is IrishLuck and I know she would be happy to help in any way that she can.  I think she lives in southern CA, too.  Also, when you join the fat graft site it has to be approved so check back and see if you now have access to all the information.  Thanks for sharing Dr. Greenberg's name.  It's great to see some doctors names on the other side of the country!  Good luck with everything as you move forward.

leeinfl

I came across Dr. Greenberg's website and blog just a few days ago  She seems very enthusiastic about the whole procedure.  Read from her website:

http://www.laurengreenbergmd.com/uncategorized/breast-reconstruction-after-breast-cancer-using-fat-grafts/

Yes, Chatsworthgirl - sites like fatgraftpatients.com will require you to post at least once in order to gain access.  It may seem cumbersome, but it does provide a higher level of security. Please make sure and post that you agree with the terms of the site and you should have access very soon.

leeinfl

Meant to post this link as well:

http://www.laurengreenbergmd.com/uncategorized/dr-khouri-and-me-my-time-in-miami-with-the-guru-of-fat-grafting-for-breast-augmentation-and-reconstruction/
 

Squishon

Thanks Kareeni for the recommendation. 

I'm excited about Dr. Greenberg, especially since I live in the Bay Area, but am concerned about her lack of experience in doing this procedure.  I have some significant fat necrosis after tissue reconstruction and am interested in finding someone in CA who has experience doing the procedure, particularly in NorCal, but would consider SoCal. 

Chatworthsgirl:  I'm not looking to have the necrosis removed, etc. till December, so do you think Dr. Greenberg will be set up and have results to look at by then?  Thanks!  

Squishon

Just found the following on Dr. K's website that is concerning to someone who is trying to get rid of all breast tissue.  (I had bilateral mastectomies and don't want to produce new breast tissue.)  For those who went to Dr. K, any thoughts on this?

BRAVA applies gentle, sustained tension on your breasts, which causes cells to replicate and produce new breast tissue. Not only does it expand the skin from the inside, it also has the effect of regenerating a breast through the expansion of tissues and nerves while keeping blood flow. This does two important things: 

http://www.miamibreastcenter.com/faq/brava-frequently-asked-questions.html 

leeinfl

Squishon - Please keep in mind that with a mastectomy the surgeon removes all (or at least as much as possible) breast tissue.  In that case, the Brava is being used much like a TE, except that instead of compressing, the Brava domes truly expand the remaining tissue to provide a space for the droplets of fat to survive.  Brava is also used for augmentation (that was the original use and study) - so there was breast tissue and cells to regenerate.  With us, there is very little tissue left, thus the multiple fat grafting sessions.  The fat that is grafted is not breast tissue - so to answer your question, I have no concerns whatsoever, and neither does my oncologist.  

Squishon

Thanks Leeinfl.  

tedwilliams

I agree with Leeinfl. My doctor gave the same explanation.



Jana

Mina1

Hello Kareenie

Just sent you a PM. Need some assistance with Dr Khouris procedure especially with radiated breast tissue. I am considering the procedure. Thanks.

Mina 

beacher4209

I have been investigating this for a while. I was set on the diep but have decided that is just too much surgery for me .Im looking to reconstruct my reconstruction. I have found a few ps's in southern Cali that say they do fat grafting. I have made a few consult appts. in the upcoming weeks. They are not doing the Brava but they do fat grafting. I do not need my skin or tissue expanded  because i already have had that and am sporting a 500cc silicone implant im hoping to get rid of. I hope that they will be able to use a smaller implant and the the rest my own tissue instead of alloderm.I have radiated skin so my hopes this will give me a much better result than what i have no which is alot of discomfort..If anyone wants there names let me know. But i will be posting my results from the consults.

EileenKaye1

Saw my radiologist this week.

He has seen great results from fatgrafting.  Says all the local PS's are anxious to do fatgrafting--it is an easy proceedure with great results--and minimal recovery time.

I definitely will be having a redo of my Reconstruction  in the future.

Eileen

sweetie2040

EileenKaye1-that's great news, but I still think it will be a while before all the PS's start doing it on a regular basis for reconstruction. I am seeing two Dr's this week who do it so I am excited to see what their method is and if I will be a candidate for it. I have 500cc's implants and severe rippling so I'm hoping it can help that.

EileenKaye1

Sweetie2040--I am in New York--If you are interested--PM to me --and I will give the recommendations from my trusted radiologist--

I also have recommendations in New York from other Reconstruction patients.

Eileen

sweetie2040

Eileen-thanks. I spoke to a Dr from NY and a lot of the ones who do FG in this area are either in NY very close to it. I'm seeing two from CT next week and I'll see how that goes. I will take the names of the Dr's you've heard of though in case I want a different opinion.

EileenKaye1

Sweetie2040

Good Luck,

Let us know how it goes.

Eileen

beacher4209

EileenKay and Sweetie2040, It sound like u are both trying to do what i want to have done,I want to remove my 500cc implant and put a smaller one in ,but also use my wound tissue kinda as a bumper around the smaller implant instead of alloderm,im sure alloderm would still be in there from the pocket ..but my ps he would put a smaller implant in but use alloderm as a bumper where i have alot of scar tissue so i might not have problems with scar tissue again he would cut away as much as he could..ALLL sound great but i want to use MY OWN tissue/fat so im searching for a ps able to do this Is this what u ladies are wanting to do too?

beacher4209

Can any of the ladies that have had DR.k's procedure please tell us about the costs, even if your insurance paid for how did u afford to fly out there 4 and 5 times and pay for accomadations. At this point i am assuming this is only for b/c ladies that have alot of money? 

dancetrancer

I can't tell you about procedure costs yet, as my first procedure is tomorrow.  That will be covered in-network for me.  Subsequent procedures will be out of network, but at least I have that type of coverage, and my deductible for my  in/out of network is the same - so it shouldn't be any additional (I hope!).  Many times you don't know exactly how it is all gonna play out until the bills start rolling in. 

In terms of travel costs, yes, of course you have to have money to travel for treatment.  I am fortunate in that my husband travels a lot for business, so we have been able to use points for flying and hotel costs.  Of course at some point we will need to start paying out of pocket for travel costs.  That's just the reality.  We are prepared to do that and feel blessed to be able to handle it financially.   

leeinfl

Beacher - I've already answered in the other thread.  My procedures with Dr. Khouri were covered by my insurance, as ALL breast reconstruction is covered by insurance as stipulated by law.  The  issue is that insurance companies vary greatly in exactly WHAT reconstruction procedures they cover and how much, as well as the amount of deductible and co-pay a patient has to pay.  This has nothing to do with the surgeons, this is an insurance issue.  I happen to have Blue Cross/Blue Shield and they covered pretty much everything after my $3000 deductible was met, however, that doesn't mean every subscriber to BC/BS has the same coverage.  Different plans, different options.....it's confusing and frustrating as so many of us have had to fight insurance battles as well as BC.  I've had to go to battle with BC/BS on some items (none of which from Dr. K) and I won some, and I lost some.  As far as flying to Miami goes - you won't know how many procedures will be necessary until you have your initial consult with him. 

Dr. Khouri is doing his part with his monthly workshops in helping bring this procedure to as many women as possible.  I think all of us can help by spreading the word, questioning our health providers and asking (DEMANDING) that this be provided as a reconstruction alternative.