BRAVA Fat Transfer with no breast

hopeful24

I thought I would start a new topic on this because I was unable to find anyone in the previous topics that was starting fat transfer with no breast.

I had massive complications for over two months after a DIEP Flap. A staph infection finally took one of my reconstructed breasts (the other is perfect). The doctor and I are in agreement that my body can't handle more long surgeries. He suggested fat transfer.

Has anyone done fat transfer with nothing but original skin and muscle? It seems that most people either already had expansion done for implants that their now removing OR used fat transfer for fill in. 

I'd like an idea of what to expect starting from scratch.

Thanks,

Marcia

EileenKaye1

Hopeful-- Dr. Khouri --Miami breast center has photo's on his website.



Some of the photo's are amazing

hopeful24

I did see (and bookmark that site). It is amazing. I'll be heading to Mayo on Wednesday and I'm anxious to hear my doctor's full plan.

EileenKaye1

Hopeful-- Dr. Khouri is the expert on fat grafting. Still I tend to think that it is a longer process than you are led to believe. I think that my PS is excellent, and that my issues are the usual.

In the past there were many patients from the Miami breast center on this forum. Hoping they will return to update us on long term results. Good luck on Wednesday. Let us know the recommendations. Eileen

hopeful24

I am anxious to hear from those outside Miami. Dr. Khouri -- who I believe is great -- was the expert three years ago. That's a long time for other doctors to become "experts" and maybe even make minor changes.



My doc, for example, made a few of his own changes to the DIEP Flap (including no binders). I have a perfect right breast and would probably have the same on the left if all the blood vessels hadn't been compromised.

EileenKaye1

Hopeful--excellent points. Have you checked out www.fatgraftpatients.com. This site has profiles from Dr. Khouri's patients plus other surgeons. I think that people are remarkably honest. And I so agree--if I am not 100 percent satisfied, I will have my BR updated in a few years. Do love my PS, but I think she also will be able to more in the future. That's my thought. Eileen

hopeful24

I've been having trouble getting registered on that site. I hope to get that straightened today. It looks like it is all Miami based, though.



I'm very happy with my team at Mayo. It's a bit of travel, but worth it. BTW, I just moved from NY four years ago. I had my first lumpectomies there with three different surgeons. The egos (and wait times) are so different.



Marcia

EileenKaye1

It is Miami based, but they have a section for other surgeons--my doctor is listed, along with others. So true, about the issues in New York. Mayo is one of the best. Eileen

kareenie

fatgraftpatients.com is not based in Miami. It is run by a lady in (I think) New Jersey.  It is not affiliated with Miami Breast Center although many of the posters went there for surgery.  They welcome patients of all surgeons.

EileenKaye1

Kareenie--thanks for the clarification. I must admit that I gained a lot of information from fatgraftpatients.com esp regarding use of brava. Had difficulty at first, but Hints and Tips regarding Brava made quite a difference. Eileen

hopeful24

I finally got into fat graft patients and was rather disappointed. While there are some recent replies, most of the stories and doctor updates are over a year old. That's a lifetime in the world of breast reconstruction.

kareenie

There are several ongoing stories of patients who have had surgery within the last three to ten weeks. Perhaps you were in the wrong section.

EileenKaye1

Implant is out, scar tissue was removed. What a relief. Going for reconstruction with total fat grafting. Should require two more fat grafting surgeries. Right now I am working on 180 degree flexibility. Eileen

hopeful24

Sounds good, Eileen. Rest up..



Kareenie... I will look again when I get a chance. I did see some recent entries, but they were at the end of old stories.



I had to cancel my appt yesterday because it was icy and the pilot didn't think it was safe to fly. I'm going up next Wednesday.

EileenKaye1

Hopeful--I think this is finally working for me without an extensive post-opt recovery period. Pt was just here working on my 180 flexibility.Again, feeling so much better. My doctor does BR from scratch with fat grafting. Too bad you are not in this area. As stated before, I really like her. She is the only one who addressed my pain issues. She did agree that I could get the cosmetics in two more surgeries. Right now I am so thankful that most of the pain is gone. Still tired from surgery, but improving. Eileen..

hopeful24

Glad to hear. I've been through four surgeries in the last two months (the first was 20 hours and they had trouble resusitating me) so I'm all for quick surgery, quick recovery!

My doctor at Mayo does the fat transfer and he knows my history with all of this so I wouldn't consider going anywhere else. Mayo is a pretty incredible place in general and the inpatient care is great. (I will be staying overnight after each procedure because of the problems I've had with anesthesia and for pain control.)

Rest up!

Marcia

hopeful24

Hi Everyone,

I don't know who has heard, but Dr. Saint-Cyr at Mayo had a serious accident last Sunday -- the day I arrived for my Monday morning fat graft. I've been waiting all week to see if another surgeon there could do my surgery. I have heard nothing.

I made a few calls yesterday and I actually managed to get in with Dr. Khouri next week! It's amazing that they have been so cooperative. I'm meeting him Monday in Miami and it looks like I will have surgery Tuesday or Wednesday.

I wish I could have done the surgeries with Dr. Saint-Cyr, but since I've been doing Brava for six weeks now I'm anxious to get going.

Marcia

hopeful24

Just wanted to follow up a bit on my progress...

After Dr. Saint-Cyr's accident, I frantically called surgeons around the country to find out who could do fat grafting. I finally went to the original, Dr. Roger Khouri. He agreed to fit me in. 

My experience there was nothing like that at Mayo. It's tough getting used to the very busy non-hospital setting where it's hard to get answers to questions/problems once you leave. This is my only option now and I'm going to try to make the best of it.

Today is three weeks since my last fat grafting, on my thighs. Dr. Khouri also did some adjustment (lipo, I think, though I didn't think there was any fat left there) on my stomach scar and starting reducing the DIEP flap breast,

The first two weeks were horrendous. The pain in my legs was constant and I had a stomach pain that I could only describe as an ovarian cyst compared with sciatica. While the legs did get better and I was able to start walking in week three, the stomach pain continued to get worse. It wasn't really until yesterday that I started to notice a little improvement. 

I think -- and I am not a doctor and have been unable to get in touch w/ Dr. Khouri -- it was a swelling around a nerve. I know I am going to be insistent that the stomach scar is left alone. I don't have plans to pose in Playboy and it's low enough that I can still wear a bikini. I am not going through this pain again.

As for the BRAVA, I'm getting through. I hated being stuck in the house alone so on the weekend i wore it at night. It was two sleepless nights, but it was worth it to have some fun with my friends. )

Next surgery scheduled September 26...

hopeful24

Fatgrafting surgery two is in the books and I'm back home. I'd like to say it went easier, but every procedure seems to bring new complications and pain. 

Dr Khouri took fat from my hips (front and back), waist and a bit from my behind. He was happy that I had "a bit more fat" for him, but not happy in the volume of my breast from the BRAVA. I told him I've done it as much as I possibly could stand the pain, even taking vicodin to get through it at times.

As far as fat deposits, he decided to concentrate on my cleavage, putting fat at the top of my left breast and doing the same with the right (in that breast it's just repositioning what's there). He also worked on my stomach scar a bit.

Oddly, I was told not to use any compression garments this time so the stomach would heal better. It meant actual spouting of blood from the holes the first day, but made it a bit easier the other days. The problem was in my back. The pain from my spine was horrendous and got worse each day after surgery. When I called, I was told to add in Tramadol and tylenol, but nothing helped.

On the day of my follow-up, Dr. Khouri said my back had nothing to do with the surgery, that I should see I chiropractor when I got home! I kept saying I was sure it was from the surgery, but he shrugged. It was the nurse and other doctor who told me that irritation on the spine can happen when doing back hip lipo (the rubbing back and forth on an area with no fat). I got stronger Dilaudid and has me also taking Celebrex, as well as icing it. One week after surgery I think it has leveled off, but not improved. 

They put me in splints (boiling water and crazy glue on my breast, what an odd thing) and told me to where them for four weeks, followed by four weeks of BRAVA. Dr. Khouri wants to do another surgery the beginning of Dec and says I may need two more since I'm not using the BRAVA enough. I asked him about other options (like taking the skin that's tucked in out, putting in a small TE and then filling it once it's closed up, but he said BRAVA was the only way. I told him I definitely want to wait until after the holidays before I have another surgery.

I honestly don't know if I will go back for another fat grafting surgery and months of BRAVA. This is definitely not the plan that was described to me from my original plastic surgery. Even without the incredible pain and stress on my life, it's insanely time-consuming and expensive. The original plan put in front of me was 3-4 months. Now, it looks like 8-10 months. 

I am  exploring any and all possible options. Had this surgery added to the breast rather than just the top/cleveage, I might just stop here, but my breast is an odd up and down. I'm going to take as many consultations as I can, including one with my original PS, who should be operating soon. I'm hoping someone out there has another option that will just finish this with one surgery. I don't care if it's a longer surgery (these are already 4-6 hours, something I didn't originally plan on) and recovery, at least it will be over.

I would never recommend this type of reconstruction to anyone who hasn't exhausted all other options.

hopeful24

Just to update everyone quickly... 

I've done four fat grafts with BRAVA and each one was filled with pain, complications and isolation (while I sat home in pain pumping my breast by myself ) I am totally done with this machine and I would be shocked if my doctor suggested it again. The latest result from it was opening an old incision and causing a huge hematoma. 

I've watched friends with tissue expanders sail through fat grafting and many other procedures. I wouldn't wish this torture on my worst enemy. After a year (next month) of BRAVA and four long, painful procedures, I still can't fill out a small B cup. I'm going to sell it to try to pay for some of the debt it's cost me and finish up fat grafting without it.