Fat Grafting....recovery & results

melmcbee

Great Catie that gives me hopw that it will hwal fast. Is there anything that I can do to help the healing? Also Catie I am from Brunswick Ga but I live in Fernandina Fl now, what part of Ga are you from?

Catie2013

Melmcbee - I'm south of the airport but have been to fernandino beach and very beautiful!



I didn't do anything except wear the compression garment 24/7 - worked for me fine.



Just expected to be colorful for a good while and wasn't!

melmcbee

What can be done to preserve the fat graphing. Ive read that 40% of the fat either dies or is reabsorbed back into the body.

jill47

Sharon, Mel big congrats on making it through! One would think at the end of the line in reconstruction land the pain and restrictions wouldn't be that bad but that not the case.  I heard too about the a significant (I think 40% is a ton) amount of fat being reabsorbed back into the body. Wildumara, I feel so bad for you if your PS is planning on mutiple fat gratings.  I feel better standing up, moving around vs sitting.  Granted getting out of bed is no picnic. Went back to my desk job on Wed, left an hour early (out of gas), yesterday only made it to noon my mid-section hurt so bad from sitting/working on a computer (when I got home took 2 pain meds & a long nap); today I made it a full day but in horrible discomfort every hour.  Sweet and healing thoughts to you in recovery.  Jill

Catie2013

I go back in 6 weeks for 2nd round. First was 6 weeks ago but also had major donor site revision too, so the grafting was from hips, outer thighs, tummy and pubic area. Dr said he took from those areas and transferred to upper breast area and donor site area - and it is a process that might take a few times to fill area needed correctly. I have no doubt some gets absorbed but know they don't just fill a whole breast with just Fat Grafting probably for that reason😘

mormor1

src3acs....

Sounds like you are having fat grafting as supplemental after your DIEP.  You're probably recovering now...so would be nice to hear how it is going!

Catie2013  It is very possible to have complete breast reconstruction using fat grafting.  If the Brava domes are used to create a blood supply mattrix to carefully inject the fat molecules, the retention rate is closer to 85%.  Three years ago, I completed four fat graftings to restroe my left breast after a unilateral mastecomy.  LOVE the results, feels like I grew a new breast! 

Recovery for me was not too bad....yes, bending was the hardest...lots of bruising.  I was able to return to work after just 3 days off (which included travel to Florida) and felt ready.  Many women would say to plan on about a week off work.  Compression garment was mentioned and that is very important.  If you do fat grafting (esp for complete breast recon), it is very important to have an experienced PS).  I had Dr. Khouri...there are others too.

Wishing you all the best!!

Catie2013

Wow, sounds like your BRAVA was a huge success! I've heard of Brava but not knowing very much about it reslly.



What I meant was without aid of anything - just putting grafted fat into the mx divot isn't done (or if it is, I will stand corrected and would love to know about it!)



Was Brava your first choice, Wisconsinrandi? And I so agree with having a Dr who knows what he is doing!

mormor1

Catie,

You're right...it wouldn't work at all to just inject a bunch of fat into a mx site!!

At the time of my bc dx, I had just accepted a new job.  I was able to have the mastectomy and start right on day 1 (it was over Christmas, so had a little more time to work with). I wasn't excited about either of the usual recon options (partially chicken about the pain...but mostly did not want to have to take time off).  It was really hard not have recon though with a unilateral mastectomy....hard on me and my DH.  In April, DH happened to hear a little "Heath Spot" about an MD in Florida that was doing a new type of recon...outpatient, no incision, much lower risk of complications.  He called the station and we got in contact with Dr. Khouri's office.  There wasn't any website....or any sources of info.  All I knew wat that it was part of a Government Clinical Trial...was in network for my isurance compnay...and I would only need to take a couple days of work. 

We both felt in our hearts that this was worth a try.  It turned everything around for me.  From that time on, this has all been an adventure!!  Even the challenges and embarrassment of wearing the Brava domes!!  Very, very thankful....oh and did I mention, how fun it is to have some curves?  Actually, you can see my pictures at miamibreastcenter.com go to photo gallery/mastecomy recon and there I am!  Below, I am the #1 case.  And you can see the cool nipple my husband made for me (a new business has developed out of the for us too...Naturally Impressive, LLC  www.naturallyimpressive.com).

I could go on and on....    Thanks for asking!

Catie2013

Very interesting - were you the first Brava patient for Dr Khouri? It is amazing how these special caring Drs have come so far to help us mx bc patients!

Catie2013

I just looked it up, I have a friend who is looking at Brava but heard the device is not covered by insurance. Did you find that problem? Photos look fantastic! And the nips do too!

mormor1

Catie,

Oh no, I wasn't the first...think I would be too chicken to be that much a pioneer, but probably among the 1st 100.  I was toward the end of enrollees in a Government Clinical Trial of 50 women.  He has likely done nearly a thousand women using this technique by now and has trained MD's from all over the world.

Good question about the FDA...though very frustrating....limiting this wonderful option to women for now.  Hopefully, in the long run though, after more studies are completed, it will be covered more fully by insurance companies and women will be aware that there is another less invasive option.  MD's can still decide to use the Brava as an off label use (it is approved for augmentation alone by FDA).

Here is an except from a May 13, 2013 statement received via Dr. Khouri:

"Over the past 8 years several hundred women were enrolled in this IRB study sponsored by Brava. Results show that fat grafting after Brava expansion allows us to successfully graft much more fat and achieve much better augmentation and breast reconstruction results than if Brava was not used. Most importantly, there were essentially no complications. Certainly less than the implant and flap alternatives. Nonetheless, the FDA is not accepting this data because it is not derived from a prospective randomized study where half the patients of a particular surgeon are randomly assigned to having Brava and half assigned to no Brava.

Plastic surgeons like Dr. Khouri who after years of using Brava on hundreds of patients are convinced of its safety and efficacy have decided to continue offering it to their patients as an off label use. They consider fat grafting after Brava preparation is no longer experimental and therefore now offer it as part of their regular practice. No need for the IRB anymore.

However, in the near future, a small group of select surgeons will need to enroll patients into a prospective randomized +/- Brava study that will be monitored by the FDA. It is not until the results of this study are out and reviewed by the FDA that Brava will become approved . On a positive note, when that happens, Brava will be reimbursable by Medicare and most insurance companies.

Till then, only a few patients from a few doctors will be able to get Brava from the company as patients in the IRB study. The others will have to obtain the devices as women seeking simple non-surgical augmentation as it is currently approved by the FDA. It is their plastic surgeon’s decision to then have them use Brava as an off label indication."

So, it is still possible to get fat grafting using Brava. Interested women should press forward in checking this out.  I did have to pay for the Brava domes (I think about $500 + some additional ones for size increase) and all the women I know did have to also.  We are not a large income family, but somehow were able to pull this all off, step by step...and it was very much worth it!

I don't mean to side-track this thread...thank you for listening.  I believe there is another thread "Has anyone tried micro-fat grafting?".  It's a very long thread.  Please PM me if you have other questions.
Glad you liked the nipples, Catie!!  They are quite amazing!

All the best to all of you wonderful women!!

src3acs

Good Morning Everyone.......Well, I'm heading into day 5 since my fat grafting.  Yes this is my 2nd revision since my DEIP in Oct 2012. I never used Brava or any kind of expander during this process.  Very very happy with the way my new breasts look and hoping the fat takes well.  I don't think I want to do this again.  I have a lot of bruising and still feel like I was beaten with a bat.  My hips are very puffy....hoping it's just swelling and they aren't going to stay that way.  Still taking my pain meds at least twice a day.  It's the getting up and down that hurts the most.  Once I'm comfortable in my recliner or standing the pain isn't so bad.  Jill, happy to hear you are getting around and working some.  Just don't over do it!!  Sending well wishes to everyone 

Catie2013

Src3acs. -I am 7 or 8 weeks out (think 7, April 12?) - funny how I can't remember!!! LOL



AND the swelling keeps going down. It's a process, so what I look like today vs 7 weeks ago is still 'getting there' - I go again in a little under 6 weeks and I think that will be my last as well. I'm just need some upper breast fill and one is bigger than the other so would like them both to look the same! But getting tired of surgery and the recouping! My tummy does crazy things when OFF the pain meds, not while on, but off. So that's a pain in itself.

melmcbee

Hello ladies. Hope everyone is doing well. Src, Im glad you gave a progress report. My bruising is fading but Im still sore to touch and the compression belt hurts. I am able to get up and down a little easier. Im also still taking a percocet maybe twice a day. I had implants placed and fat injected as well and my breast skin is still sore. Are you still taking pain pills and are your breast still sore? Didnt we both have surgery on the sameday may 30th.

wildrumara

Hi ladies - I am now five days post op lipo and fat grafting.  I only took pain pills the first 48 hours,  stopping yesterday.  I would say that my tummy is just tender now.  I can't believe how bad the bruising is though...YIKES!   I am very impressed with how the "foobs" look. The breast cancer side especially!   I see my PS on Friday.  Im anxious to see how much fat he actually took out.  I'm thinking it wasn't much.....I hope that I will be able to tell that I had the lipo on my belly when this swelling goes down??   Sitting five days post-op, I will do it again, if need be. 

src3acs

Hello Everyone,  Yes, Mel, we had surgery on the same day.  Sounds like  Wildrumar had surgery the same day as well.  I am still taking pain meds at least twice a day.  PS went through my back and I still feel like I was beaten with a baseball bat.   I also feel like I have a binder around my mid section even though I'm not wearing one.  My breast haven't been sore at all.  I never had implants and they are still pretty numb from the initial DIEP.  But the lower rib cage is sore....not sure why.  Catie....happy to hear the swelling will go down.  At first I thought he didn't take fat from my hips until they turned purple.  I don't see my PS until next Monday.  I'm sure I will get all of the details then.  Happy to hear everyone is on the road to recovery.  Please stay in touch ladies so I know how you all are doing.

melmcbee

Src, I hope you are feeling better today. Healing hugs to everyone

jill47

Hi ladies! You are all coming along nicely.  I went off pain meds too fast and back to work too soon. If I would have to do this again I would take off a fell week of work and stay on the pain meds longer. So don't feel bad being on pain meds 5 days later ( I should have!).  I'm happy to report most of my bruising is gone, barely noticable. I see PS tomorrow, he'll be pleased. That K-Creme must of really helped, I'm not typically a fast healer, so I'm surprised. I made some lifestyle changes, the spanx+binder has been a eating control device, didn't know it, but you can only eat so much while compressed 23.5 hrs/day!  Wanting to stay trim, I've been eating very healthy, I opened an acct at myfitnesspal.com w/ my weight loss goal (want to get back down to pre-dx weight) last year & I'm eating healthy for the first time in over a decade. Begin each day w/ a brisk 10 minute walk in my PJ's w/ my binder exposed, it's early & after work walking for 2 miles.  I feel good. Will consult w/ PS tomorrow, I don't want to go too crazy on weight loss and lose the fat grafting work ) - :  It feels soooo good to have some natural fat in my breasts, they are full, soft & DH said they feel natural.  Hugs too all! 

melmcbee

Jill you sound so good. I wish I had your energy. Healing hugs

src3acs

Hello Ladies....well one week out from my fat grafting.  Have to say I thought I'd feel much better by now.  Maybe my pain tolerance is really low.  Drove for the first time today.....next time will have to take a pillow for my back.  Went to the grocery store.  So glad my daughter went with me.  By the time we got through the check out I was exhausted and in pain.  She had to load and unload the groceries.  No breast pain....it's all in my back and sides.  Sorry to sound so negative.  Feeling very depressed and just want to wake up with no pain at some point.  Also, not much support at home.  I will get past this .  I think once I get back to work next week everything will fall into place. Hoping all of you are doing well and healing quickly. 

Catie2013

The first 2 weeks are the hardest, but I didn't have any from my back - so sorry you are going through this! I have to tell you though it will get better! Hoping it goes swiftly for you! And you can vent anytime everyone here is cyber behind you (in a non-stalking way!)



Gentle hugs

jill47

Hey Sharon, you may most certainly post your blues here, we all get it. Are you cleared to take motrin by your PS? That would help the inflammation and back pain which I'm guessing is from back only sleeping, that put me in PT for 3 months last fall after bmx.  1 week out is not that that long at all.  A week from you should feel much better. Don't know if you are cleared to for short easy walks but getting outside w/ some fresh air and moving helped me.

Saw my PS 2 days ago, he couldn't be more pleased. Hey I am too  Next PS appt July 1st, he plans to lift all restrictions.  Right after appt I'm spoiling myself with a 1 hour facial after all this, I deserve it.

Healing wishes to all....jill

src3acs

Thank you Catie and Jill.  I was feeling so sad the other day.  I guess I'm just tired of hurting whether it's a little or a lot.  I find it sad when you aren't feeling good and your SO doesn't ask how you're doing, really doesn't show any concern.  I think that has just made me feel worse.  All I get is....when are you going back to work.  Well, I'm going back Monday whether I feel like it or not.  I'm very lucky to have an understanding employer.  If I don't feel well after a few hours I can go home.  It's funny,  the guys at work email or text me everyday to ask me how I'm feeling....I don't get that at home.    Catie....I don't think I had any fat taken from my back....but my PS went through my back to get to my hip area so that is why I hurt from hip to hip and across my back.  I used ice for the first time yesterday and that seemed to help a little.  Swelling in my breasts has gone down.  Almost wish that would have remained.  The indentations at the top are starting to show again....not as much as before.  Quick question....after your fat grafting surgeries were you put in one of those flimsy surgical bras or given something more supportive?  I'm still in my flimsy bra until I see the PS.  Thanks so much for listening to my concerns. You all are great.  Keep healing and staying strong.....hugs to all of you

jill47

Good morning Sharon:  I'm sorry your SO is not providing your the love and support you need now.  That is why we are here  but I know it's not the same. My DH still doesn't get why I need to see bc doctors for the next 6 years. To him cancer is gone and no worries time to get back to "normal" ha!.  He doesn't get it but I know all you ladies do & more importantly, my doctors, do.  Getting back to work with what sounds like very caring and supporting people should help you feel a little better.  Take work easy, don't let yourself get too tired, leave early if you have to. Re: bras, I'm back to the bras I wore pre-fat grafting which are wireless bras, genie's and micro-bali's for sleeping. I just started side sleeping again, not all night but a good portion. I'm seeing a little bit of upper pole indentations too but PS says it will take up to 6 months for the fat to settle in. One last thing, I finally asked PS about the sandpaper feeling I still under my right (cancer side) arm pit and arm from SNB 2 removed and 2 taken out left side but that side feels o.k., he said how it feels after 18 months after bmx is how it will feel for life. That sucks.  I see my MO on Tuesday, quarterly exam, lots to talk about.  Hugs to all, jill p.s. I'm tired of all the pain too, coming up on a year of it.

Catie2013

Src

So hard to have SO or DH who just doesn't 'get it'. Mine has been good but is like Jill's DH in that he thinks - they got it, it's gone, no worries! OH HOW I HOPE, but still know the MO is now on my short list of people to see every 9 months! The PS probably at least 2 more times, BS every 6 months - and have promised myself a colonoscopy - hate the thought of the prep - but that's also in the near future!!' I AM NOT a hypochondriac - but sure sounds like it, doesn't it? My dad is right now in hospice for brain mets from melanoma - he has had 5 bouts since 1985. Most recent in his scalp and no clear margins - so the mets - SO I have to add Dermatologist to that list. I think I'm NED and pray, but DH is positive! LOL. So know Jill where you are coming from.



Src - my dad was one who couldn't face when people were sick. He wouldn't know how to react. So he ignored or pretended to ignore there was a problem. Drove my mom crazy trying to get him okay with her problems - my mom was alive for one of his surgeries. I was there for the next 3, then for the last one - I was dx with bc again when he was dx with another melanoma within the same week. I couldn't be there for his surgery because we live 7 hours away from each other but my son was there and my brother. He has been so sweet and caring and very concerned about me, even now when he isn't always lucid - so there is hope for those men who just don't get how to be supportive or concerned. I hope your SO gets it soon, in the meantime, we are here for you! ( and even then!!!)



BRAS- put in flimsy one for about 4 days then PS said 'no bra'. - so tonight we went to an out of town wedding and it was on a lake and I went in a long black sundress with no bra (pretty crisscross straps). Felt pretty good! DH said I looked beautiful - wow that's been a long time coming!!! And brother said 'nice boobs'. LOL. No headlights cuz no nips - but it was cute! Same brother I had take a fanny shot to show PS via email a possible seroma last July. Too funny for words - he is 3 years younger than me and we are close but getting even closer with what is going on with our Dad.



DH is sleeping, wedding was fun but I'm wide awake so much excitement. Also back hurts from being up so much and possibly back sleeping. What does PT do for back with backsleeping issues?? I also had 14 hour surgery for bmx, SGAP in April 2012.



Hugs all!

jill47

Hi Cathie, I love how clearly you communicate your thoughts and message. Thank you for explaining me better too   You've had a race with bc and your poor father, I'm so sorry.  That must be so difficult for your entire family. Colonoscopy? Yeah...when I turn 50 in a few years I'll probably get one too.  Not a bad idea.  My Dad is like your's in that he can't face "bad news" as he calls it.  He only called my once from dx through about 1 month ago. And when did call it wasn't to check on me. To this day I don't think he truly understands what I went through as I told my Mom the details but she is pretty bad at explaining medical things. Example when I had my uterine polyp months ago she kept referring to the problem as fibroids  need I say more? My sister and I get a chuckle out of Mom. 

Your 14 hours bmx is unbelievable. That is super long, thought mine was long at 6 hours.  My BS ordered the PT for me b/c I did sleep on my back, like a mummy for 6 weeks post op. PT will increase your range of motion and release inflammation and strenghten the back.  It was 70% effective for me; the rest came from being able to run again.  Hugs to all, jill

gotoell

Had Stage 2 lipo and fat grafting today feel really good...I'm planning on just taking one more day off and going back to work on Thursday...unless I wake up tomorrow and feel different

wildrumara

Hi Gotoell -  That's awesome!!    What do you mean my stage 2....does that mean, its your second time having it done?  

I am now 2 weeks out from mine and I feel completely normal.  I had a lot of bruising and its finally starting to dissappear.    My PS said that next time, he will inject some sort of medication into the area beforehand so I won't have so much bruising   He also said that he will take it from my hips instead of the stomach again.   I still can't tell any difference in my stomach......well, maybe a little around the belly button area, which is where he said he took most of the fat.  I'm a little disappointed actually.  The foobs look better though!!   I will see him in two weeks and he said he will have a better idea of how much fat actually absorbed.......and then in 3-6 months we will decide on if/when we want to do more grafting! 

gotoell

I had Diep in January so that is considered Stage 1 and Stage 2 are the revisions that are needed to make everything look good.  So, my first fatgrafting was Tuesday and I am replying from work today!  I had no bruising, just minor swelling.  I'm not sure if it is why but I took Arnica which I read about it is supposed to help with bruising, and I took it for a couple of weeks before and I am still taking it.  But really only minor soreness.  Just took two pain pills Tuesday night to sleep because sleeping on my back is difficult.  As far as the results I do see more volume in my Diep breast but it is a little lopsided so not sure if that is swelling.  I think I will need another fatgrafting session, but this was so easy that is fine.  I hope your results make you happy!

GreenCowgirl

I used Arnica Montana a homeopathic supplement as well as an arnica rub on gel.  I had no bruising at all and very little pain.  The compression shorts were the biggest pain and soo sexy.  ugggg  I will certainly try this again at my exchange.  My Ps will not take tummy fat(darn) he says that is saved for a back up plan in case implants dont work.  Will have to go for thighs/hips.  He did not take much at the first surgery, hope he does more this time, as i know around 50% is absorbed.