Has anyone had micro fat grafting?

Maria-Here, here best of health, and curves to go with it, for ALL of us!!! Yes, my doctor is setting up the protocols to start doing this procedure here at his own office. I expect to have to do more transfers than is done for a 'revision'. It only seems logical, and I'm not looking forward to that aspect. But, I can't stand having an implant inside me and the pain that it has caused. I never wanted big boobs. FYI I live in the land of plastic-Newport Beach, CA. I would be happy with teenager size boobs. I would rather be flatter than ball shaped.

You wrote:I am confident that the fat transfers being used for my reconstruction are the best available widely used techniques.  No one has said it's not possible, it's just not common.

Just because something is widely used, common or 'standard protcol' does NOT mean it is best. It means just that-it is common and widely used

What a wealth of information on this thread!  Thanks to all who have contributed.  Any when there were differences of opinion, thanks for being civil.

I am 8 week post op uni tram, there is still such a large degree of swelling and hardness that I have no clue where the deficits are going to be (I'm hoping for minimal).  My PS has mentioned possibly needing to lipo from my natural breast to make them symmetrical and I have no clue what his thoughts of fine tuning the tram breast are.  It will certainly be on my list of questions at my 3 month appt. In addition, fat transfers and his experience with that procedure will be discussed.

I plan to keep an eye on this thread for additional experiences and information.

 Robin

Do not be fooled into thinking that this is minor or not surgery! I have the stitches, bruises, and discomfort to prove it. Although there are no incisions, there are "punctures" (for lack of a better word).

My PS used a small cannula and since I only had fat removed from acrossed my tummy, he used one incision through my naval to do the whole job. I too, had bruising and would post pictures of my tummy here, but they aren't for the queasey. I cannot imagine going through thison a regular basis as the breast is enlarged by suction. My tummy is jsut now becoming non-sensitive/non-tender after 3 months!

Happy, I lost about 60-70 % of the graft.  My situation is that the grafting is being done in the radiated area, and no PS would dare guarantee what will happen in that area.  I looked at my before and after shots yesterday,  from before the first surgery to right now, it is absolutely amazing.  Although I am far from perfect, yet I have come so far.

The biggest thing is, if your were to casually see me and talk with me, you would not notice anything different about my breasts.  It's when the clothes come off, or if I am trying to fit something in particular that I notice the issues. Like deciding which cup size bra to buy, one to fit the right perfect, or the left perfect.  I know that many women without the history of BC have this same problem. Micro fat grafting has been a wonderful addition to the rest of my reconstruction.  Another patient yesterday shared her "photos", it was amazing how a lumpectomy can take a litteral bite out of you, and the grafts and fill it in.

Meece

It's sounding more and more like the CA and NY docs know all about the Miami doc.  I'm glad it's available for those of you who want it.  Go for it! 

Kari - welcome to this discussion.  It sounds like you will be the one to give us the best first hand knowledge of Dr. K.  and the Brava procedure.  Do you think you will go to Miami for a consult?  Let us know. 

Believe me - I am as excited as the rest of you.  If I ever lose my implants, I already have the "pocket".  Fat transfer away!

Be well,

Maria

Hi all: My question is...since I had an implant that had to be removed because of infection, there is loose skin. Would I still need to use the Brava bra, or does the pocket remain open enough to do the fat transfer without the brava bra?

It is exciting to know that new possibilities are being explored. I read recently that docs in Australia have invented a procedure where the body grows new breasts. This is for real and they are in trials now. Apparently they create the pocket and stimulate the growth of fat cells.

I was watching the news this morning and they had a blurb about the fat grafting that was in place of implants.  They didn't mention the brava bra, but mention ed that platelets have been added to the fat to make it have stem cells. to lessen the reasorption of fat, but still indicated that having complete breast using your own fat can lead to uneveness due to the unpredictability of fat resorption.

I think they harvest the stem cells out of your platelets, which I am assuming come from your own blood donation?

You're both right Mouse and  "Angel Meece",

While the fat is being extracted, it is separated in a centrifuge type machine.  Any liquids like injected local anesthetic and blood are left behind when the separated fat is captured into a syringe.  It's like separating the fat when making gravy.  The syringe is large  - like the ones used to fill the tissue expanders with saline - but the needle looks like a very thin metal crochet needle.  The needle opening is offset from the tip, allowing the fat to be injected in very thin streams. 

Note:  These are my highly technical observations from having it done while awake, and having it all explained to me by the good doctor!  But I did see the machine, the separated fat, and the syringe and needle. 

On another note, I saw the PS yesterday, and neither of us notice any fat loss at this point.  I will follow up in 6 weeks.  Meanwhile, off to sunny FLA for the spring break - driving from Long Island to Marco Island!  The last time we did this trip was three years ago, before my diagnosis, so we are all looking forward to it.

Be well,

Maria

Hi Mouse,

I'm back and the trip was heavenly!  A long drive, but worth it.  The weather was sunny and in the 80s so we got to swim every day.  Now we're back to reality, but it's okay after a break.  I like reality, too. 

To answer your question; No, I did NOT have radiation.  I was guaranteed radiation and was possibly facing chemo had I opted for a lumpectomy - this according to my breast surgeon when he was trying to prepare me for every possible outcome for lumpectomy vs. mastectomy.  I should note that he did not pressure me toward one or the other choice.  He was my second surgical consult, and so different from the first, who said "You have plenty of breast tissue, we'll do a lumpectomy, followed by radiation".  That was it, no options, no additional information, and no referral to a plastic surgeon.  I went into surgery knowing that I had greatly minimized my chances for needing treatment, but also knowing that if it was more extensive and/or in the lymph nodes, I would need treatment despite the masts.  I did not need tamoxifen, either.  I am always aware how fortunate I am.

How are you doing? 

How about everyone else?  Has anyone had any fat transfer procedures?  Any updates or information to share? 

Be well,

Maria

I went to see Dr. Khouri at the Miami Breast Center for a consult about breast reconstruction using fat transfer (no implants). I decided the procedure wasn't for me. The Brava Technique Dr. Khouri invented involves wearing plastic suction cups to stretch the skin and create a "scaffold" for the injection of fat. You must wear the cups ten hours per day for 3-4 weeks before the first fat injections (using liposuction) can occur. Usually, you would need to repeat this process two or three times to get a reasonable breast size. The fat is injected in tiny droplets, which helps prevent necrosis. Dr. Khouri says there's minimal re-absorption of the fat.

As part of the consult, Dr. Khouri had me try the suction cups for about 10 minutes. Even in that short time, I found them painful on my radiated side. I didn't really think my skin, especially on that side, could withstand all those weeks of suction. (If you skip days, you lose the benefits.) The good news for radiated skin is that if your skin could make it to the next stage, fat injections, the theory is that the stem cells within the fat would grow new blood vessels and actually help the radiated skin recover a good blood supply. Thus, radiated skin could actually improve using this technique. Dr. Khouri said this has occurred in patients he's treated.

HOWEVER, and for me this was the critical point, research has shown that when you stretch the tissues with suction this way, it causes tissue growth to occur. Not enough to make new breasts, which is why the fat transfer is necessary, but still some growth (the Brava System is also marketed for breast augmentation without the use of fat transfer). Since even the best mastectomy leaves some breast tissue behind, the last thing I want to do is stimulate new growth of my remaining breast tissue! I spoke to a woman who had breasts made using Dr. Khouri's technique. She's very happy with her results, but she now has mammograms again to make sure everything's okay. The last thing I want is to return to the anxiety of mammograms.

I do think fat grafting may be the wave of the reconstruction future, but there are still many kinks to be worked out and it needs to establish a track record of safety regarding cancer recurrence before I'd be willing to consider it. I think Dr. Khouri sincerely believes his technique is safe and effective, but I'm not willing to consider it until there's lots more positive data.

Ironically, the result of the consult was to reinforce my belief that, for me, not having reconstruction was the right choice. I know most of you reading this post do want reconstruction (this is the Reconstruction forum, after all LOL), so I did want to let you know the result of my research. Fortunately, there are numerous other options available to you.

Barbara

debsie1,

It's my impression that fat transfers to fill in dents and divots has a good track record of safety and effectiveness. So I hope it will work well for you.

Barbara

Erica,  thank you for sharing yuor experience and letting us know what decision you've made and why.  Sometimes I wonder, if those same wise concerns would come to me in a consult.  Would I have the wisdom to ask the right questions, or to put 2 and 2 together.  I need to have my divot filled up a bit more.  I am very happy with the recon that I have had done to date.  at least everything is facing forward and at the same level now.

I have a question about the Brava "Bra"  would it easily be concealed under normal clothing?  Or would you have to attempt to wear it while sleeping or relaxing after work?