Has anyone had micro fat grafting?
Comments
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thank you, Erica, for personally researching this! I talked to my ps about it this week. he was very excited about the future of fat grafting, and he uses it alot for "finishing" work. his primary concern was the Brava system. he did not believe he could get any of his patients to wear it, and I had to agree, it looks barbaric! (he also stated that the Brava part would not be covered by insurance, altho the fat grafting would, I have not researched this). however, he did seem optimistic that a new generation of external expanders would be coming, since actually only a small area of the chest needs to be expanded, so why all the Madonna-esque body armor? and he also said that a conventional expander would also do the job, however, would require the usual surgery for that. so, I left hopeful that fat grafting has a place in the future of recons. Erica, I share your concern about the expansion causing breast tissue to grow. I would not want that either! I also have to wonder about any kind of "re-growing" of breasts by any method. my concern comes out of a previous conversation with my ps who pointed out that cancer, by its very nature, is cell growth gone wild. is it safe to cause any kind of new cell growth in a part of the body that has already had cancer, or maybe anywhere in the body. hm.
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Hi Everyone. I've been off the boards for a bit (I'm ok...just busy). Just getting caught up on this thread and wanted to say a big thank you to Erica/Barbara for her post. That was great info you gathered. I agree with her insight as well that it seems that fat grafting definitely has its place with filling in lumpectomy divots and such, but it is definitely becoming clear that whole reconstruction still needs some fine-tuning. Although, I have heard many positive things about it bringing life to radiated skin. So even if it was used in conjunction with an implant, that might be good too
I did want to mention for people who are considering the brava, to keep in mind that most cancers begin growing in the ducts, and since these are all removed during the mastectomy, I would think the risks are small that you would have a new cancer start in the small amount of tissue that may grow. I'm not sure how it works with a recurrence, though.
Since I have decided that the whole breast fat grafting isn't going to work for me, I asked to see another ps in London to get another perspective. He suggested that I put an implant on the left (the prophlactic side), and implant with latissimus dorsi flap on the right (therapeutic, radiated side). I have to say, when I started looking into recon, I was very opposed to cutting into other parts of my body to create breasts. But, with the lat flap, they take a small amount of tissue and muscle from your lat area. Since there are a bunch of muscles that all do the same thing, he said most people never notice a difference in strength/stability back there. (Unless you're an olympic rower or rock climber). You're not taking muscles from your core which support your spinal alignment, etc. like the tram flap. He said the lat muscle and skin they take is put under the pec muscle to support the implant because the pec only covers the top portion of the implant - hence the issues will perforation, etc. This also serves to replace some of the damaged skin. He claims that with this procedure, it can bring a radiated side up to the same success rate as the non-radiated side.
So, this is what I'm considering doing now. I just wanted to throw it out there for others who are in the same boat I am.
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My PS also suggested the latisimus dorsi flap, along with an implant. He said because I was so thin it was the best 'option' for me. I am so glad I didn't do the procedure. It was very hard to find photos of what my back would look like, but, I did, and it's ugly. Not just the huge scar-the deformity of the back muscle. You have to know that what they do to your muscle is downright guinea pig science. It is severed and twisted, tunneled under the skin, under the arm and repositioned. I've heard of women who have had the procedure and regretted it. I'm unhappy with my implant procedure. I didn't realize the ramifications of cutting the pectoralis muscle and the pain it has caused. Have you ever had a muscle spasm, one were you can see the muscle flexing? That's what you have after implant surgery-an 'ALIEN' breast.The breast only appears natural in certain positions. I look at it as the lesser of 2 evils...I know I would have hated myself if I had done the latflap surgery.
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Yes, I had it in November. I had a divot above my mastectomy and it was filled. I think it went well. It is hard for me to tell - right now I am also experiencing mild capsular contracture, so the implant is pushing up where the divot formerly was and the grafting took place. Once that is corrected, I will know better the final result of the grafting.
...The fat-funding from my hips, however, was stellar! ;-)
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I wish my ps had taken more fat-fund. I asked him to do more next time. Mine was belly fat and I don't see a big difference. Maybe I was in denial and I had more than I thought.
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I am scheduled for a bilateral breast mound revision with fat injections on May 6th. I am a little freaked out about it. I do not have my implants in yet, I still have the expanders. He wants to plumb up my radiated side because my skin is so thin. He will also plump up the front part (nipple area) on the non radiated breast. He is taking fat from my non radiated side just above my armpit and from both sides of my lower back I believe. I am having this done at Mayo in Rochester, MN. I was expecting to have my implants put in at this time but I guess I would rather do this first and have a better chance of the implants working.
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Good outlook, shortgirl. We can't always out-think our health care providers. They must have a reason to do it this way.
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makingway - When did you have your implant reconstruction done? About the lat flap combo surgery you turned down - other than the disgusting-sounding procedure, what were the bad experiences you had heard of from others?
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For the record, I am happier with my LD flap w/implant combo side than I am with my implant only side. It's has a much more natural feel and appearance. I have a scar on my back, but I don't really mind because I also have scars across my breasts now, too. When I look at photos of those reconstructions with donations from the abdomen, they aren't so pretty either. It really didn't take away any use of my back. I can still swim, and - unfortunaly - vacuum. It was also a blessing, because it was the solution to my seriously damaged skin following infection. When I think of my grandmother's mastectomy, I know I am fortunate to be alive during this medical era. Eventually, there will be an alternative to mastectomy, and the reconstruction issue will be a memory from a prior generation.
Be well,
Maria
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mouse- I had my implant exchange 8-03-09. I don't know if you've watched the hour long video of the procedure.Someone had posted it here earlier. If you haven't watched it I will try and find it for you. PM me if you'd like. I didn't do the LatFlap surgery because it is such a brutal assault on the body. I know many people hate me for saying it, but I speak the truth as I experience it. Many women are grateful for the reconstruction options we have. I, on the other hand am not. After going through a uni mx and ALND, expander and exchange I sat in my PS office and told him this. I told him that I couldn't believe how limited we are with our choices for reconstruction options. It's horrid-it comes down to basically 3 choices;
1.no reconstruction
2. implant
3. sacrifice another body part
I knew going in what the implant exchange surgery would entail. The cutting of the chest muscle, in order to make a pocket, looked so simple. I truly didn't consider that this was going to cause any future pain. I was ecstatic when I found out about the new surgery being performed by Dr. Khouri. I wish I had known before I had my chest muscle severed. My cousin, who also had BC, has a close friend, who had BC and had the lat flap surgery and she regrets doing it. I can't remember if it was because she still has pain from it. I will ask when I talk to her next. What the doctors don't tell you is that many women who have their chest muscle cut end up with Post Mastectomy Pain Syndrome. There is a forum here on the subject. It is phenomenal how many women are in constant pain from this 'simple' procedure. It isn't only mastectomy patients that experience this. Women who undergo breast augmentation experience PMPS as well!!! To me this is a clear reason not to have the pectoralis muscle severed. It is difficult trying to decide which route to take. It also difficult when you've taken a route you could have avoided. Doctors only tell you so much. Just enough to appease you. I've learned an awful lot in the last year. One thing I have learned is to not give any doctor the credit I once did, before my surgery. I have found that each doctor is limited in their knowledge. You have to do your own research. Ask lots of questions of doctors and those outside of the profession. Most importantly realize they all have their own bias.
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Maria - thanks for your perspective. Glad to hear you're so happy with your LD flap recon.
Makingway - I know it's difficult sometimes to speak your own truth for fear of judgement, so I do appreciate your point of view. I have often felt the same way about reconstructive options, and have seen it the same way about only having those 3 choices.
I've decided to just worry about healing from my bmx for now, and holding off on making any real decisions on reconstruction. In the mean time, I'll continue gathering as much information about my choices as I can. My bmx is scheduled for May13th. I have to wait for at least 6mo-1yr after radiation anyway, so who knows, maybe during that time I'll adjust to having a flat chest and may end up being perfectly happy like that. I'm trying to stay open to many possibilities because I just don't know how I'll feel until the time comes.
My big hope is that the fat grafting will be perfected in the coming years to allow for a proven, viable full reconstructive option for us. And for me as a Canadian, hopefully one day the procedure will be covered by my provincial healthcare system (right now, it is not). I feel this is definitely an injustice because it forces women like me who don't have the money to spend on reconstruction to chose from the other procedures.
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I have read about what is happening in Australia where they are "regrowing" breasts from fat tissue but it doesn't sound like it's the same as the Brava system. Apparently they are now doing it on a small number of women but it may be available within a few years for more of us. I'm sure I still have the article some where and could post it if people want to read it. I'm hoping that the Canadian government would pay for the trip to Austalia if it isn't available here.
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Go Australia!
Well, considering we are a commonwealth, I think it should be mandatory to send us there, don't you! LOL
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Mouse6, I totally agree with you.
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Yes, I read about the Australian technique somewhere, maybe on these boards. They are using an "expander" that creates a space in the breast that acts as a "scaffold" for fat injection. The expander eventually biodegrades (not sure that's the right word, but it is absorbed into the body) leaving a breast reconstructed with fat. It sounds pretty interesting. I believe they're now starting human trials in Australia. Definitely something to watch.
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Another Canadian here agrees.............hrf could you post that article for us please???
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Here is the article:
SCIENTISTS are poised to begin revolutionary surgery to help cancer victims regrow their breasts.
The world-first trial could also change the cosmetic surgery industry by allowing women to grow bigger natural breasts.
The experimental stem cell breast-growing technique - called Neopec - could replace breast reconstructions and implants within years, the Herald Sun reports.
The trial offers hope to more than 5000 Australian women who lose their breasts to cancer each year.Start of sidebar. Skip to end of sidebar.
End of sidebar. Return to start of sidebar.
Scientists from the Bernard O'Brien Institute of Microsurgery in Melbourne will implant fat cells, which will multiple rapidly and be shaped into the breast she lost during cancer surgery.
The trial is believed to be just the second time in the world tissue engineering has been carried out in a human.
Bernard O'Brien director Prof Wayne Morrison said using the stem cells of our own fat to regenerate body parts was a huge step forward on current techniques, which try to repair or cover-up damage.
If successful, the Neopec technology could be widely available to breast cancer patients after a three-year trial.
But Prof Morrison said it would be probably a decade before it could be used for cosmetic purposes.
The process relies on surgeons implanting a biodegradable synthetic breast-shaped chamber beneath the skin on a woman's chest to act as a scaffold for the new breast to grow in.
They then redirect a blood vessel from the woman's underarm through the chamber to a 5ml piece of the patient's own fat, which spontaneously grows to fill a fist-sized space and form a new breast over the next four to six months.
The fat tissue stops growing when it reaches the chamber to ensure the desired shape and size, while the chamber degrades after the breast is formed allowing for a simple operation.
It is hoped a second-generation chamber will have its own artificial blood vessel to simplify the implant surgery.
The world-first technique has already been proved in pigs, which grew new breasts in just six weeks.
Chief operating officer Dr Phillip Marzella said the process could take longer in women because, unlike animals, humans stop growing at adolescence.
But his team has already developed a dissolvable gel called Myogel to stimulates fat growth when placed in the chamber to speed up breast growth.
The Bernard O'Brien Institute has previously made headlines by growing working heart tissue.
Prof Morrison said the breast replacement technique could be the tip of the iceberg.
"If it is satisfactory we could use this method to treat any type of contour defect whether it is breast, a congenital deformity or trauma such as where someone has suddenly lost chunks of themself," Prof Morrison said. -
My understanding is that they will do the procedure within 3 years for those who have lost breasts due to cancer. Should we charter a plane to go to Australia when they are ready for us? The cosmetic thing is a long way off.
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Thanks for the post hrf. This is a different procedure from the Brava... It sounded good until I read the part about taking a blood vessel from under the arm Urrghhh! The thought of having anymore pain under my arm scares the heck out of me.
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It sounds pretty amazing, but I always worry about the "what they find out later" stuff....you know? What if there are problems that develop from this that they aren't prepared for? Seems something always ends up being wrong with something at some point in time....sigh.
Oh well, guess time will tell..
thanks for posting....it will be fascinating to watch the developments of this.
blessings..robin
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Thanks for the post........certainly very interesting and something to keep informed on...........
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I have a concern, it may sound stupid, but how does the fat know when to stop growing? And how long will they have to test myogel to make sure it doesn't cause cancer? I think it sounds really great as an alternative to our options.
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hrf...thanks for the article. I'll definitely be following this.
Now I'm gonig to be imagining pigs with breasts for the rest of the day! LOL
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A question of curiosty for those who have had fat transferred to fill in dents/divots....I just had this procedure down nearly 2 wks. ago to fill a dent in my upper pole of my MX side ( I'm a unilat.). Post surgery due to swelling, the area filled looked awesome...fuller. The area still appears full but I now have noticed that the area filled feels like there is a lump there. It feels "pebble-ly" under the skin to my touch as I run my fingertips over the area. Has this occurred with anyone? Is this normal. Does it dissapate as time goes on? I did & do understand that this "lumping" can occur as a side effect from fat necrosis. If this sensation will disappears in the future...then fine. For now...I am alittle discouraged having this weird sensation. My PS at my post op said not to get too excited because these fat cells do tend to die.
Hoping for a reply on your experience & thoughts on this.
Thanks!
NAE
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Hi Nedeza;
I am sorry to hear about the lumpiness....when your PS said not to get too excited did he mean that the fat necrosois would happen and that little would remain of the fat transfer??? I am planning on having this procedure done this summer and was wondering if you can answer some of my questions. Were you put to sleep for this (my PS insists on this) and where did they harvest the fat from?? Also how painful was it and how much time would one have to take off for work? I am sure that the other girls who have had this will chime in soon and answer your questions.......Thank you so much....
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Hi Nedeza,
I am also having this done in 2/12 weeks and also want to know how bad it hurt and how much time you took off from work. I am having my surgery on a Thursday and am wondering if I can go back to work on that Monday? They are taking fat from my other side above my armpit and at the bottom of my TE. They are also taking some from my lower back. The are doing some on both sides. A little on the non-radiated side and a lot more on the radiated side. Any helpful hints or any knowledge you can share with us would be greatly appreciated! Thanks!
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debsie! & shortgirl:
Look back here for my posts of March 5, 6 & 7 for my experience with this procedure. I had it done on Thursday, and was back at work on Monday.
Be well,
Maria
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The procedure itself wasn't not too bad. Some soreness. My fat was harvested from one of my thighs, PS said to wear a girdle for 3 weeks but she informed me at the post op that I was healing nicely & it would be not necessary to wear a girdle. Not much was taken. The donor site is still slightly sore. My area where the fat was injected...the dented area...is still alittle sore. I do know that I was told the fat grafting can fail & that the body will absorb it. What this exactly means I am not too certain. I am hoping this lumpiness will disappear eventually. I think part of my "problem" is that just as I was stepping back to my "norm" way of life...another surgery. I know I must have felt this way after each surgery and that it will take time for everything to heal. Patience, right! Oh...I had the the procedure done when I had my healthy side lifted thus I was under general anesthesia when PS did the graft also. I went back to work 10 days later.
Again...if someone can give me some response on the post effects of this...much appreciated!
Thanks everyone!
NAE
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I'm going to have this done this summer. I had some necrotic tissue in my DIEP breast and once this has reabsorbed, will head back for fat/lipid injections. My PS says this is still fairly new with the jury still out there but they are seeing 60% success rate and fairly safe procedure without many problems. Only downfall is the time spent int he OR doing the procedure (nothing like the DIEP in comparison). I'm anxious to learn more and will share after my next PS appt first week in June. AGain, there is the added benefit of having liposuction done on those problem areas.
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hello- I am post -op 8 weeks from stage two of TUG flap. I had stage two to help with symmetry(gain volume) and help fat necrosis. I had lipo sculpting- outer thigh, inner knee and love handles. I also had fat injections to help with volume
I am thrilled with lipo areas so far!
My breasts were huge after fat injections. the Doctor was able to add more -knowing that about 40-60% would reabsorbed. They have reduced in size. I am a Full C and am thrilled if my breasts stay this size. The doctor said I will know 3-6 months out. I went to NYC and supposedly had the state of the art procedure where they used a certain centrifuge system and small cannula to harvest fat. I was under for 3 hours and had two Doctors help eachother.
Fat necrosis was broken up and he aspirated some fluid and that hs really help with necrosis areas.
Just receieved via mail the checks for the Doctors that I have to sign and hand over. GEEZ! What an expensive procedure this was......
Fingers crossed it will work and I can move on with my life!
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