Has anyone had micro fat grafting?

Where did you have the fat removed from?

You poor thing.  I only had it removed from my abdomen from my ribcage down.  I wish he had to search more to find some.  I was thinking the other day how I washed he had taken soem from my inner thighs and then though how uncomfortable the healing from that would be.  That sounds like a plan!

I had surgery in beginning of Dec of '08 then the end of November of '09, I think I will put off anything more for awhile, so I can use my vacation time for...Vacation!

Hi Meece, thank you for asking about me.  I am still really sore, but doing better.  I was off work for three weeks and just recently went back.  I am an RN and we have to do 12 hr shifts, so that has been a real shock to my system after being off and pampering myself.  I am impatient and want to feel good right away.  I have to say I am definitely symetrical now, and that makes me happy.  The left side that had the fat grafts is fuller, hoipefully those stem cells are doing their job and increasing circulation.  I had radiation after the lumpectomy last summerr.  The PS estimates that 80 per cent of the grafts will survive.  He may be overly optimistic.  But you know at this point, it is ok.  I just want to enjoy life!!!  and feel great.  Have a good fourth and I hope you are feeling well.                                                            Kristina

I'm on the west coast and had mine done in So. Cal. 

My symetry is somewhat lacking right now.  Call me crazy, but rather than the grafted side shrinking, I feel like my "plain side" has grown.  I will definitely discuss this with my onc next month.  My PS is her DH, so she can consult with him.

Thanks Happy,

Do you know anybody that has had entire breast construction by this Dr. I was scheduled to fly to Miami, however good old side effects have warrented me further evaluation,testing and now i have lost my flight to Miami. Financail i would not be able to keep up with this.  thanks for your advice.

Enjoy the 4th (celebrate)

KKDM,

Where did you have your fat grafting done at.  I am seriously considering this method as i don't have enough fat in one area, nor do i want scrars all over from incisions.  I had an appointment with Dr. Khouri in Miami but had to canceal because of i hope side effects only.  Tests will tell. Did you wear the brava system?  Any information you can provide i would be grateful for.

Hope your healing well!!!

I'm not sure if I should be posting here, but only because of how difficult it was for me to find any info on this procedure prior to my surgery I thought I would (mods, if you feel I shouldn't, please delete). I found this thread looking up something else related to my procedure.

Anyway, I did not have cancer, but in '92, '93 and '95 had surgeries to remove tumors that ended up being benign. The first and third were simple biopsies (that left only small defects), but the one in '93 was a lumpectomy which removed about 1/4-1/3 of my left breast. I live in NJ and flew to Miami to have Dr. Khouri perform my procedure. My consult was the end of January, I wore Brava for 11 weeks prior to surgery (April 16) and today is 11 weeks that I've been wearing it since (he recommends 12-16 of wear post-op). (I wonder if post-op wear is shorter for mastectomy reconstruction, since there are typically a couple of procedures necessary to "re-create" a full breast.)

I certainly have no experience of whether Brava would be painful on skin that has had radiation, but for the area where my lumpectomy was (outer 1/4 of my left breast, closest to the armpit), it sat almost directly under the rim of the dome. I had to pull the dome out to the side to get as much of the lumpectomy area inside the dome as possible. It was not painful for me, just the pressure of the domes as felt elsewhere - but then again, that area had been numb for many years.

Eleven weeks post-op, I believe almost all of the fat has taken (Brava (in addition to "micro" fat grafting) seems to be the key in the fat surviving). BUT the most amazing part of this, which is mostly what I wanted to share, is the restoration of sensation. I had about a 1-1/2" scar in the center of the lumpectomy that was numb along the scar and about 1/2-3/4" all around it - for 18 years.

HOWEVER, over the past 11 weeks, I am slowly regaining sensation there. It is odd and fascinating to me. Dr. Khouri has explained for mastectomy patients creating a "sensate" breast. I couldn't wrap my head around that until I started getting sensation in this whole area. (This morning I actually felt an itch on that skin!) Also, everywhere that fat was transferred has full sensation (I was pretty flat chested in general, prior to any of the surgeries (an AAA cup), so Dr. Khouri augmented as well, to even everything out - when all is said and done, I'll probably (hopefully) remain a small B cup).

I know my situation is nothing compared to what you ladies have endured, but since I stumbled on this forum and was so hungry for knowledge about it myself, I felt I should share my experience. If anyone doesn't mind that I posted, and has any questions, I would be happy to share any experience I had that may be helpful.

(I have a sister-in-law who had one breast removed due to cancer, about 6 years ago, and a very close friend who lost both breasts last fall. I wish I knew of this procedure to share with them before their reconstructions. However, since most/all implants eventually need to be replaced, I will share this with them then.)

Edited to add:

Someone metioned scars from the injections. I had more injections around each breast than I could count - probably at least 20 per side. My surgery was April 16, and today you could not find one single scar - even with my 50 year plus reading glasses on! And immediately after the procedure, I thought there was no way that the lipo scars would disappear, ever. Now they are barely visible. They are far, far lighter than any of the million moles and freckles on my legs. And from how they've progressed, I don't imagine they'll be visible at all in a couple of more months.

I hope some/any of all this has helped anyone considering Dr. Khouri.

Alexandra-aaa,

Could you please clarify jseda's statement that the Brava system cost is approximately $800 to $900 without insurance coverage?!   I believe that may be a typo.  It would cost most women more than that to fly round trip to Miami for a consult. 

Also, to clarify, you are regaining some sensation in a scarred area subsequent to a lumpectomy, and I think most of us can relate to some areas of our body numbed by scar tissue, but I don't think anyone but a woman who's had mastectomy(s) can relate to the complete numbness of the entire breast  and surrounding area.  My BS tells me it's permanent, and most women get used to it, as I pretty much have.  My PS says restoring or preserving sensation at/post mastectomy is the "holy grail" of reconstruction.  Even some fat transfers have not restored any sensation, nor did we expect them to. 

You are a new member here and your post does sort of come off as an advertisement for Dr. Khouri and his Brava System.  I hope he's not promising restoration of sensation to women like me as many, many women are devastated by this loss. 

Be well,

Maria

Maria, I also got that feeling.

I was under the impression that the loss of sensation or the numbness was because nerves had been severed.  I didn't think incresng blood flow could repair nerves, I could be wrong.

I was charged $715 for my initial BRAVA purchase. That included smartbox, domes and skin care kit. Depending on how long you use the domes, you may need to replace them. Replacement domes are $299/set. It would be great if insurance covered this - it can add up quite a bit.

The sensation I am (re)gaining is in two places. The surface skin, where the actual lumpectomy incision and stitches scars are, and the 1/2" or so of surrounding (skin) tissue. Prior to this, for 18 years, you could have scratched that skin with your fingernail, and if I wasn't looking I wouldn't have known. Now all but the very center "line" of that incision has some feeling. It's been slow, but I do feel contact where I haven't before. Also, I have feeling in the entire augmented breast(s). Wherever there is fat, there is feeling, even in the area where the lumectomy deficit was. Dr. Khouri does call the "re-created" breast "sensate".

This isn't a typical fat transfer, so I don't know how that would feel, but wearing BRAVA before surgery creates new blood vessels, as well as expands the tissue, to support and nourish the fat. There is also a high concentration of stem cells in fat, which is believed to be a factor.

Dr. Khouri's explanation of regained sensation (http://premierguidemiami.com/dr-roger-khouri-fat-grafting-workshop-miami/):

PGM: You have performed surgery on women who have lost their breast to cancer, tell us a little about that?
Dr.K: The same procedure is actually applied to women who have lost their breast to cancer. So it's better if a small girl who has AA, nothing of a breast, the same would apply on a woman who unfortunately have lost her breast. We can regenerate the breast, we can grow it back by injecting fat, stretching the tissue with the Brava device, and inject fat inside. We give back a breast that feels normal, looks normal and has normal sensation, without any incisions.
PGM: Does it really?
Dr.K: Yes, it has grown back to it's normal size the nerves grow back with the breast, so it gets sensation as compared to a flap or an implant where there is no connection to the nerves.

I do apologize for sounding like an advertisement, but in all honesty, like I said about my sister-in-law and friend, I wish I could have told them about this before their reconstructions. My sister-in-law had a pretty "easy" time of it, but my friend did not. She had expanders for quite some time, and then only recently got her implants. This has been going on for her since the end of last summer, and she has had awful recoveries from each of the surgeries.

Actually, I first visited this forum a few years ago, after my sister-in-law's cancer came back (she had a lumpectomy the first time). When she was diagnosed the second time, only then did she find out that ALL FOUR of my father-in-law's sisters died from breast cancer. I was married to my husband when two of them passed away (the other two had passed years before we met) and we were never told from what - only that they were "sick". Had any of us known, my sister-in-law may not have chosen HRT. Her first diagnosis came a year or so after starting that. She told us about her diagnosis because I have a daughter who will be 20 this year. She has a daughter in her late 20's and my husband's brother has a daughter in her 30's (all of us have 2 sons). While she won't have BRCA testing done, she wanted the daughters to have the knowledge and that option. All three of the girls decided to never go near the pill. This site came up in many google searches, and I did read a bit, but never felt comfortable posting to ask anything since it was not me who had cancer.

I did register this May, a few weeks after my surgery, because this site came up again when I google'd more info on my procedure. (I periodically look for other patients who have had the procedure done with Dr. Khouri just to compare experiences). But I still felt uncomfortable posting. However, this week I came across it again and saw questions that I could answer. And while I did not have cancer, a lumpectomy is a lumpectomy and thought I might be able to share useful information/experience. As I said, when I was first researching this procedure last December, there was very little to nothing out there from any of Dr. Khouri's patients. I believe even his website was pretty new at the time.

I know I am quite enthusiastic, which could certainly be interpreted as "advertising", but it is very fascinating to me from both the reconstructive as well as the augmentation sides. This was really the only option for me and having learned about it 18 years after the fact was very exciting. I was always told that implants weren't an option because I had no breast tissue to cover them (I was always very, very flat chested (AAA cup)). Plus my scarring/deficit was far out to the side where an implant wouldn't cover. When I first learned of fat transfers, it was in relation to a company called Cytori and a product extracting/concentrating stem cells (Celution). Inquiring into that let me to a NY surgeon who does fat transfers. When I called to schedule a consult, the receptionist asked if I was going to be part of the BRAVA study. While I learned of BRAVA many years ago as a breast enhancement device, I had never heard of it being used prior to a fat transfer. I went to clinicaltrials.gov and read the study, saw that it was run by Dr. Khouri and called for a consult. (He is also a micro surgeon who had done TRAM flap reconstructions for many years.)

(You had mentioned the cost of flying to Miami for a consult would be more than the cost of the BRAVA system (not sure if I was reading that correctly), but a round trip ticket from NJ to Miami in January was about $350. I should have rented a car for the day, but took cabs (about $150 for the day - it was necessary to go for an MRI while there). And his consult was only a co-pay for me since he participates in my insurance plan. So all in all, it was less than $600 for the day.)

My figures on the Brava bra system are correct. I'm attaching email from company for you to read.

Dear Ms. Seda: I apologize I forgot to send pricing information to you.   Please have your physician provide the attached information needed on the Physician Checklist for sizing.   If you order the product in July 2010, we are offering $100.00 off the price. The cost would be $879.95 with ground UPS Shipping. Please allow 2 weeks for production.
You may find some general information on http://www.miamibreastcenter.com/ - This is Dr Roger Khouri's web site but may provide you with some additional information on what Dr. Neligan and he are doing.

Hope this gives you some insight in the system.

Your information is appreciated. I too am quite excited to get started with the Brava system/fat injection. Do have one question though. I only have one side needing the system. Do they have one sided systems or do you wear it on both sides. I'll email my PS and ask him as well. Thanks again.

Interesting question about "one-sided" systems. The week I had my surgery, the reconstructions were at Kendall Medical Center on a Friday, the cosmeetic procedures were performed the next day at South Miami Surgery Center. The patient right before me was a young girl who lost one breast. I would like to think that it were possible to purchase only one dome.

However, the couple of times that one of my domes needed to be replaced, I was told that you needed buy them in pairs. I don't know if that's still the case, and if so I do wish it would change since they are so expensive. For me, however my body is configured, it was always the right dome that the silicone rim broke down on. I have quite a collection of left domes in perfect condition!

As for the rest of the system tho, there is nothing else that would really be different whether it was for one or both sides.

Hello Ladies,

Thank you for all the information on fat grafting-very interested in this method.  When some of the ladies mention sensation or feeling is that in the nipple area also?  I so want to get out there for an appointment.  I also believe it will be the future of reconstruction.

Stay well all...

Hi Hope,

Before finding out about this procedure late last December, I had gotten to a point where enough was enough (a little off topic, very afraid of sounding insensitive, but I do want to be truthful). As I've mentioned in a previous post, prior to any of my surgeries I was completely flat chested - my breasts never really developed. I'd never been at peace with it, considered implants from time to time, but was really too flat for that to even be feasable. 

After getting past the fear of each surgery's outcome, I'd soon forget about how lucky I was, and go back to miserable. To the point of creating a "Flat Chested Support Forum" (not for A/B cup ladies who consider small = flat, but for women who truly never developed).To the point of trying enhancement herbs and massage which ended up inducing lactation.  To the point of stopping the herbs and actually keeping up with induced lactation for quite a few years (it "hid" the deficits, brought me to an A cup, and I also justified its cancer preventative benefits).

By last fall, when I turned 50 I figured I would get implants anyway so breasts wouldn't be front and center in my mind more than 1/2 a century. It always seemed so self-involved and I hated it. I joined an implant forum for information shortly before finding out about Dr. Khouri, so I posted my experiences with this process there, as well as on my forum. One of the questions asked by ladies on both forums was about the possible loss of nipple sensation (one of the many things that scared me about implants).

I asked him about it in one of my emails to him. This was his reply:

"Yes, the greatest advantge of this technique is that it preserves sensation for the augmentation and most interestingly, for the recosntruction it gives back to the women a sensate breast upon which we build sensate nipples!"

The "sensate nipples" part confused me a bit. I mean, I know it couldn't be true nipple sensation - stimulation increases prolactin, is directly tied to erotic sensations, etc. BUT, I guess the nerve regeneration to the tissue at that precise spot might cause the feeling felt by that tissue to be interpreted by the brain as coming from the same place as a nipple would feel it...? I honestly don't know, and didn't pursue asking him how exactly this works since my (and the ladies asking) concern was possible loss of sensation.