Has anyone had micro fat grafting?

This is such exciting stuff. I've been hesitant to tell anyone about my plans, like a kid who makes a wish on a birthday cake, you don't want to jinx it by telling anyone. But my surgeon has officially made plans to fly to a conference in October and learn this method from Dr. Khouri. So I guess this is my official plan for reconstruction. 

So can I ask for details from any of you who have done this procedure with expanders in? If I understand correctly, your first surgery is to remove the expanders and do an initial lipo transfer. Correct? Do you use the BRAVA afterwards, but not before? How extensive is the surgery? Is there much down time? And what about the muscle that is over the expanders, does that get put back in place?

Thanks to anyone who can answer these questions!  And if any of you are in or near Utah - the good news is that there will soon be a new option for this procedure!

This is all incredible. Just the thought of having all that fat that makes us feel so ugly suddenly put to good use!

One question: does this fat EVER chemically become breast tissue and thus prone to BC recurrence? 

I had traditional fat grafts because of divots following my reconstruction with implants and it makes me nervous to think I might have planted little seeds that could harvest BC - but maybe I am off? 

Luna- Yes!!! Isn't it amazing? I want my implant out, and a real boob back so bad....

Have you read how it's done on the website? It doesn't take much fat. It's done over 2 or 3 procedures.

Thanks NotMyTime for finding those articles.  I have seen them also...but didn't know where...

Luna5  About weight gain or loss...I saw something Dr. Khouri wrote, that it is just like anybody gaining or losing weight.  The breast size tends to fluctuate some with BMI (body mass index).  I believe the estimated rate of retention with the micro fat grafing is 90%.  I have had these new breasts now about 1 1/2 yrs...they aren't going away any more than anyone else's would.  The fat connects into a blood suply mattrix.  It either connects and becomes living tissue or dies soon after the grafting.

1Athena1  Fat redistribution is a beautiful thing!!  Dr. Khouri is an artist and you feel like you have had body sculpting.  You just have to be patient with the proces...it isn't instant.

Apparently this is a list of BRAVA approved/trained "specialists" who offer the BRAVA system.  I am surprised to see how many are NOT plastic surgeons...

http://www.mybrava.com/doctor-list.asp

That is what concerns me Lago..... 

I think you're talking about two different things. And I think the confusion stems from the fact that Dr. Khouri invented BRAVA.

One thing is the physicians/dermatologists/etc., who offer BRAVA for breast enhancement only. It's been sold as such for nearly 10 years. Quite honestly, I don't know what the benefit would be in purchasing the system from anyone other than directly from BRAVA. If you buy it directly, you have access to their coaches who have far more experience and expertise with the device, and its use and idiosyncrasies than any of the physicians (well, except Dr. Khouri!).

Also, that article and the "Brav-argh" forum are over eight years old. And the forum consists of just a handful of users, who are anonymous and many of which had not even finished the course of wear. They are both regarding BRAVA alone for enhancement, unrelated to fat grafting. (You can see a number of before/afters here though: http://www.bravaresults.com)

This thread however, had been discussing BRAVA being worn a number of weeks pre-surgically to create a "fertile scaffold", a matrix, to inject tiny micro droplets of fat all throughout that matrix. BRAVA is then worn again for several weeks/months post-op to maintain that new blood supply to support the newly transferred fat. I believe its part in fat transfers, as well as the technique of "micro grafting" has more or less separated this procedure in a huge way from traditional fat transfers.

As far as the specific physicians you mentioned, I have come across Todd Malan's name/website/articles quite a bit in researching this before my procedure. He is a gynecologist. Why ANYONE would trust someone who is not a board certified plastic surgeon to perform such a technique dependent surgery, or any plastic surgery for that fact, is beyond me. Dr. Malan also concerned me because he has pictures of Dr. Khouri's patients on his website, which unless I missed something, implies they are his patients. As for Dr. Coleman, I have read quite a bit about him as well. From what I understand he has quite a bit of fat grafting experience in many areas, but I believe his use of BRAVA is pretty recent. No idea why his prices are through the roof, other than that he is Manhattan. I have no information on the other groups/doctors you list.

Also, the BRAVA website, where you are finding the list of doctors offering the system, has nothing to do with the surgeons who are trained in using BRAVA in conjunction with fat grafting. While Dr. Khouri did invent BRAVA, his site is http://www.miamibreastcenter.com.

I hope that helped differentiate the two uses of BRAVA. The overlap can get confusing.

(Perhaps the BRAVA site needs to clarify that those providing the system are not necessarily (if at all) surgeons performing the BRAVA enhanced micro fat grafting procedure.)

BRAVA SATISFACTION SURVEY: 

http://alturl.com/f8988

It is important to know all of the aspects regarding this type of breast expansion process.  There will be positive opinions and there will be negative opinions.  We need to hear from all sides.  This is a serious and potentially expensive option for women who are considering the BRAVA system, rather than implant-based or autologous donor-based procedures for breast reconstruction.  

whippetmom-you are implying that implant and autologous procedures used for breast reconstruction are less 'serious', as well as less expensive, than using a Brava system??? That is not the case. Autologous procedures are extremly invasive!-serious and require long operation and recovery time. They are also very expensive. With implant reconstruction the chest muscle is severed to allow room for the implant-pocket. This is also more invasive than the Brava system and can create problems such as Post Mastectomy Pain Syndrome. The best PS here in Newport Beach quoted me a cost of $28,000.00 for reconstruction using impants. That is 5 times the cost of reconstruction using the Brava system. Of course not all PS are created equal... I spoke with my PS who claimed he would eventually be set up to do the Brava reconstruction surgery. I asked how much it would cost. He quoted me @ $15,000.00-and that's unilaterally. I don't understand how he can justify that cost when Brava's own inventor Dr. Khouri is doing it for 1/3 of the price.

Mouse6...did you ever think you would generate so much dialogue on this topic?  Wondering if you are still considering this option?

Jseda...wondering if you started the process?

 Deborah...appreciate the article on skin care ideas...good stuff.  The 2002 article shouldn't even be shown anymore...that is very outdated.  I think I heard the big breakthrough was the use of skin prep to avoid skin breakdown...any of course this isn't the approach used by Dr. Khouri anymore (though sounds like maybe other MD's are trying to promote this approach).  Love the verse!

hope...I think someone else posted that Dr. Ahn was also very expensive....sorry, but maybe I'm wrong. 

 whippetmom...I think you have a good point.  I know I have probably mostly expressed the positives, but there are important considerations in deciding which option is best for each woman.

There are out of pocket expenses...for the Brava and for travel especially.  If you try to cut costs be sure it really is a cost savings though.  I ended up with insurance problems in Milwaukee (each state is different and some do not have coding that will allow this to be considered breast reconstruction.  As soon as they see liposuction...they think it is cosmetic).  Would have been cheaper for us to travel to Miami each time.

 You need someone who can take pictures....and you can't ask just anyone to take pictures of your breasts...at least I wouldn't:D  My husband was very helpful in helping when there were "leaks" in the Brava system.  There may be very competant women out there though that don't need that help.

You need to be able to wear the domes for 10 hours a night (or day) consistantly.  They aren't something that works very well on the soccer field or running other errands (unless you are much less self conscious than most of us).  I did wear them out in public in Miami because I didn't know anyone...and my sense of adventure was stronger than my embarrassment.  I did work full time with doing this process though.  My curfew was just 8 pm.

 You need to be willing to wait awhile for answers at times if you go with Dr. Khouri (unless things change).  He is so busy and so is his staff.  When you are on his radar immediately pre or post op, you get incredible attention ...simple questions can be hard to get answers to.  Check Alexandra's forum though...that is fabulous for connecting with others who have done this and you will get lots of support and answers to nitty gritty questions. 

This is an amazing option for some women, but it isn't for everyone.  It is good to know what you are getting into....even though if I did know all of what it would involve, I probably wouldn't have done it, and I'm so glad I did go through with it!!

with care,

wisconsin randi

Well, I called Dr. Khouri's surgeon training program coordinator and found out that there's a doctor in Atlanta who has gone through his training... Dr. Namnoum. BUT, the coordinator said "We don't recommend him because he hasn't continued ongoing training with Dr. Khouri."

I decided to call Dr. Namnoum's office anyway and see if he's performed this procedure (frankly, I wouldn't mind being a guinea pig if it meant being able to have the surgery here instead of having to fly to Miami). His website doesn't even MENTION the procedure or have any patient photos (just of other types of reconstruction), so that makes me a little nervous, but his nurse insisted he's done it, so I set up a consultation for next week.

makingway, I'm not going to be able to have Dr. Khouri do my surgery, unfortunately. It's a long story but it just isn't a possibility. My only hope is that the other plastic surgeon I've met with will be willing to go through training with Dr. Khouri... I've emailed him explaining what it is and urging him to do it, but I haven't heard back.

I'm so depressed about this because I can't even TRY to have a baby until this is all done, and I will be 40 in March......

CrunchyPoodleMama: Dr. James Namnoum IS an expert and a renowned plastic surgeon.  He is on my preferred plastic surgeon referral list.  His name is included in medical treatises along with the names of the most sought-after plastic surgeons in the U.S.  He is the Chief of Plastic Surgery of a prestigious hospital in Atlanta.  He contributes regularly to the American Journal of Plastic and Reconstructive Surgery.  He is highly respected in the field.

http://www.atlplastic.com/DrJamesNamnoumblog/2010/02/25/dr-namnoum-and-one-of-his-breast-reconstruction-patients-features-on-fox-5-atlanta-to-discuss-fat-transfer/

http://www.miinews.com/pdf/eag_featured/spring_2010/AutoFat_FTR_EAG0310v5-032210.pdf

He has been doing fat graft transfer for breast reconstruction for years....

http://www.northside.com/about_us/PreferredHospital.aspx

I hope it works out for you!

Deborah

THANK YOU, NotMyTime, whippetmom, and makingway!

Deborah, that is great to know that he is so well-respected... thanks for those links, too - I had watched a couple of his videos but had missed the news feature that was linked from the blog entry you posted:

http://www.myfoxatlanta.com/dpp/news/fox-5-special%3A-fabulous-fat-022410

Interesting that he didn't acknowledge Dr. Khouri in this story as the one who developed this technique (in fact, it said "Davies met Dr. James Namnoum, an Atlanta plastic surgeon with the breakthrough idea to use Davies' own fat cells" - mmkay!). Also, it said that this woman did micro-fat-grafting with an implant. I need to confirm that he's done this with patients who had micro-fat-grafting only, no implant. (In fact, during the anchor banter at the end, the anchor asked the reporter if Dr. Namnoum thought this could someday replace implants, and the reporter said he "THOUGHT" it could, but there isn't enough data yet to say for sure. Say WHAT??)

Hm, after rereading the transcript of the news story, it says the woman wore the Brava 4-6 hours a day. Maybe that's why she needed an implant - she didn't wear it enough! LOL

Would it be psycho-stalky of me to contact this woman and ask her a few questions about her experience with Dr. Namnoum??

makingway, what does Dr. Khouri charge (just so I'll know whether Dr. N. is charging 3x his cost too!)? (Sorry, this was probably said somewhere in this thread)