Has anyone had micro fat grafting?

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  • cathmg
    cathmg Member Posts: 278
    edited October 2010

    Hi All,

    I just had the fat grafting done last week to fill in a dent and round out contours of my L reconstructed breast. The details: general anesthesia, 1 hr. surgery, lipo from stomach area, 4 teeny incisions with no stitches.

    I had moderate pain for 3 days, and a little bruising at both surgical sites.

    I am pleased with the improved contour, and have a good cosmetic result. Hopefully the fat will not be reabsorbed, and this will be a one shot deal. My PS did say he might have to repeat the procedure. I think this is it for me, though. I'm tired of doctors!!!

    The expense was covered by insurance (after my ridiculously high deductible) as a revision.

    All the best, Catherine

    PS I'm in Maine, and this procedure was done at Plastic and Hand in South Portland-I would definitely recommend them.

  • mradf
    mradf Member Posts: 398
    edited October 2010

    Hi Everyone:

    This thread had gotten a bit quiet.  I've been waiting to report that, in lieu of repeated fat transfers, I had surgery yesterday to implant some FlexHD (a brand of allgraft) under the scar line where it had become "indented" or like a "valley" (for lack of a better description).  It was about two hours under general anesthesia, in the hospital, home same day.  I do not feel any pain or discomfort at all.  I can unwrap and shower tomorrow, and will most likely go back to work on Monday.  I've already had some fat transfers, and time will tell if I need any more, but this was the best choice for me at this time.  PS told me that he thinks I will be pleased with the outcome, trying to achieve symmetry.  From the top down view, peeking under the wrapping, it looks pretty good!

    Be well,

    Maria 

  • GointoCarolina
    GointoCarolina Member Posts: 753
    edited October 2010

     This thread needs to be kept where it can be seen,so many women are not aware that this might be an option for them.I wonder if we should start a different thread,maybe "microfat grafting:another option  for reconstruction" and refer to this thread? So much good info here.

  • leeinfl
    leeinfl Member Posts: 317
    edited October 2010

    I agree - I sure wish I had known about this.  I'm now over 3 weeks post-op from having my 600 cc implants replaced with 300 cc and another 300 cc worth of fat grafting.  So far, my breasts continue to look much better than before.  They look normal instead of looking like implants.  Obviously, I'm still healing and I have to wait for the final results, but I'm pleased and happy with my decision. 

    We need to be aware of all options for reconstruction and this is definately an important alternative.

  • swimangel72
    swimangel72 Member Posts: 1,989
    edited August 2013

    Seems to me that most DIEP or free-tram flap patients have had some fat-grafting done during their revision surgeries. Like Catherine,  I already had fat lipo'd from my underarm area and injected into the top of the foob to help make it look rounder (this was done as an outpatient last year). My fipple has since gone flat - so next Monday I'm scheduled for a revision to the fipple - at the same time, my PS plans on doing some lipo from my stomach and injecting it into the areola-area (just under the fipple) to give it more of a cone shape.(I only agreed since he said I won't need drains.)  I didn't think this was a new style procedure - I've read about it before - but perhaps you are all talking about recreating an entire breast mound from fat grafting instead of from a flap??

  • NotMyTime2Go
    NotMyTime2Go Member Posts: 34
    edited October 2010

    Yes, Swimangel, that is what is being discussed here. It's a combination of lipo-suction and an external expander that allows for a complete reconstruction of the breast without a flap. 

     I for one would have liked to know about this option before my attempted diep-flap surgery.  No sense worrying about it now, except that I'd vote to put this thread in a more prominent location.

    I don't think I've ever been so excited for an event that I'm not attending (ie. the training in Florida this weekend.) My doctor has cautioned me that he won't know if I'm a good candidate until after he goes through the training, but I can't help but have my hopes up. I think I remember someone on this thread saying they would be there? If so, my thoughts will be with you! I'd be curious to know how many doctors are in attendance, and any other newsworthy info. 

  • leeinfl
    leeinfl Member Posts: 317
    edited October 2010

    I know of two women who have posted here who have had reconstruction and augmentation who will be at the workshop to show the amazing results of this procedure. 

    Have you checked out the website?  They post some info on the workshops and list some of the attending surgeons on one of the links there.  Poke around, has loads of info: Miamibreastcenter.com

    I'm happy that your doctor is learning this technique so more women will have the option of going this route.  I hope you will get good news!

  • CrunchyPoodleMama
    CrunchyPoodleMama Member Posts: 1,220
    edited October 2010

    Okay, girls, QUESTION:

    Did anyone have an initial fat graft done at the same time as your mastectomy?

    or do you know of anyone who did this? If so, why was this done, and did the intial fat graft "take"?

    My plastic surgeon has been trying to ask this question of Dr. Khouri for the last month, but obviously he's had a very busy travel schedule lately so he hasn't been able to get through to him.

    I'm trying to confirm my mastectomy date but we need to know whether there's a legitimate/useful reason for an initial fat graft to be done before any Brava use has occurred.

    Thanks!!

  • leeinfl
    leeinfl Member Posts: 317
    edited October 2010

    CrunchyPoodleMama - try emailing or calling yourself.  I emailed him and he answered very quickly - but again, he is super busy.  I don't know when this man sleeps - he's constantly traveling, teaching or operating.  That said, when you have your appointment with him, he takes all the time in the world and calmly answers any and all questions.

    I don't remember if I read it here or somewhere else, but there are things that can or should be done during the mastectomy to make your end result with fat grafting better/easier.  Again, not sure where I read it, so I'd definitely try and make contact with either Dr. Khouri or his surgery coordinator, Cindy.

    Good luck!

  • CrunchyPoodleMama
    CrunchyPoodleMama Member Posts: 1,220
    edited October 2010

    Thanks, Lee... actually I'm having a local plastic surgeon do mine, so I won't be having an appointment with him... but Cindy and Rosie have been so super-helpful so far, I will try asking them!

  • hope123108
    hope123108 Member Posts: 58
    edited October 2010

    Can someone tell me how you see what Dr.s attending his work shops?

    Thanks,

    Hope

  • tedwilliams
    tedwilliams Member Posts: 178
    edited October 2010

    Trying to catch up with all the posts......I have been wearing my Brava for 2 weeks.  There are times when it is uncomfortable and times it isn't.  I will return to my plastic surgeon in 4 weeks to reevaluate the next step in my reconstruction......I have been reconstructed and deconstructed (my DIEP failed and was removed).  I have read all the concerns, yet those same concerns can be said about any procedure.  There is the chance that cancer cells are left behind or new one forms---that is life.  And yes the literature that comes with the Brava says women like me should not be using it, but than again I am not using it grow bigger boobs, I am trying to create a pocket for my own fat cells to be used to recreate what I lost to cancer.  The cost for the system was $750---a set of two and I only use one.  No insurance did not cover this.  I do already see a softening of the skin heavily damaged by radiation. 

     I wonder why there is such a fuss about mentioning a doctor's name.....the NOLA group sings the praises of the Center for Breast Reconstruction.  Someone has to throw the first pitch so the rest of the team can play.  

    The surgeon I use just completed a seminar in NO on fat grafting with surgeons coming from all over the world to participate.  Just yesterday I saw the photos of the process I will be going through in my doctor's office.  The woman had a bilateral mastectomy with radiation.  She was not a candidate for DIEP.  The results are amazing...she will need tattoos.  I had a nipple/skin saving mastectomy.  

    I never wanted to be on this journey and I never had breast envy until this summer when my flap was removed and I was left with a rather unusual chest.  As with anything in life whatever you choose make that choice armed with information.  But always be cautious of the information and keep searching.  Not everything works for all people...but don't criticize me for making the decision I did or tell me I need to look further for all the negatives.  If you look for negatives you will find them.  

    http://www.fatgraftforum.com/

    This is the link for the  forum that was held in NO....there are photos, almost all are for implant failure, but can give an idea of what the results can be.   

  • tedwilliams
    tedwilliams Member Posts: 178
    edited October 2010

    Decided to do some searching.  Using the link for the Fat Graft Forum, I googled the faulty listed as presenting at the forum.  Here's what I found:

    http://www.ncbi.nlm.nih.gov/pubmed/20333521

    http://www.ncbi.nlm.nih.gov/pubmed/17415234   The theory that the stem cells in the fat cells help in healing/repairing radiated tissue damage

    http://www.hcasaludinternacional.com/CustomPage.asp?guidCustomContentID={48BA6AB4-961E-48D7-A74B-82674DB38A5A}

    http://www.ncbi.nlm.nih.gov/pubmed/17312477?dopt=Abstract 

  • leeinfl
    leeinfl Member Posts: 317
    edited October 2010

    Wow - thanks for posting all the info you found.  It's just incredible!  The photos from the NO seminar are amazing and show just how natural the breasts look with this procedure.  It'll be 4 weeks tomorrow and I love the way mine look and feel.  Still slight soreness where most of the work was done to fix the pockets, but I'm very happy. 

    yes, we never wanted to be on this journey but here we are and we all need to make the decisions that are right for us.  I agree - if you look for negatives, you WILL find them.  There are lots of risks and negatives with all the reconstruction options.  

    From one reconstructed/deconstructed to another - best of luck.  Keep us posted.  

  • Kitchenwitch
    Kitchenwitch Member Posts: 374
    edited October 2010

    It looks like I am going to be having a mastectomy (I will just do the one side and worry later about making the other match in terms of lift/size). Apparently (big sigh) there is still some question of whether I'll need radiation afterwards, so I guess there will be some waiting between the surgery and the reconstruction.

    I am hoping for nipple-sparing (BS says he sees no problem doing that and feels confident about the procedure in my case, though obviously it might not work). And then I really, really, really want to do micro-fat grafting for reconstruction.

    Does anyone know if the PS will put in a tissue expander or something at the time of the mastectomy? The BS thought that was a possibility. My appt. with Dr. Ahn to discuss this isn't till November. I am just wondering if anyone knows anything about what I can expect to wake up with, post-mastectomy for DCIS.

    Thanks! 

  • leeinfl
    leeinfl Member Posts: 317
    edited October 2010

    Kitchenwitch - sending hugs your way.

    Since my DCIS was extensive, I went with a double MX.  I didn't know about micro fat grafting to restore breasts, so I went with implants and the immediate reconstruction.  My PS wanted me to have mastectomy first, and placing the TEs in another surgery.  I pushed to do it in one surgery, so I woke up with the TEs in place.

    If you want to do the fat grafting you don't need the expanders.  That's the beauty of this procedure - no more incisions.  You need to research this further - you have options!

    Good luck and look into all the web sites that tedwilliams posted above for more info and guidance. 

  • capqueen
    capqueen Member Posts: 34
    edited October 2010

    Hi Kitchenwitch

    You seem to be pretty sure about what you want and I don't want to be discouraging, but I wanted to give you my experience with BRAVA and fat grafting.  I had an immediate TUG.  Due to some complications I lost volume.  So, I used BRAVA and fat grafting to gain about a cup size.  I found the TUG to be much easier in terms of impact to normal life.  Two weeks down and then back to pretty normal activities (I work out, work full time etc)  BRAVA is a HUGE pain. It interferes with all parts of your life.  You cannot do anything while wearing it.  It interferes with sleep and made my husband totally crazy.  I have worn it for probably 4 months or so and I can't imagine being able to do it for several rounds.  Just one view, but wanted to give you that perspective.  Wish you all the best with whatever you decide.

  • CrunchyPoodleMama
    CrunchyPoodleMama Member Posts: 1,220
    edited August 2013

    Okay, girls, things are finally moving forward! When I last updated, I was going to go with a plastic surgeon (Dr. N.) who had trained with Dr. Khouri. When I met with him, he was utterly discouraging about this procedure and finally admitted he's never done it without also doing an implant. He spent the whole appointment trying to talk me out of it, and started throwing out wild ideas that aren't remotely part of Dr. Khouri's protocol.

    At the time, I figured I had no choice but to go to him since I can't travel to Miami for now.

    BUT! I've been communicating with the awesome Dr. Hanna, a plastic surgeon I had already met with before I knew about Dr. Khouri's technique, and he is on board to do the December workshop and do my reconstruction early next year! WAAAAAHOOOOOOOOOOOOOOOOOO!!!!! I'm so excited now that he's going to be doing my reconstruction. His work is absolutely beautiful, plus I connected with him better on a personal level (the "Dr. N." character is a fuh-REAK, if we're being perfectly honest here). So excited I'm jumping up and down like a kid!

    Kitchenwitch, I was wondering the same thing about a TE at the time of the mx.... purely for easing my mind psychologically. Right now, I'm envisioning waking up with a shriveled, empty breast (I'm doing skin/nipple-sparing) and am NOT looking forward to that. But, I didn't know if having a TE in there would interfere with healing (especially with regards to the nipple). BTW, I'm doing the same as you... unilateral and I figure I can worry about symmetry later. I hope to have a baby and breast-feed from my healthy breast, so I expect to wait until post-breast-feeding to do a lift on the non-DCIS breast.

    capqueen, I appreciate your sharing your perspective. I'm actually not familiar with TUG so will have to look that up. I am fortunate in that I work from home and only interact with customers a couple of times a week, so I plan to wear it throughout my waking hours. Did you find it hard to do computer work for long periods of time wearing it?

  • capqueen
    capqueen Member Posts: 34
    edited October 2010

    Hi Crunchypoodle mama

    I found that you really can't move at all without losing suction on the BRAVA.  This means for me at least it was impossible to do much of anything except sit/lie still.  Typing at a computer is possible but difficult - once you move your arm the thing would pop off.  Standing up from a seated position usually means you lose the seal.  For me, once you put on the BRAVA you are totally useless.  Maybe you will get better seals!

  • CrunchyPoodleMama
    CrunchyPoodleMama Member Posts: 1,220
    edited October 2010

    Hmmmm.... that is good to know... thank you!

  • klp1
    klp1 Member Posts: 56
    edited October 2010

    I'm just finishing up with reconstruction after having a skin-sparing mast and a ms free-tram.  I've had fat grafting twice now to fix contour defects and it's worked really well.  I did have one hard area removed during the last procedure with additional micro-fat grafting.  My PS mentioned that he's getting ready to do a couple of reconstructions using total micro fat grafting.  He is NOT using an external system (BRAVA).  He will first implant a TE to hold the space, then do micro fat grafting in several separate procedures.  Each time he adds more fat, he will deflate the TE to compensate for the fat he added.  At the end of the process, the breast will consist of all fat and the TE will be removed.  That seems to make so much more sense than an external system like BRAVA.  I'm just amazed at how this could revolutionize the reconstruction process.  What a wonderful possibility to get natural reconstruction using your own tissue without having to sacrifice a donor site like is required in flap procedures!!!!!   Thank goodness for reconstruction research and innovative surgeons! 

  • NotMyTime2Go
    NotMyTime2Go Member Posts: 34
    edited October 2010

    Holy Canoli Batman! Now we're getting somewhere! Do you mind sharing the name of your ps? PM me if you'd rather. I want to refer my ps to him for details. Since I'm sitting here with the TE's in place, that seems like the perfect solution. 

  • leeinfl
    leeinfl Member Posts: 317
    edited October 2010

    "Thank goodness for reconstruction research and innovative surgeons!"

     Amen to that!!!

  • NotMyTime2Go
    NotMyTime2Go Member Posts: 34
    edited November 2010

    Hey All -- I'm back with the same question I asked a couple days ago. I have an appt. with my ps tomorrow to (hopefully) get going on my fat-grafting procedure. Since I currently have expanders, and he mentioned taking them out and letting me heal before starting on the BRAVA, I'd really like to have the name of the doctor that klp1 mentioned who is going to attempt total reconstruction with just the internal expanders. (or any doctor who is in on that procedure). I haven't had any luck with google searches and I really want to have all options on the table tomorrow. Delays seem to be the name of the game with this whole reconstruction business, but I'm sooo ready to move forward. Any help would be appreciated!  

  • CrunchyPoodleMama
    CrunchyPoodleMama Member Posts: 1,220
    edited November 2010

    NotMyTime, I wish I had answers for you; I still have so many questions myself and haven't been able to get through to Dr. K, he's been so busy (obviously). I wonder if we should have an FAQ spot where those of us with questions can list our questions in one place, and those who have been through it and know the answers can help us out...?

  • whippetmom
    whippetmom Member Posts: 6,920
    edited November 2010

    Notmytime:  Did you send a PM to klp1? She might not be reading this thread often...

  • NotMyTime2Go
    NotMyTime2Go Member Posts: 34
    edited November 2010

    Yes, thank you I got it! You ladies are the best! I'll post after my appointment tomorrow with whatever I learn!

  • sdstarfish
    sdstarfish Member Posts: 544
    edited November 2010

    Hey Ladies:

    I went to Dr. K recently. My experience was traumatic overall. I'm only 4 weeks out so I'm still in shock. But the hospital he uses was the worst I have ever experienced. I hate to throw a damper on anyone's hopes...just be very cautious if Dr. K wants you to have your procedure at Palmetto Hospital in Hialeah, FL. Message me if you want more details...don't have the energy to post it here.

    Just thought I should speak up so no one else goes through what I did.

  • CrunchyPoodleMama
    CrunchyPoodleMama Member Posts: 1,220
    edited November 2010

    Oh yikes, Lisa, that sounds awful! I'm curious to hear some of what you experienced, but understand if you're not up for talking about it... I hope things get much better from here!

  • leeinfl
    leeinfl Member Posts: 317
    edited November 2010

    sdstarfish -

    I'm sorry you had such a bad experience at Palmetto.  I had my surgery there as well, and aside from the facility being older and in need of updating & maintenance, my experience was the total opposite.  Everyone I was in contact with couldn't do enough for me and my husband.  I was just commenting yesterday to my husband how sad that my local, much newer,"pretty", modern hospital gave me such bad service compared to what I experienced in Palmetto.  Aside from the language issues, I was very happy with everything.  Sure wish you could have had the good care I had...

    So sorry and hope you feel better soon - hang in there!

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