Has anyone had micro fat grafting?

Crunchypoodle: I will be in three nights most likely. Yay for the ipad! I have a netbook (and an ipod touch). I'll be wondering the same thing.. as I have been for the last few weeks. I still regret the fat grafting but I am glad they'll reconnect the nerve. Now all I have to do is worry about the margins (including for the nipple path report).

http://www.cellreconstruct.eu/CellReconstruct.aspx

Just found this site while doing research on recovery times for the fat grafting.  Under the Learn More tab are interviews....the first interview has photos of before and after MRI's. Very interesting the healing of the scar tissue from the fat grafting.

I am now 6 weeks into wearing my Brava in prep for the fat grafting.  It is not the most comfortable thing to wear and is a pain in the butt or chest, I should say.  But I am seeing results...to get the visual of my before.....think of a Space Saver bag and what it looks like before you suck all the air out.  My breast looks like the after....like someone sucked all the air out.  The radiated skin is softening and the deep indentions are plumping up.  I use the hand bulb to get and maintain the suction....I just hook up the pump to even out the pressure....guess I need to change the tubing to just the suction bulb.  Why didn't I think of that before.

I had a skin/nipple saving mastectomy with a TE.  After radiation, the TE was removed and I had the DIEP procedure.  Due to the damage from the radiated skin there were problems with swelling and blood clots....the flap was removed.  

I have the lopsided chest and wear a fake boob in the special bra.....dressing each day means finding clothes with necklines that will not gap because the bra does balance me out but does not cover the indention where cleavage should be.  So no strapless holiday apparel this year.  All the news about the new body scanning at airports.....a fake boob and a sunken chest.....pat down or scan???

My body is scarred....I have a flatter tummy but a very long, very visual reminder of yet another insult to my body.  But I am on the right side of the grass and that is truly a blessing.

I go tomorrow to discuss my progress and to schedule my first grafting.  Scheduling around the birth of grandson #2, house hunting trip to Aberdeen, Scotland and trying to sell and pack up a house.   I am looking forward to this next step because my body and soul feel that is the right thing to further aid in my healing.  

So as I read all the previous postings, I am reminded of how similar yet how different all our journeys are.  The choices we make are ours and must be made for our best lives.  I am so thankful for those who have taken the chances with new ideas and technology----patients and doctors.  I am sad for those whose journeys have been further complicated by the stupidity or lack of understanding from others.  Questions and searching are needed, but put downs or negative input are a waste of energy.....these forums are needed and a great source of info and feedback, I just get pissed at the tone some take and the attitudes.

There are many great surgeons out there pioneering the next choice in breast reconstruction.  There are also many questions concerning the safety, but I am of the generation that ate snow ice cream during the time of atom bomb testing and DDT.   

I saw an oncological breast surgeon yesterday.I chose to see a woman as I hoped she would MAYBE have a better grasp of understanding my situation.She was not very receptive to my hopes of immediate fat grafting,but said she would ask the plastic surgeons she works with.She said that it is not possible to reconstruct a whole breast with fat grafting.I assured her that they can, that I have emailed and talked to women who are having it done.I offered to give her Dr.Khouri's website,she said the surgeons would know what I was talking about.I felt like she thought I was a nut case and that there was no way possible that I could have information that a DOCTOR did not know about.I am so discouraged by these doctors who will not listen when I try to tell them what I want.I had phoned another doctor who states on his website that he knows all the latest techniques and is learning more every day.His receptionist said she would ask him about it and called back to tell me that he said this procedure is illegal and he will not do it!I am going to email info to another surgeon that I saw,but I did not know about the fat grafting at the time .He seemed to be doing breast recon for the women and not as an ego trip for himself like so many seem to be....I am hoping maybe he will  have an open mind.I just do not know how to find a PS who is willing to learn something new.And most of all listen to me and not act like I am on a weekend pass from the asylum.

I do have a doctor in New York City who is willing to try the fat grafting for me.I originally contacted her about SGAP and she is a wonderful person,I really feel comfortable with her.The reason I am looking for someone else is because of the distance,NYC is over 4 hours from me.But if I cannot find anyone closer to home,I will go to her.How much were you quoted for a price on the Brava? I think Dr.Khouri told me it would be $570.I do worry about investing that much and then finding I can't use it for some reason.Like I have mentioned before Dr.Illouz in France has been doing breast recon with microfat grafting for 25 years and he is emphatic that the Brava is not needed.Now if you are stretched from the internal expanders,can't they just deflate and remove them and put some fat in to start and then do a little more when that has settled in?If your skin is stretched,it would stay stretched  wouldn't it?Maybe you could ask if anyone had their expanders removed and did not have implants and if they stayed stretched out..I know that Dr.Ahn removed implants for a woman and replaced them with fat grafting,her testimonial is on Dr.Ahn's site.Would you like Dr.Illouz email address and your PS could get in touch with him?Might be worth it for him to touch base and see exactly how Dr.Illouz does it.

Alexandra, Thanks for posting those pics, I hadn't been able to visualize the system with the pictures I've seen. I have to admit the size of those puppies is a little daunting, but I do see your point with the silicone gel vs. hard domes. 

I am confused about pricing of the Brava though. Pandazankar was told $570, which is about what my ps was told ($275 per dome). But when I requested pricing from Brava I was told approx. $900 for the sport system and $1200 for the system with a charger. That doesn't include shipping or the skin care (wasn't told how much that is), and only includes one set of domes. From what I've read, at least two sizes will be needed, and the silicone tends to break down when you use the hand pump that's needed right before surgery, so sometimes multiple domes are needed. So I can see this easily running into $2000 or more. It kind of reminds me of the Lucy episode where the vacuum salesman sells her "the works" than wants to know if she wants that pretty shell that covers "the works", or the hose or attachments, etc. 

That was why I went searching for a cheaper system. There is one out there that uses Brava domes with their own airlock system (which I've read on a forum that you can make for $7 in fish tank supplies). But they start talking like that and I start to feel completely insane. 

So maybe I'm missing something and we mastectomy patients get a better deal on Brava than others? (I asked my ps after getting the bid, and he didn't know why what they told me would be different than what they told him.)  I will inquire again of Brava, but in the meantime yes, Pandanskar, I would like more info on this Dr. Illouz. Does he have a website? I did a search and learned that he's considered the father of liposuction, but couldn't find anything on complete breast reconstruction. 

Three weeks till my surgery and I don't know if I'm any closer to deciding which way to go... 

I forgot to say about the handmade one..I own goats and donkeys,they are manufacturing a device for milking where you attach a cup to the teat and then squeeze a trigger handle and the milk goes into a bottle..milking is not easy for everyone..anyway,they sell this for about $200.A woman found a way to make one for $10 and it works better than the pricey ones!So maybe the $7 is worth it to see.I would love to know what forum you found that on,I have a friend who is very handy...He has beautiful LONG red hair and he donated it to Locks of Love in my name,so I know he would be happy to try making one..or two.. of these...

Hi NotMyTime2Go,

You may have gotten the info fro Pandazankar already, but the price of $1200 or so for BRAVA is usually if you purchase direct from them as a consumer, using them for augmentation only (with no fat grafting).The $570 is when you order the system as a fat graft patient of Dr. Khouri's (maye as other surgeons' patients too...?).

As for the hand bulb...I'm not sure about mastectomy reconstruction (vs lumpectomy) with more damaged skin, and this may just vary patient to patient, but I (and some of the ladies I know who have had the procedure) started using the hand bulb early on. It might be a matter of what your skin can handle. The last week is when the domes are typically worn 24/7 for maximum expansion.

What you were asking about fat grafting immediately following TE (or implant too) - removal gives you the "empty space" - I don't know if the way the other systems are worn would even accomplish that space. It's only a very temporary swelling, different than what BRAVA or TE's would create. 

(I also am sending you a PM - but wait til you're not at work to read it, lol!!)

I started following this thread when I was trying to figure out what was going to happen and whether I would do any sort of reconstruction if I needed it.  In th end I made it through with simply a lumpectomy but as I have already had a second surgical biopsy, I keep up because one never knows.

I am so worried when I read about people thinking about using homemade devices or discounted devices or talking inexperienced doctors into trying this complex procedure. 

Ladies, This is your health and your body that you are talking about.  you will be living with both for a really long time.

Bite the bullet. Delay your reconstruction if you must but get the most experienced surgeon you can so yoiu have the very highest chance of success and the very least chance of complications.   Don't get someone who is learning the technique, especially when a technique is as complicated and tricky as this is---get the guy/gal who has already done it. Its not a question of spreading cancer cells--its a question of skill & sucessful outcomes and that can only be achieved by practice.  My first surgeon said I needed a mastectomy and not a lumpectomy.  The surgeon who actually did the procedure did such a neat job you can barely tell I had a lumpectomy.  I am sure my first surgeon is very competent but she is also young and less experienced than the surgeon who finally operated.

Buy the right equiptment recommended by the experts. Don't skimp.  You want good results, isn't that why you are going through all of this in the first place?

You are stronger than you think and you can live without a breast for a while if thats what it takes to be able to pay for the really good doctor who does the job right.

Sorry to be a nag but I guess I've read one too many posts about people wanting surgeons to learn a procedure etc.  I wish the best for all of you.

I agree, we all need to get the best surgeon possible.The problem with the microfat grafting is that it is so new,very few surgeons are that experienced,except for Dr.Khouri in Florida and traveling there is not an option for me or for many others, for reasons that have nothing to do with finances..For all the breast surgeries and recon, the treatments and all, there had to be women who were the first.I am so very gratefull to the women who were first given herceptin,they paved the way to save my life.I bless them every day.So I guess I feel the need to give something back.I would only have this done by a surgeon that I totally trust.It breaks my heart every time I read of a woman who has had implants and she is in pain or has to have them removed or the ones who have flap surgey and it fails.This has no guarantee either,but unless someone leads the way,how will we know?As far as the used devices and home made ones,we are really just bouncing ideas off each other,it never hurts to discuss these things.I am concerned that I will pay out money for the Brava and not be able to wear it due to being so sensitive over my scar,women have rashes etc.That is a lot to pay for a device that you may not be able to use.That is one reason I would like to try something  cheaper first and see if I could even stand wearing it.I have been in touch with a doctor in Europe who does not use the Brava and I have been doing as much research on this as I can.I have been researching recon for over a year and the fat grafting for several months.I knew I did not want implants so my other option was flap recon.I read everything I could find about it and was not sure it was worth it to me to have such a lengthy surgery and recovery to regain my breasts.Then I found out about the fat grafting and I know this is right for me.Before that I researched mastectomy versus lumpectomy and for various reasons chose mastectomy and have never been sorry for that decision.I plan to have a prophylactic mastectomy on my other breast and hope to have immediate fat grafting.But if not,I will wait and keep researching.We need to know the pros and cons of all our options in this journey and do what is right for us,both physically and mentally.

Good News! I talked to the Brava people and learned that the device isn't as expensive as my original quote (my fault for not specifying why I needed it, I didn't think about that other use.) And even better, she offered to send it directly to my doctor's office where I can look at it before committing (as long we don't remove the packaging). That was my biggest worry--making a commitment before seeing it with my own eyes. He'll also be getting samples that I can try on. So...I'm feeling much less anxious about the whole thing. 

NotMyTime2Go  I am sorry you felt I was bullying you--it certainly wasn't my intention.  And I certainly get that its a personal and emotional decision--after all, thats what prompted me to post in the first place.  But the sad truth is that some people will take advantage of a person in an emotional state and will promise things they can't possibly do, sometimes in a malevolent way because of money and sometimes just because they misjudge their own abilities and want to help someone.  When I hear clearly vulnarable people talking about persuading their doctor to try something he is unfamiliar with, I can't help but be concerned.

I am so glad to hear that so many of you have done such great research on doctors.  Thats great. We all know about the people who picked the plastic surgeon for reconstruction who turned out to be a specialist in hands not breasts and end up with problems.  And to be honest, I am not sure that being skilled in lipo is the same thing.  While I certainly do appreciate that someone has to go first--my godmother was one of the first to take taxol--I don't think this is necessarily the same thing and I do think that one still needs to be careful about what short cuts one is willing to take.  Every time we go into the hospital for a surgery there are risks--not just of an unsuccessful surgery but infection and the like.  With a doctor who has no track record on a procedure, how do you fully evaluate the risks?

I have typed numerous responses, but decided that none sounded civil enough for this forum. But with chemopause-induced insomnia, I'm quite certain I won't be able to sleep unless I get this off my chest. I have never once in my life been called vulnerable. Nothing even close. After enduring heart surgery, double mastectomy, chemo, radiation, chemopause, herceptin, failed diep flap, and a year with internal expanders, I do not believe I deserve to be told to bite any bullet or toughen up. I'm there, I'm tough, and I'm smart. Sometimes we have to choose from less than perfect options, but that's life. And if we're really lucky (or clever or tough or blessed or whatever) we can make something good of a bad situation. That doesn't mean my decision is the only right one, but it is mine and it deserves respect. Okay, I wish the expanders were off my chest too, but that will have to do for now. Good night and good vibes to all.

NotMyTime2Go:  The word "vulnerable" is not an insult, nor does it seem to have been used here that way.  3montsmama made some very good points.  I agree with her on many counts, and I've expressed some concerns on this thread myself.  By your very own description of yourself, you are vulnerable.  We all are.  That's why we come to this website.  Being strong and being vulnerable are not mutually exclusive.  I am both.  I've lived without a breast.  I lost my sister to BC in June.  Right now, I am waiting for test results from a uterine biopsy done early Friday before going to work bleeding and cramping.  I've spent the weekend doing my chores and errands.  Today I purchased the Thansgiving meal ingredients which I will prepare on Thursday.  I think I'm pretty strong.  I think I'm pretty vulnerable. 

Be well,
Maria

Hi, all - I am back from my DIEP procedure (not really a day at the beach and even tho my PS is very skilled I do feel like I ws sort of talked into something more lucrative for her that she likes to do. She is very skillled at it). All i have to pass on at this point is, I think the skill and the experience of your surgeon is paramount.  I would definitely have trusted my PS to do the grafting but I guess I was on the fence about living with a breast for a while (there's a possibility of rads for me).

I had a PS resident tell me with utter confidence that it is not possible to graft an entire breast with fat grafting. I started to argue with him then just gave up. Too exhausted post surgery, and he was busy taking out some staples and causing a lot of pain he didn't warn me about in advance.

Anyway fight for what you want - find a doctor who believes in it as much as you. If Dr. Khouri says it can be done I believe it can be - but not every doctor believes that. I am I guess a little sorry I didn't hold out for grafting. I feel like I've been hit by a freight train.

I hope it's ok for me to still check in here -  I think this is the best procedure ever and I'm really interested to see how everyone does. And if my other breast turns out to need help I'll be doing that. Also fat grafting will be used to fix this breast if it has to have radiation and some of the fat is damaged.  

Yes I believe I've just this week had done what you are asking about. I recently had a bi-lateral mas. back in Aug. using the fat from my stomach for reconstruction- On the stage 2 procedure (12 weeks later) liposuction was used to fill in and re-shape and contour. Im glad I had it done, would do it again-if ness. but would appreciate if you could be more specfic as to what questions you would like to know about the experience. This would help me answer you better. Feel free to message me if you want to.