Has anyone had micro fat grafting?

Kareenie,

My follow up appt is also on the 19th!  At 1015 am - let's make sure we all meet up!  Will this be your initial consult?

Really look forward to meeting you and Kate

PS - see you on the fat graft forum....

Sweetie2040 - I know what you are going through, so anytime you need ANYTHING, please let me know.  Good thoughts being sent your way.....

I am so sorry sweetie I know exactly how you are feeling.  I can't eat right now as I am so unsure of what to do.  I think we have been so mutilated we are scared to death that it might be worse. Do you take the risk or put up with what we have?  Is it that bad or are we looking for the impossible. That is what keeps going through my head. I just want to look normal.

I guess we need to go into whatever procedure with our eyes wide open to what can be the best and worst outcome. The fat grafting certainly seems the least invasive.

Kate can't wait to hear about how your meeting with Dr. K goes!!!  I may do that. I am planning on going to a woman in NYC to get my tatooing done as she is a trained artist in her own right and now does medical tatooing. Her work is amazing. Since I have the one full and one partial areola that are now not even I figured I should go to her.

I wish a sense of peace to all of us today

sweetie that is what I did. I cancelled my surgery which was scheduled for today.  I am going to get some second opinions. I have mixed feelings as that just pushes out the nipple reconstruction but I think it was the right decision.  You know yours was because of the sense of peace you had.  That is a good thing.  I am concerned about if you have to redo the fat injections after a couple of years.  I am thinking like you I think if I remember. I like the size and shape just not the ripples. Oh well. Another part that people don't understand happens when you have breast cancer with a mastectomy.  Take care

Thank you so much leeinfl.  Yes all those feelings and why should we feel guilty ........ but we all do. We just want to look normal. I am so glad you are so happy with your results.  Did Dr. K ever say you will have to come back every couple of years to have more fat injected?

Thanks again for understanding all the feelings

That's right....from that first day of being told we have cancer, all we want is to look and feel normal again.

No, I am done.  From the very first fat grafting session, I saw very little (if any) loss.  That's been 6 months now.  The subsequent fat grafting sessions were not to replace any loss, but were done to add more fullness (besides him wanting to improve the folds).  Remember, the fat is injected droplets at a time and not in a big "glob".  Obviously this technique is the reason for the fat surviving so well. 

I'm headed down for a follow up visit on April 19th and hopefully will get a chance to meet some ladies from here, but after that.....Nope! - aside from dropping by to say "hi"  and "thank you so much for my beautiful breasts" - I will have no reason to see him anymore.

sunshinegal:

There's great new info on this topic.  Check out the newly published review entitled "Oncologic Risks of Autologous Fat Grafting to the Breast" in the January issue of the American Society of Aesthetic Plastic Surgery's Aesthetic Surgery Journal 

http://aes.sagepub.com/content/31/1/68.abstract 

Interestingly enough, that issue also has an article pertaining to nipple sparing mastectomies.

You need a subscription to read the entire articles, but maybe you can ask your PS about it.

Also, autologous fat grafting to the breast is a topic at the Aesthetic Meeting 2011, "Affirming the Science of Aesthetic Surgery", May 6-11, 2011 in Boston (organized by the American Society for Aesthetic Plastic Surgery and the Aesthetic Surgery Education and Research Foundation.

Click around on the journal site and the meeting site and you'll see familiar names pop up again and again.

Yes, even though I'm "DONE", this whole process is so amazing to me that I still do research and try to stay on top of the latest news.  It's just so intriguing...

sweetie I did not post picturs. I sent some to whippetmom maybe she posted them?

sunshinegal -

I'm sorry, I meant to copy the main point and totally forgot to do that....here it is and again, sorry for the "duh" moment.....

As the frequency of fat grafting to the breast has increased, some investigators have raised the possibility that this procedure may potentially increase the risks associated with breast cancer. Their concerns included not only interference with cancer detection, but also promotion of tumor formation or recurrence mediated by mechanisms such as aromatase expression, angiogenesis, and tumor stromal cells. However, published clinical studies describing outcomes of fat grafting to the breast in more than 2000 patients have not reported any increase in new or recurrent cancers.

kareenie- Uh oh, I think we have a problem.  I also have an appointment with Dr. Khouri on 4/19 at 9:00 a.m.  I have email confirmation from Cindy in his office.  Doesn't seem likely he would schedule two consultations at the exact same time since they usually take awhile.  I have an email into Cindy to straighten it out.  

Does anyone know how long Dr. Khouri has been doing his kind of fat grafting?  Everyone keeps saying that the fat is just going to get reabsorbed in a few years.  Does he have long term results that anyone knows about? 

Erica - I asked my oncologist about recurrence and fat grafting and she vehemently shook her head and said I have nothing to worry about.  Also, a 2000 patient study isn't exactly a small study.  Yes, it's still a fairly new procedure, however, weighing it's benefits against the other reconstruction options (and their inherent risks) is what every woman has to do on her own.  For me, having this as a revision, was a tough decision.  Not because of the procedure itself, to me that was fascinating and exciting.  Every woman considering a revision knows how hard it is to make that decision.  Also in 2009, the American Society of Plastic Surgeons reversed their position and now considers fat grafting to the breast a safe method of breast reconstruction.

Kate33 - Don't worry about the appt time.  Plan on being there a while since he will take the time necessary for each patient and that pretty much makes staying on schedule an impossible task.  The "traditional" method of fat grafting is simply injecting a glob of fat which usually leads to significant fat loss.  Remember that Dr. K's method is injecting droplets at a time.  Very different technique.  Also another critical prerequisite is viable space available to support the injected fat.  That's where either the Brava domes or previously expanded tissue (current implants or TEs) come into play.  He calls it "preparing the field" - makes perfect sense.  Can't expect a glob of fat that is pressed into a tight area to thrive.... Dr. K developed the Brava in 1999, he had done traditional breast reconstruction for over 20 yrs, clinical trials of Brava/fat-grafting started in 2004,  mastectomy patients were added two yrs later.  Fat grafting itself has been done for a long time, this is a refinement of that procedure that gives much better results.  

I'll PM another bc.org member and ask her to PM you - she had fat grafting about 2 years ago and continues to be very happy.

Hi Lee,

I was actually thinking about my reply above and was tempted to edit it, since I'm aware that so many plastic surgeons use fat grafting as part of conventional implant reconstruction and are convinced that it's safe. Actually, I was more concerned about the Brava inducing cell growth than I was about the fat cells causing problems. I know Dr. Khouri feels very confident that Brava is safe. I suspect he'll eventually be proven correct (no big studies yet), since expanders themselves cause tissue growth (as the tissues "stretch" to accommodate the expanders) and lots of study has been done of that, with the conclusion that it's safe and doesn't increase risk of recurrence.

In my case, I was happy without reconstruction but my DH and I had always joked that if there was ever a reconstruction that could "grow" me new breasts, I'd look into it. So, when I heard about Dr. Khouri, naturally I was curious. I haven't ruled it out altogether, either. That's why I keep reading this thread with interest.

BTW, I saw you photos on Fumi's site and you look beautiful. Dr. Khouri really did an amazing job (your nipple tats look great, too).

kareenie- I got an email from Cindy in Dr. K's office and I guess we both DO have an appointment on the same day at the same time.  Not sure how that works but she recommended we bring a book!  Guess it'll be a long day.  We should just sit in there together (after the exam, of course!) since we'll both probably be asking the same questions!

leeinfl- Thanks for the additional info.  Makes me feel a lot better.  Looking forward to meeting you in person on the 19th!  

Thanks Lee for the PM,

I just check in now and then, but really enjoy interacting with those considering fat grafting.

Thanks for having so many facts at your fingertips, Lee.  I also really admire those of you doing lots of research before making your decision. 

Even though I am an RN, and usually do like to research things, when we first heard about Dr. Khouri and fat grafing as an option for breast reconstruction, there wasn't much to research.  I was glad to hear that it was part of a government clinical trial..esp. since that waived MD fees.  Everything was in network for my insurance and most of all, it sounded like something I could do.  I didn't want the pain or long recoveries of flap surgeries or expanders and implants. Then on top of that, Dr. Khouri had been invited to do a symposium at Froedert Hospital in Milwaukee, WI and said I would be a great candidate as a demonstration of the technique.  I felt God was opening these doors for me, so went through that door with very little idea of what I was getting into.

It really has been a positive adventure.  Dr. Khouri has been fantastic to work with (though bring a book...waiting rooms can involve a lot of waiting...he is so incredibly busy!). He is extremely accessible when you are on the radar right before and after surgery and his enthusiasm is very motivating. 

 I am thrilled with the results!!  It's been almost three years now since my first fat grafting.  It really is so much like "growing a new breast".  I had a unilateral mastectomy and the new breastt matches the other breast very well. It is soft and even has sensation!  I am not worried about it being reabsorbed.  He even added a little fat to the natural (right) side and raised the nipple a bit to perk things up.  So I went from a unilateral 34A to a nice 36B/C.  I also have a nice flat tummy and went from size 12 pants to size 8. You can see my photos at miamibreastcenter.com under reconstruction unilateral with augmentation.

 It is more of a process...wearing the Bravas...several procedures....traveling to Miami (glad I did though).  For me, the recovery was not very difficult.  I actually only took three days off work each time...most women would want to take at least a week or two to be safe  (I think maybe the thinner women might experience more pain).

 I am done, do not need to return ever...except Lee, wouldn't be surprised if you get asked to go to some conferences.  Dr. Khouri does fat grafting training courses for plastic surgeons from all over the world.  I have been a part of two of them.  It is quite exciting.  Last time there were 15 women at all stages of fat grafting who were part of the interview...yes, show and tell)  Dr. Khouri even does a live surgery where the surgeons can ask him questions as he is doing it.

 At these conferences, there are study results that do seem to be encouraging as to no increase in cancer (even slightly lower incidents of cancer) or problems reading mammograms.  There were all the same concerns about expanders and flap surgeries in the beginning also.  As breast cancer survivors there are so many potential scares for risks but this is just using the principles of tissue growth through expansion (used without problems for decades, at least, in the medical community) and then transferring some of your own body fat (non breast) into another area.

 Some of you mention having to wait to have nipple reconstruction.  I am using Naturally Impressive Nipple prosthesis.  These are "stick on" but very, very realistic.  They stay on securely about a week at a time.  You can see photos at naturallyimpressive.com   Feels like the finishing touch....even if just until you can get the nipple reconstruction.  These were also featured at Dr. Khouri's conference and the surgeon's seem very impressed as sometimes it is difficult to get realistic results with surgery or tatoos. 

 Well, guess I've gone on long enough...wishing all of you well as you make your decisions. This is a tough journey and I think we all long to feel "normal" again.

 So excited some of you will get to meet!

randi- Thanks for sharing your positive story.  I have a consult with Dr. K this month so it's great to hear some success stories.  Especially from those of you who are years out from having it done.  So glad that everything has worked out so well for you and I am grateful to all of you who are the "pioneers" of this amazing procedure!