Has anyone had micro fat grafting?

I was very keen to go forward with this wonderful surgery of microfat grafting, but after surveying some oncological and plastic surgeon sources have found a few minor concerns/questions that bear consideration for a few patients. 

In my case, after consulting with three oncological surgeons and two oncologists, I was advised to wait for now on such a procedure. Unlike most of the successful cases here, I have had lumpectomy with no radiation, no chemo, and had high grade triple negative bc.  So my cautions may only apply to a very small minority.

There is some concern for those patients with a lot of remaining "native" breast tissue after cancer treatment.  The combination of stimulation from the Brava device along with the multiple canula or graft sites into the native breast tissue in some patients may be undesirable as it is inflammatory, albeit temporarily.  The long term effects of this action is not yet fully understood, particularly in treating areas surrounding and within the tumor bed.  In some cases the tumor bed is still present (like mine).

Microfat grafting should be clearly represented to those who are seeking non reconstructive global cosmetic augmentation that it is secondary to liposuction.  In other words, patients who approach mfg for breast augmentation should be clearly told that it is not a primary augmentation as such; that it is for subtle changes secondary to liposuction.  

I love the concept of this procedure and am grateful that it is now available, but I do feel that I was a little bit "over sold" on the potential upside and "under sold" on the potential down side.  It may be that this is only specific to me because I have not had a mastectomy (nor rads) and had a very high grade bc.  

I am still looking forward to some type of recon and it may well include mfg but not until I am more clear about these questions.

Climbergirl, just saw your post about your visit with Dr. K.  Glad it went well and to hear that you will be moving forward with the process.  Thanks for outlining your visit with him.  Mine is next Tues and it helps to have an idea of what the process will be.  Curious about your statement that you willl only be a 34B when finished 3 treatments.  Is that because of personal choice, because you are thin or ?

MsBliss,

I hope you don't think I am being nosy, but I thought that radiation after lumpectomy was standard of care.  I never heard of anyone having lumpectomy without radiation.  Again, forgive me if there is a good reason for this.  I just wanted to mention it, as I know that recurrence can be quite high without it.

 I also wanted to mention that I went to my local PS today. He started fills on me.  I went along with it because I am clueless as to what I want to do.  He said let's do it and see how your skin responds, saying we don't have to decide today what kind of recon I will have.  None of the options sound good to me.  I am in the mode of "I just want what I had back." I asked him about whole breast fat grafting.  He immediately said, "if you want that, there is a doc in Miami who does it."  He was less than enthusiastic, saying it would take 6-7 surgeries.  When I asked whether it was any different to move fat around surgically vs. liposuction, he was very careful to say "you would think not, but we just don't know."  He also said they have been doing it for a long time as an adjunct to other procedures. 

I find myself getting teary whenever the conversation turns to implants, but I just can't shake the "fear of the unknown" when it comes to the fat grafting. So many things were never believed to be harmful, and later found to be, at least for certain people.  I have been lurking on the DIEP thread for a while, and all the ladies seem so happy, but hearing their experiences is, to me, quite scary (taking bone out from the sternum?).

So here I am...TE's expanded by 1 oz (woohoo! But I really felt that needle!) and I don't have a clue what to do.  I may end-up being the longest person EVER to have tissue expanders in while I try to figure this out.

Tinkerbell - My implants were exchanged with smaller ones and then I had 3 rounds of fat grafting.  My photos are on the photo site.  The thread is called fat graft recon and I have the same screen name there.  Before I felt like I had grapefruits stuck under my skin.  They felt fake, looked fake, were cold, hard and one rolled to the side and had a major dent.  My cleavage was a boney, concaved mess.  What I have now looks so natural that if I didn't have the MX scars, you wouldn't know that they aren't my original pair.

If you posted and agreed to the guidelines on the fatgraftpatients.com website, then the administrator will give you access.

Yes - this IS amazing....

@ Irishluck

 Yes that is the size we talked about as I am naturally small. Honestly, the bras that I wear now are just called "Medium" but one that I bought last year was a 36B. So somewhere in that ball park I guess. I really have paid no attention to that stuff in a long, long time. Mx will do that to you Underwires are a distant memory.....so I am starting from a Mx and have had some rads. The rads makes it more challenging for sure as the area will take longer to stretch and get the cells jump started. My skin is in good shape and all of my yoga has kept the area open. I cannot even tell you how hard I have had to work to keep that left arm and shoulder happy. Unreal! My BC surgeon left NOTHING as Dr Khouri so duly noted. 

@ MsBliss I can understand your Oncs concerns. In the study sheet that Dr K gave me it does mention that fat necrosis can make scans very hard to read. If you still have breast tissue after a high grade tumour dx they will not be stoked at all for you to do anything like this. My Onc at Dana would freak out if that was my situation. 

 Here is another Q that I neglected to ask on....when Dr K injects the fat cells....do they just go under the skin? I cannot believe that I did not ask this!  Where is he shooting for the cells to end up? As you all know...sometimes you get the good questions later after you see the MD~duh.

Be Well and Thanks for any info,

kd

I certainly agree with Kate! Had I never found this forum, I would have had "traditional" BMX, would have had incisions across both breasts, and would have lost both nipples. It was HERE, not from my former BS or PS, that I learned there were other options.

Not everyone is a candidate for NSM, FG, or any one procedure. However, you never know about this until you are evaluated by someone who performs these. The free exchange of ideas here serves a marvelous purpose to educate women about what could be rather than what has always been!

I am still in the process of receiving the fat grafting.  My next one is scheduled for Aug. 5th.  My surgeon in the New Orleans area hosted an International Fat Grafting Forum in April.  Below I have placed a link to one of the surgeons with information concerning fat grafting.  There is a video that shows the process.

In looking at the photos from the fatgraftpatients.com, I realize my experience is different.  After the lipo I did not have all the bruising...there was some faint bruising on my sides but nothing like in the photos I saw.  Even my breast did not have the bruising I saw in the photos.  I did have small incisions on my breast as he tried to loosen the skin stuck to the chest wall.  I had a nipple skin sparing mastectomy and we are working to preserve that skin and the nipple, but radiation has damaged the skin and created a few bumps in this road.  I did not have the oozing that was described by others...my compression suit was filled with pads but they had very little drainage upon removal the next day.  I wore my compression garment for 4 weeks....the first week I showered with it on and after that took it off, washed and dried it, then shimmied in with lots of baby powder.  It truly felt funny not to have it on.  I would have traded to Spanx but could not find them in the small town I live in. I do not intend to have an implant and if the results I want cannot be achieved with the fat grafting then we will move onto plan D...although I would be happy with a B.

Due to the fat grafting forum, my surgeon found a tissue bank to store the extra fat he collected, thus only one lipo procedure.  So in Aug. my fat and I will fly into New Orleans to be reunited.

Dr. Khouri invented the BRAVA, but did not invent the fat grafting procedure.  This procedure has been done in Europe for many years.   My surgeon did a clinical trial at LSU for fat grafting with great results.  My point being there are other surgeons doing the procedure.

When I voiced my concern about the fat grafting, the BRAVA and cancer cells, my surgeon responded that if the cancer cells are there the BRAVA might cause them to show up in 4 months rather than 6 months.  But if they are there they are there.  The positive research concerning the healing affects of the stem cells in the fat outweighed my concern about the cancer cells. 

http://www.beauli.com/en/beauli/about_beauli 

Jana 

Forgot to mention, my PS said that today's implants will 'outlive us' meaning they are not expected to need replacement in 10 yrs. Any of you ladies heard that? I know this is not the implant thread, but just wondering.

Lee, amazing that you mentioned nipple placement, because that was on my mind today. I was wondering if I decided to do implants with FG on top, for a few years, what would happen to nipple placement if I decide to deconstruct implants and do total FG? Kate, from your photos, this was not an issue for you either. Any comments?

It seems we have two different discussions of micro fat grafting going on.  Some of us a talking about entire breast reconstruction using fat grafting (BRAVA) and others of us are talking about small modifications that are to be made to either a implant recon or a diep recon. 

Right? 

Did some research today and came across this article.  I will also post the link to the recent issue (May 2011) of "Annals of Oncology" that it references as well.  Very interesting and encouraging studies.  QUOTE:  Conclusions: Lipofilling seems to be a safe procedure in breast cancer patients. Longer follow-up and further experiences from oncological series are urgently required to confirm these findings

http://seattleskindoc.wordpress.com/2011/05/31/fat-grafting-to-breast-for-reconstruction-found-to-be-safe-in-controlled-clinical-trial/ 

http://annonc.oxfordjournals.org/content/early/2011/05/21/annonc.mdr158.short?rss=1

It can be done but you have to be really overweight for the surgeon to be able to take enough fat from your belly to add to make two full breasts. If you don't have enough belly fat you will not be able to get this procedure done.

Kareenie,I think I remember her saying the fat strips would be about 1 cm in width.Still Beautiful,I think you are confusing flap surgery with the fat grafting.Chinablue,fat grafting can be done to construct a whole breast,can be used in conjuction with implants,can be done with tissue expanders or the Brava or nothing as they have been doing in Europe.It can be used to correct lumpectomies or flap surgeries.Tinkerbell99,the Brava is not FDA approved medically and so insurance does not cover it.

pink- I was told our implants only last about 15-20 years.  It would be wonderful if they outlived as I'm planning on living until I'm a 100!  

tedwilliams- Thanks for all the new information.  I think it's wonderful that more and more surgeons are figuring out ways to utilize the fat grafting.

chinablue- I really wish they would come up with new terms for each different  type of fat grafting.  It gets very confusing for the patient.   Especially when there's so many different ways of doing it, different risks, different SE's and different results.  It's hard for a potential patient to compare apples to apples.   

Lee- We'll be the old girls in the rest home with the perky boobs!  (@)(@)

"We'll be the old girls in the rest home with the perky boobs! (@)(@)   " by Kate

You betcha!  With a glass of wine!