Has anyone had micro fat grafting?

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  • mtks
    mtks Member Posts: 190
    edited June 2011
    MBJ- I just wanted to thank-you so much for making me feel better about the surgery/FG that I am about to have. I have to admit, I was leery about the traditional FG but after seeing you-you have given me a better outlook on wants in store for me. YOU look sensational! If my results are anything like yours-I'll be very happy!! Thank-you for all your help!! It can be very frustrating at times-not knowing what is the right approach about so many things in this reconstruction journey. It is valuable to have you and others for emotional & moral support on this board. Where would I be if it weren't for you and others?..... Thanks!!:)
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  • Tinkerbell99
    Tinkerbell99 Member Posts: 243
    edited June 2011

    This pisses me off... The Brava unit is FDA approved to make larger boobs, but NOT for us?? U wld think it'd b the other way around!!

    So this procedure NOT using BRAVA for & gals who have implants is still called fat grafting or lipofilling? I wanna b cOrrect in using the terms when I c my PS on Mon. For the gals who have implants & have had it done, has anyone had this done after u already had the implants? Do u c a difference in where they took the fat? Do ur foobs feel warmer or do u have any sensation ?

    I learned a "new trick", for when I don't have pockets N I always have my phone handy to put it inside ur "bra"... Well this is great... Except for when ur phone moves... I had NO feeling where it moved... I went to get it N realized it was 1/2 way down my foob!! Lol. Now I keep it part on my foob N part on my chest where i have feeling!! Lol. Anyone else put their phone there?

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  • Tinkerbell99
    Tinkerbell99 Member Posts: 243
    edited June 2011

    Have another question.. Do u gals think that NOT many dr's do this is a similar situation w/ the 1 step!!! I know had a hard time finding one... Thx to another member on BCO they helped me find one.. Not saying I'm happy w/ my outcome b/c I'm not & often wonder if i wld have been better off w/ the TE?

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  • alexandra-aaa
    alexandra-aaa Member Posts: 50
    edited June 2011

    Hi Tinkerbell99, I'm Alexandra from fatgraftpatients.com.

    Just wanted to clarify - BRAVA was invented by Dr. Khouri 10+ years ago. It's FDA approval is not for cosmetic OR reconstruction when used as a medical device. Meaning as pre-expansion prior to fat grafting, whatever the reason for fat grafting. 

    BRAVA was used for over ten years to slowly expand the breasts externally (worn for 10+ hours/day for 10-20 weeks). It causes significant swelling that eventually results in permanent growth (you can read more about it at mybrava.com).

    It's only about 6-7 years ago that Dr. Khouri thought to use the device to pre-expand the breasts prior to fat grafting (again, whether cosmetic or recon). It was known that aside from the permanent growth it caused over longer periods of time, it created the "fertile matrix" that Lee has referred to throughout this topic. It creates the new blood vessels that allow the transferred fat to survive much better than without it. That's why it's worn both before and for a few weeks post-op.

    Pretty much all the surgeries being performed with it now are technically considered to be a part of the ongoing clinical trial (you can read about it at clinicaltrials.gov - just search "BRAVA" and it shoulld be the 1st or 2nd result). It's also why any other surgeons need to get approval for their patients to be a part of the study.

    BRAVA is currently waiting FDA approval as a medical device to be used in conjunction with fat grafting (for whatever reason). It's current approval is only for it as a cosmetic device unrelated to ANY surgery. Definitely check out mybrava.com - it will give you more of a background as to its use this way.

    Hope that helped to clarify.

    Alexandra

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  • leeinfl
    leeinfl Member Posts: 317
    edited June 2011

    Nice explanation Alexandra - thanks for clarifying

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  • MsBliss
    MsBliss Member Posts: 536
    edited June 2011

    Dear Pinkbutterfly,  Yes, you are right that rads is the standard after lumpectomy....I had two lumpectomy surgeries; the primary surgery which was for tnbc, then a second one for a dirty margin which had high grade DCIS.  I didn't do chemo because of secondary health issues, and then, I had a hot spot, which required a second biopsy; then came some bad liver numbers which needed to be settled.  By the time all of the delays accumulated, it was too late to start chemo (which I couldn't do anyway) and rads was so delayed that the benefits were too diminished to go through with it.  My surgeon nearly punched me in the face when he learned I had not done rads! Wow, he was so mad.  He practically insisted on booking me for a mx....

    Edited for spelling....

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  • MsBliss
    MsBliss Member Posts: 536
    edited June 2011

    Dear Tink, Probably not a great idea to have your phone next to your chest wall.  Remember, some cell phones put out a lot of EMF and your upper structure has been through enough!

    Edited for grammar....

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  • MsBliss
    MsBliss Member Posts: 536
    edited June 2011

    Climbergirl, yes, any fat necrosis is an issue, primarily with standard fat grafting, but in this case, this wasn't the concern.  The major concern is the biological events that are part of using a stimulating device like the Brava along with the action of grafting fat cells into the native tissue.  After a mx, it is not really an issue because there is so little native tissue present.

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  • MsBliss
    MsBliss Member Posts: 536
    edited June 2011

    Kate33, I'm so sorry I wasn't clear about what I meant by "overselling"....I was talking about my visit to Dr Khouri's website and my subsequent conversation with his office.  But clearly, this only applies to the very fewest of patients like myself.  But, I am not in worry mode with regard to my lumpectomy with no rads....not at all.  In fact, for my particular case, it was probably the best way to go.  If I decide to do some sort of recon it will probably be with implants because since they would be put in submusculary there is less poking around near the old tumor bed or in the native breast tissue in general.  Had I had a mx, I think I would def go for the mfg....no doubt in my mind.

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  • Anonymous
    Anonymous Member Posts: 1,376
    edited June 2011

    Alexandra-AAA,

    (not anymore, I've seen your pics!)

    Do you know if the Brava is CE marked ( i.e approved in Europe)?

    MSBliss,

    I am so sorry to hear about all you have been through. I hope that they are going to keep a VERY close watch on you.

    MBJ,

    Did you have whole breast recon using FG? Have not come across anyone who has. Can you share with me where I can see your pics?

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  • Anonymous
    Anonymous Member Posts: 1,376
    edited June 2011

    Lee, thanks for posting the link. It's the "longer follow-up and oncological experiences" part that I struggle with. For this reason, I can imagine that FDA approval may take a while. I wonder, though, are these studies already underway?



    Alexandra, do you know?

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  • MsBliss
    MsBliss Member Posts: 536
    edited June 2011
    Dear Sandy,  I agree with you about the free exchange of information about potential wonderful treatments.  But as I wrote to Kate, I never meant to imply that mfg was being oversold by our "enthusiastic" forum members--I was talking about Dr Kouri's website and my conversation with his office...and then I qualified my statement by explaining that I am probably a nation of one--a slightly different case.  I am very thrilled with the options offered by mfg, just that there are a few caveats that may apply to the odd case or two that has not had mx. 
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  • MBJ
    MBJ Member Posts: 4,352
    edited June 2011

    Pinkbutterfly:  Pm me for access to the picture forum or to see my pictures.  I had implants plus standard FG, not micro FG.  I am hoping to direct my PS to micro so I can have this sometime down the line as it is a better procedure but not available to everyone yet.

    mtks:  You are very welcome!. 

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  • Tinkerbell99
    Tinkerbell99 Member Posts: 243
    edited June 2011

    @ Ms Bliss whats EMF N how does keeping a cell inside my "bra" hurt my foobs?

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  • Tinkerbell99
    Tinkerbell99 Member Posts: 243
    edited June 2011

    Kate, I PM u already, but for any woman that had FG w/out the BRAVA system....id love to know more.  I cannot afford OUT OF POCKET expense  I cannot go to FLA..:(  maybe another time..so like many of u, money is a concern.  I am seeing my PS surgeon again tomorrow for a "pre-op" appointment & just like my very 1rst appointment i had w/ him when i had the 1 step w/ allorderm don a yr & 1/2 ago..i want to be prepared w/ questions & know what i am talking about.  he was so surprised how knowledgable i was about all this.  Thank you to all the women on these disscussion boards who have helped me thru all this.  My left implant is off tot he side & he said this time when he fixes it (he "fixed it" 1x already) he will use more allorderm to move it over & keep it in place.  I have a large "clevage" area between both foobs.  He is NERVOUS to touch the rt one b/c after my surgwery last yr, i devloped cellulitis.  I healed fine, accept the right one has dropped & i have pain above the rt implant b/c its bone N skin.  I want him to move over both & give a lift. I want him to do the MFG to fill in all the boney areas & the ripples....i know..noone sees them except me..but i want them "perfect".. or as close to perfect as they come. Nobody can tell except me that i do not wear a bra....but i KNOW!!!! it just bugs me b/c PS are supposed to b perfectionists & make it all look beautiful...ok enuf rambling..just wanna get my "facts" straight b4 tomorrow....if there is a site that anyone can refer me to that explains theis procedure w/out using the BRAVA & having implants in place would be so helpful b4 tomorrow.

    thx & hugs

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  • kareenie
    kareenie Member Posts: 339
    edited June 2011

    Tinkerbell -- Both Leeinfl and Kate33 had microfat grafting done by Dr. Khouri with implants and no Brava. He replaced their previous implants with smaller ones and did micro fat grafting over the new implants. They both look great. Lee had your exact problem -- implants moved off to the side and bony area where there should have been cleavage.

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  • Tinkerbell99
    Tinkerbell99 Member Posts: 243
    edited June 2011

    ok ladies..went to my ps today & it turns out what he has done 2x already is MFG..wow!! little did i know....the only problem is i still have to much width in between my foobs..so ....surgery is set for begining of Aug & he is gonna replace what i have for larger ones to help fill the void more & then do more MFG all arnd..so i am praying!!! Maybe one day in the nearer future the Barva system will be covered by insurance!!! Thx $ everyone answering all my questions!!!

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  • MBJ
    MBJ Member Posts: 4,352
    edited June 2011

    Tinkerbell:  That's great news!  Who is your dr. and where is he?

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  • kareenie
    kareenie Member Posts: 339
    edited June 2011

    Tinkerbell:

    If he is harvesting fat with a tiny needle he is not using enough fat.  He should be doing liposuction to harvest the fat and should be able to inject 150 cc per breast and put a smaller implant not a larger.

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  • leeinfl
    leeinfl Member Posts: 317
    edited June 2011

    Have to agree with Kareenie - why would he have to go with a bigger implant?  The idea is to have more of your own natural tissue, not more of the implant. 

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  • Anonymous
    Anonymous Member Posts: 1,376
    edited June 2011

    Tinkerbell- Just wanted to let you know that what your PS is proposing is completely opposite of what Lee and I had.  Our PS, Dr. Khouri, would put in a smaller implant not bigger, and then use that space to place the fat.  When fat is just injected without doing this usually only about 50% is retained afterwards.  For Lee and I it was more like 90%.  If you're happy about a bigger size than, by all means, go for it though!  I personally wanted to stay the same or smaller so definitely did not want a larger implant placed.

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  • MBJ
    MBJ Member Posts: 4,352
    edited June 2011

    I have a question:  Does Dr. K ever keep the implant and just add FG?  My MX side is smaller and it would be great it micro FG could fill in the front area that's cold and even up my breasts.

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  • leeinfl
    leeinfl Member Posts: 317
    edited June 2011

    MBJ - Initially, Dr. K was going to do just that in order to fill in my dent, but since I had a lot more going on, we went for the total re-do.  I'd email him photos and ask.  Hope he can even you out!

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  • MBJ
    MBJ Member Posts: 4,352
    edited June 2011

    Lee:  Do you have a ballpark idea of what this would cost?  I would have to pay out of pocket!

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  • leeinfl
    leeinfl Member Posts: 317
    edited June 2011

    MBJ - sorry, no idea.  Dr. Khouri is in network so I only had to meet my deductible.

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  • MBJ
    MBJ Member Posts: 4,352
    edited June 2011

    Thanks, Lee!

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  • Tinkerbell99
    Tinkerbell99 Member Posts: 243
    edited June 2011

    Kate, I know it's opposite of what u had. When I 1rst had surgery, I asked for a "small" implant. I was a DD & had a reduction yrs ago & went down to a C. I hated being "big". It hurt. I didn't know that the implants wld have little progection. MY BS really cut out all tissue & he showed me where my muscle is. He said & showed me abt movin over. I wish I cld explain it better... But going to a larger implant & the MFG shld make things much better. He explained what he did in the past & it was what MFG is explained in every article I have read. I just don't explain things correctly!! Lol. I am praying that this will work. I see my BS Monday & go for my 1rst fitting too!! So i will explain to her what he said & we'll go from there. I have to trust him. I don't have the support to travel to another dr for other opinions & for me to go to them. I wish I did... I also don't have the money. I wish I cld see dr K & pay for the BRAVA!!



    MBJ (sorry if I'm getting ur initials wrong)... My Dr is in MD & his name is Guy Cappincino. He is really nice & has been really patient w/ me thru this all! After my surgery last yr I developed cellulitis & was hospitalied... Then I developed a PIC line infection & while in the hospital my veins kept bursting when they gave me IV!! I was a mess & in agony!! I've come a long way since then & my dr really has been so understanding. I can be a Bi**h when I am NOT happy & in pain!! He even told me to get a 2nd opinion last yr when I was so unhappy... He said maybe he's missing something... The other dr agreed w/ him!! Not many dr's do that!!

    Well I've rambled on long enuf!!! Have a gr8 nite all!! Thx 4 all ur support!!

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  • kareenie
    kareenie Member Posts: 339
    edited June 2011

    MBJ - reconstruction revisions should be covered by your insurance. Why would you have to pay out of pocket?

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  • MBJ
    MBJ Member Posts: 4,352
    edited June 2011

    kareenie: My insurance is only good in the state of california under MediCal :(

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  • dustylady
    dustylady Member Posts: 37
    edited June 2011

    PinkButterfly....

    You asked if anyone has had MFG for complete reconstruction...Yes.  I had a BMX about a year ago (June) and started my MFG process in Sept., with Dr. K.  He completed my R breast in two MFG sessions (about a C cup).  My L had radiation about 18 years ago, so it is taking a bit longer.  Photos are on the fatgraftpatients.com website.  I am so happy with my results.  Right now, they are not symmetrical, but am sure they will be when Dr. K is finished.  I am planning to add some photos with prosthetic nipples included (from NaturallyImpressive.com), so the full effect can be appreciated.  But with the current photos, you just have to use your imagination about the nipple!

    I was not even going to have recon, because I didn't want implants, and flap surgery sounded like too much for the result I was probably going to get.  I am SO glad I learned about Dr. K's procedure!

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