Has anyone had micro fat grafting?

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  • GointoCarolina
    GointoCarolina Member Posts: 753
    edited August 2011

    Jana,does your insurance cover the cost of the fat banking? I would think if you only have the lipo once, the following procedures are shorter?and easier recovery? When I saw Dr.Loomis,he was concerned about my scar tissue.For those of you with scar tissue and adhesions,did you find the Brava helped ?

  • tedwilliams
    tedwilliams Member Posts: 178
    edited August 2011

    Insurance did not pay....wondering if we could have turned it in for out of pocket expenses.  Need to check that.  At the time we were willing to pay the $1600 to avoid other surgical procedures. I believe there is a fee of $200 to continue the banking after one year.  

    The procedure on Thursday required only a mild sedation...like a colonscopy.  I was sitting up drinking tea 10 minutes out of the operating room.  And was dressed and heading to the bed and breakfast 20 minutes after that.  I was given a script for pain medications, but only took Tylenol.  I flew home to Texas on Saturday morning, made the drive from San Antonio to Center Point and picked up the 4 legged kids all on my own.  My sister was with me for the procedure and we had a sister weekend.  The recovery is much faster...today, Sunday, I am still slightly sore---feels like the soreness from an injection.   

    So far for me, the Brava is not pulling the adhesions away from the chest wall.  But the skin is turning pinker and getting softer.  I think that is happening for a cominbation of reasons, the fat cells, the Brava and its process, and my body just healing from all the treatments. 

    This is a learning curve and there are new techniqes being created by some very talented physicians.  They each will tweak the recipe just as we do in baking to make it their own.  I don't know what the success will be but feel there is a chance to avoid another major procedure.   I know that many of the major players in this procedure do meet and discuss processes and procedures.  There has been a fat grafting symposium in New Orleans for the last two years.  Dr. Khouri was a presenter. 

     Jana 

  • hrf
    hrf Member Posts: 3,225
    edited August 2011

    Since there is so much evidence that this system works, why aren't all the doctors jumping onboard. It sounds so much easier for everyone than having major surgery and certainly much less expensive

  • leeinfl
    leeinfl Member Posts: 317
    edited August 2011

    hrf - I have to go back and find the article, but I read somewhere that the reimbursement for surgeons isn't that great compared to "regular" reconstruction techniques.....I imagine the implant manufacturers aren't so pleased about this procedure either.  Just my 2 cents worth, but I've always said that if this was a cure for ED, it would be plastered all over the TV, magazines and internet!

  • hrf
    hrf Member Posts: 3,225
    edited August 2011

    Lee, I hate to agree with you but I do think it's a $$$ thing. The implant guys are going to make more money off those women who want to enlarge what they already do have. In comparison, I think we are a small group but money is money - I hate that medicine can be big business. 

  • mormor1
    mormor1 Member Posts: 136
    edited August 2011

    pandazankar -

    The Brava did pull out my stubborn scar (not quite sure if there were adhesions or not).  Dr. khouri had to work at a stubborn dent area, but eventually did get a nice shaped breast completed.  I think he uses a technique called Rigotti something...sorry to not have it right here.  He does a lot of needle pricks and it helps lift areas that might be dented in. I think it is so much better when women have the first fat grafting right after the MX is done....wish I had known about this then.

     Jana - fat banking sounds very appealing.  I think it would be easier for the surgeons too.  It all will get easier and easier as time goes on and techniques get perfected.  I think as more women find out about this, the demand will push MD's into doing it no matter where the money is for them.  Appreciate your realization that there aren't guarantees when we do things that are still being pioneered.  I feel very fortunate to have gotten good results.  I had never talked to anyone who had it done before...there was no message boards, no web site...It just intrigued me.  I was part of the original study.  Do you have any idea how many women have done the fat banking and if there are stats on retention yet?  Are you part of a study?  Thanks for keeping us posted on this interesting approach.

  • katehudson25
    katehudson25 Member Posts: 2,467
    edited August 2011

    Hi kate33 and wisconsinrandi,

    Thank you so much for letting me know. I will contact alexandra. Thank you both so much for your support.

  • katehudson25
    katehudson25 Member Posts: 2,467
    edited August 2011

    Hi,

    Does anyone know what other breast repair surgery there is after a lumpectomy, besides fat grafting? My surgeon is out of town till the 17th, and he is going to recommend a plastic surgeon. In the meantime I am trying to find out what my options are. I am still feeling very blue about my right breast being smaller than my left. I am small to begin with. My breast looked fine after my first lumpectomy, but the surgery I had Aug 1 was a wide-excision lumpectomy and more tissue was taken. 

  • Chicago1018
    Chicago1018 Member Posts: 147
    edited August 2011

    Hi ladies -  just posting this here too. . .an article about fat grafting and safety from web-md

    http://www.webmd.com/breast-cancer/news/20110729/fat-injections-safe-for-breast-reconstruction-after-cancer?ecd=wnl_brc_080911

     Jana - I think your doctor was named in here specificially.

  • tedwilliams
    tedwilliams Member Posts: 178
    edited August 2011

    Chicago1018:

    He was mentioned.  It is a learning curve just as many things in the world of cancer are.

    Jana 

  • jseda
    jseda Member Posts: 142
    edited August 2011

    Thank you for the information. Am happy for you. I will take the information to my appt but most likely it will be something that they'll consider down the road for those in need.

    Good luck

  • hrf
    hrf Member Posts: 3,225
    edited August 2011

    Five years ago it was a challenge to find surgeons who could do DIEP where it seems like the standard now. I wonder if the brava/fat grafting will catch on as quickly

  • katehudson25
    katehudson25 Member Posts: 2,467
    edited August 2011

    HI,

    Nobody answered my question, a few posts before this one. Does anyone know what other breast repair surgery there is after a lumpectomy, besides fat grafting?

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

    katehudson- Not sure there are other options.  When I was originally given a choice of lumpectomy vs MX I didn't even know about fat grafting.  No options were given to me at all.  Since I was quite small a lumpectomy was going to take about 25% of my breast.  (As it turns out final path report showed MX was the right choice, anyway.)  I do know a neighbor of mine ended up doing augmentation with implants to correct her lumpectomy defect.  You might want to post your question again under a lumpectomy thread if there is one.

  • katehudson25
    katehudson25 Member Posts: 2,467
    edited August 2011

    Hi Kate33,

    Thank you so much for letting me know.

  • katehudson25
    katehudson25 Member Posts: 2,467
    edited August 2011

    Hi,

    I feel much better after talking to my surgeon's associate today. Shesaid in my case we can do a breast augmentation for both breasts and a lift. Wahoo I am a small b and I always wanted to be a little bit bigger. She said with fat grafting there is a risk for calcifications. Calcifications on a mammogram is how I found out that I had breast cancer, so fat grafting won't work for me.

  • mradf
    mradf Member Posts: 398
    edited August 2011

    Hi katehuson25:

    Do a little more research on the safety of fat grafting before you dismiss it out of hand.  I'm thinking your surgeon's associate may have scared you unnecessarily.  Fat grafting has such pleasing results and has been determined to be safe for a very long time.  Fat grafting is not new. 

    Another option is allograft (AlloDerm or FlexHD, etc.)  I had a "gap" or a "valley" along my scar line and it smoothed that out.  For some small breasted women it's used as the sole reconstruction material, and it's used in many - if not most - post mastectomy implant reconstructions to help support the implant since all the underlying tissue has been removed. 

    Absolutely consult a qualifed Plastic Surgeon before you decide on any method as there are pros and cons to all; and the best plan for each woman is highly individualized.

    Best of luck to you. 

    Be well,

    Maria

  • hrf
    hrf Member Posts: 3,225
    edited August 2011

    I agree with mradf  There is a lot of research out there that says fat grafting is safe. It's worth checking it out further.

  • katehudson25
    katehudson25 Member Posts: 2,467
    edited August 2011

    Hi,

    Does anyone kinw if a breast augmentation with implants, and a lift is done brfore or after radiation?

  • cp418
    cp418 Member Posts: 7,079
    edited August 2011

    There are so many posts here - so maybe I missed it.  How do you go about finding a PS who is qualified-trained to perform fat grafting in your state?  Or is this procedure still in the beginning stages of catching on with patients and PSs?

  • katehudson25
    katehudson25 Member Posts: 2,467
    edited August 2011

    Hi mradf and Hrf,

    Thank you both for letting me know.

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

    katehudson- The downside to the implants is they don't last forever.  They need to be replaced anywhere from 10-20 years down the road.  You will have incisions and you coulod lose sensation in the nipples.  Like others have said I would do more research.  Usually the ones trying to talk patients out of fat grafting are the ones who don't do it in the first place.  The risk of calcification really depends on the technique the PS uses.  If they are injecting the fat in globs there is a higher risk of this happening.  When they inject it in drops, like Dr. Khouri does, the risk is quite small.  As far as overall risk of complications I would say it is higher with implants.  You can have ruptures, capsular contraction, etc.  Definitely do your homework and figure out the best option for you.

    cp418- Some have found their surgeons just by googling fat grafting + your city.  There is also another thread on here where women have been posting the names and locations of their FG doctors.  You could check on there as well as the Brava site.  The title of the thread on here is called "Microfat grafting or BRAVA doctor recommendations".  Where are you located? 

  • cp418
    cp418 Member Posts: 7,079
    edited August 2011

    HI Kate - Thanks!  I just saw the post you referenced on the list and will check it out. I'm located in NJ and if this is something I pursue --- was hoping to stay within the tri-state area.

  • tedwilliams
    tedwilliams Member Posts: 178
    edited August 2011

    Kate33:

     Well said.  I am working so hard to avoid implants for the very reasons you stated.  I found several articles about this subject.

    http://www.psnextra.org/Articles/Future-of-Fat.html

    http://www.bestofneworleans.com/gambit/fat-chance/Content?oid=1714507

    http://www.ktvq.com/news/fat-injection-for-breast-enlargement-may-hinder-mammogram1/

    Bottom line, do your research, don't rush into a decision, find a surgeon you believe in and trust. This is your journey and you need to be in control.

     Jana 

  • katehudson25
    katehudson25 Member Posts: 2,467
    edited August 2011

    Hi Kate 33,

    I definitely will do more research. The only surgeon I have spoken to so far is my surgeon's colleague. My surgeon is out of town, and I have an appiontment with him Wednesday. He will refer me to a plastic surgeon. So I haven't even discussed this with a plastic surgeon yet. I live in the Los Angeles area. Do you know a plastic surgeon here? Thank you so much for your advice. 

  • kareenie
    kareenie Member Posts: 339
    edited August 2011

    Katehudson25 - Your radiation should be finished before you even consider any reconstruction method.  Depending on how much damage the radiation does it might affect what reconstruction can be done.  Implants after radiation can be problematic.  The beautiful thing about fat grafting is that it actually reverses the radiation damage.

  • katehudson25
    katehudson25 Member Posts: 2,467
    edited August 2011

    Hi Kareenie,

    Thank you for letting me know.

  • katehudson25
    katehudson25 Member Posts: 2,467
    edited August 2011

    Hi Kareenie,

    Thank you for letting me know.

  • tedwilliams
    tedwilliams Member Posts: 178
    edited August 2011

    My plastic surgeon and radiation oncologist consulted with each other before my mastectomy and prior to radiation.  I really appreciated that they were willing to work together for my best interest.  

    My radiated skin is the major player in my reconstruction, deconstruction and now remodel.

    Jana 

  • katehudson25
    katehudson25 Member Posts: 2,467
    edited August 2011

    Hi Jana,

    Thanks for letting me know. I have not chosen a plastic surgeon yet, but when I do I will have him consult with my radiology oncologist.

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