Has anyone had micro fat grafting?

Kate - well said!  I might add the following as far as costs go:  I pulled out my itemized statements. My initial PS charged $9680 for my TEs and implants. That is not including the $2772 for the bilateral nipple reconstruction. So despite the enormous difference between these two procedures, the costs were pretty much the same.  Obviously these do not include hospital/surgery center use or anesthesiology services.

I wholeheartedly agree that it is a shame insurance limits our choice of doctors and procedures.  Like Kate said, we should be questioning the plastic surgeons who are content with continuing to do flap and implant surgeries and not offering this much less invasive alternative that promises much better results.  I'm sure it's a lot faster, easier and probably much more lucrative to throw in an implant!   

Barbara- I hear your concern and that was pretty much the reason I "bit the bullet" and traveled to Miami to have my revision done with Dr. K.  I figured if I was going to do it I wanted to go to the one with the most experience.  I have heard that some doctors have attended multiple workshops of his.  (Dr. Lauren Greenberg of Palo Alto stated that on her site I think.)  I do think his seminars are extremely well attended.  Also, on surgery days he has many doctors observing.  A member on here just had her surgery and there were 10 visiting doctors that day alone.  I guess if someone can find someone trained in Dr. K's method (which isn't so easy, either) they would have to decide if they want to be one of their first patients or not.  I suppose at one time or another some brave women decided to be someone's first patient and that's how things improved but it is a scary proposition, though.  I think I'd definitely question how many surgeries they have done and their rate of success as well as ask to see before and after photos.

kate33 ,which abreviations are you having trouble with i will try to explain,thanks

Micro fat grafting can be done without using the Brava system. I just found a published paper from Italy using the same fat grafting technique as Dr. Khouri....but not the Brava nor implants. It was very successful.



Insurance is not an equal opportunity....each company has it's own guidelines as to coverage. Many are lucky to have great coverage but many also do not. Sucks.....we should all be able to get the best of care. Unfortunately federal law does not mandate only the best get to operate on us.



Jana

Binga ,Ted williams and lalisa ! AMEN

Perhaps it's an oversight, but Dr. Trott does not list this type of Fat Transfer on the 'Breast reconstruction' page on her website.

Ladies,

Feeling for those of you wanting to do this, but finding obstacles.  I am quite sure I wouldn't have done it if I knew ahead of time how much it would cost and how many procedures it would take!  Would seem way too overwhelming!  Somehow, it all worked out though.  Kind of like raising kids...have no idea how we got through raising five kids on a very small income, but we did!!  My DH handles the finances...we just live very simply..old house...old cars...no frills.  Our insurance covered pretty well...still cost a lot though for traveling and all...no frequent flyer miles. 

 For those of you who just want small breasts, this is a GREAT approach!!  You probably will just need one round and one set of BRAVA, so it would cost a lot less.  There may be some MD's who would do it without Brava.  Some MD's at the conferences have said Brava is needed for more than 150 cc's of fat.  The nice thing about the fat grafting approach is that you don't get a "tennis ball" effect.  The shaping and sculpting are so natural and lovely.

 Dr. Khouri is very actively training MD's.  He has fat grafting trainings twice a year...usually October and February.  This October it is going to be a webinar.  He always has MD's in training with him.  He has expressed that this is a very simple procedure...much less complicated than flap surgeries (which he had also done for many years prior to fat grafting).  The great thing is that, there isn't much risk of complicationns, so even if you have an MD do it that is fairly new at it, you aren't at great risk of problems.  There is somewhat of an art to it though and Dr. Khouri is an artist in shaping lovely breasts.  Wish there was a nice easy way to find out who is doing this in different parts of the country.  I know there is a thread listing some MD's on bc.org.  I need to add a couple I heard from a good source that do it on the West Coast.  I am quite sure Dr. Chris Nichols in Tacoma, WA is doing fat grafting for breast reconstruction also.  I believe it is a very transferable skill, though there is an art element to it, as I mentioned.  Wish there were better resources too at Dr. Khouri's office to help with insurance type questions.  These things are important in making decisions.

 Keep hope!  I believe this option is growing and eventually will come to a PS near you!

makingway- I believe Dr. Greenberg is just now taking patients for the fat grafting recon so that's probably why it hasn't been added to her site.  But she does talk about it in her blog if you scroll back a little ways.  

wisconsin- Thanks for all the great info.  It's nice to hear it is a simple (and hopefully easy to learn) procedure.  I think this will make a lot of women feel better about going to someone other than Dr. K.  Having done it I know that his office is not the easiest to get to for many.  I think your post will give hope to many.  If you need the link to the thread where you can post FG surgeons I'll include it here-

http://community.breastcancer.org/forum/44/topic/769795?page=4#idx_97 

For LA girls: my lymph massage therapist who hears EVERYTHING since she works with bc patients, told me yesterday that Dr Barbara Hayden (mentioned in this thread) only operates once a month. If anyone sees her, be sure to ask questions about how often she does the procedure, or any reconstruction procedures.

Thank you so much Kate33 for the thread.  I saved it now for future reference and finally did get a few MD's posted on there.  Someone told me they had fat grafting through Dr. Ferguson in Utah and I am quite sure Dr. Chris Nichols in Tacoma, WA is doing fat grafting, but you'd have to check for sure.  I think Dr. Greenberg is an exciting new option for the West Coast. 

 Thank you Beacher, so glad what I shared was helpful.  Part of what I think has been sensed as defensiveness about Dr. Khouri is that there is such an intensity about the experience.  His enthusiasm is contagious and he gives so much to his patients that it makes us want to stand up for him.  He is the originator and he does excellent work, we are confident of that.  There have been some articles indicating not everyone has had such good outcomes as he has had.  Not everyone uses the same approach...and that may be fine. But you should check carefully on what you would be choosing.  I think tedwilliams experience is very intriguing.  It isn't that everyone HAS to go to Dr. Khouri (Lord knows, he is already doing the workload of several surgeons, in addition to his specialty of hand surgery!).  From reading her blog, I would fully trust someone like Dr. Laurel Greenberg, even if she isn't as experienced.  Many plastic surgeons are wonderful artists.  If we could get another dozen trained surgeons out there around the country, it would make options so much easier.  Just be sure you check on insurance in each state though!!  It should be coded breast reconstruction, other and not say anything about lipo in it!   I sometimes have access to inforamtion on who is doing fat grafting through our nipple prosthesis clients.  Will keep you posted if I hear of others...and it's fun to hear from all of you!  Thanks for your input Lallisa and welcome JLK!

I saw Dr Trott. I really connected with her and found out that she trained in July '10 in Miami for 2 days in the OR with Dr K. I believe she is one of the most knowledgable and experienced Drs in the area. She follows Dr Ks protocol and has done TONS of research. She really loves and believes in the procedure.

Another interesting thing about Dr Trott is that her specialty is lipo. And the more I think about it, the more I realize that this is very important. I don't want any indentations or weird contours from the lipo.

Still thinking it over, but will probably start with the Brava when I get back from a business trip mid October.

Wisconsin, thanks for the advice about the insurance- code it breast recon and say NOTHING about lipo. I will pass that on to Dr Trotts office.

Hi Eileen-a few weeks back I had a noticeable dent/compressed area on one side--my PS said if it did not soften up (it did) he would do some fat grafting (he raised that option, I didnt ask). There are some ripples now and we will be discussing pocket tightening but it seemed like fat gratfing was definitely in his bag of tricks. Not sure if he just uses it to correct small areas, but I think he is terrific and perhaps worth a call...Mark Sultan (Park Ave and 89th St.)

Ilene (spelled the other way)

Dr Trott does use the Brava. She told me she follows Dr K's protocol. She has been doing the procedure for about a year, with I think about 4-5 patients? I did not ask for an exact number, but she talked about different cases and showed me photos, some augmentation and some reconstruction.

Her office takes insurance, which is pretty amazing- my experience is that many recon PS in LA do not. The Brava is not covered (it is not FDA appoved) but you can get one through her office at about $900, I think?

Lalisa, My appt. is on Thursday,and now i am even more excited! Thanks so musch for sharing your experience. So you are thinking mid October,thats wonderful.....I will let you know how my Thurs. appt. goes Take Care

Just got off the phone with Cindy at Dr. K's office...she was very helpful. I am considering participating in the Brava Clinical Trial, for which they are recruiting. The Brava costs an additional $550, with the need for additional domes costing a further $300. There is also a consult fee of $150. I was told that I'd need 3 grafts, maybe more depending on what I want. I was surprised to learn that these procedures are done under a general anaesthetic, although she said I could speak with Dr. K. about this. Was anybody else put out every time they had a graft?

TIA,

PLJ