Has anyone had micro fat grafting?

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  • EileenKaye1
    EileenKaye1 Member Posts: 469
    edited September 2011

    SusansGarden

    I am also interested in having implant with fatgrafting at the present time.

    Seems to me that it will be more perfected in the future--and would also be looking forward to complete fatgrafting the future. 

    My BC was almost 15 years ago.  We have seen amazing strides from PS.  Alloderm helped me considerably.

    Sounds promising for all of us.

    Lets try to keep our PS up-to-date--with new, better proceedures and more esthetic outcomes.

    With many hopes for the future.

    Eileen

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

    I have talked to Dr. Khouri before I decided on my plan. I am doing implants, but my ps does micro fat grafting to correct issues. He has talked to women at the PS seminars. Some love it, some did like like the length of time everything took and said they wouldn't do it again. Some had the fat transfer not take? Not sure on how this works. Maybe it absorbs into your system?

    If I remember correctly, Dr Khouri told me that for recon with fat grafting, small is the best, like a B range.

    I thought it sounded great, but there is no one in Indiana according to him, although he said he had a friend at the med center that he thought would work with him for training and do it.

    I am hoping that in 5 years, if I should need a replacement, I will be able to pursue this avenue then. I didn't want to have to travel a long way with no support system.

  • Anonymous
    Anonymous Member Posts: 1,376
    edited September 2011
    PLJ ~ I have to have general anesthesia for each fat grafting session. And I am just having a little in to help the aesthetics of the implants.   I believe that is standard.
  • leeinfl
    leeinfl Member Posts: 317
    edited September 2011

    PLJ - Yep, everyone I know was put under.  I really wouldn't want to be awake for the lipo part of this.  He prefers general anesthesia - it's usually just a 2-3 hr procedure. 

  • PLJ
    PLJ Member Posts: 373
    edited September 2011

    Thanks, ladies. I guess it was just the way things were worded on their site. (Click on Breast Reconstruction after Mastectomy and read under 'Benefits of Dr. K's Procedure...') I had something called conscious sedation for gastroscopy and biopsy several years ago. They didn't put me out but I don't remember a thing. Regardless, mfg is exciting and definitely the future of breast reconstruction!

  • Crescent5
    Crescent5 Member Posts: 442
    edited September 2011

    I'm still on p32, but I had to pause to thank pandazankar for the list of co-investigators. My presumptive PS was at the top of the list in my state. Dude never mentioned MFG when I met with him in Jan! (I'm considering PBX NSM). The 2nd PS I met with wasn't on the list, and he advertised as a BRAVA specialist (said full breasts couldn't be done yet). The list gives me more names to meet with. THANK YOU!

    Thank you all for your experiences, and a special shout out to Kate33 who was the one who let me know about NSM. This thread gives me so much hope!

    Yay!! One of the docs on that list is a woman. I think that might make a difference since the 2 yahoos I've met with don't really get why I don't want to look like I'm wearing jelly donuts under my skin.

  • christine47
    christine47 Member Posts: 1,454
    edited September 2011

    I am having fat grafting and nip recon on thursday.  I have implants and PS is filling upper pole on one side, small divet and under arm.  I am so excited, he did not train with Dr. K,, but seems confident in what he is doing.  He told me several sessions might be needed.  I am having general anesthesia and he told me 4 hrs.  I will let you know how it goes.  Getting very excited and a bit nervous.  Love the thought of technology allowing for eventual replacement of implants with FG.

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

    Crescent- Jelly donuts are never a good look!  LOL!  Good luck with everything!

  • mormor1
    mormor1 Member Posts: 136
    edited September 2011

    I wonder if this is the longest thread ever on this site!!

    So excited for you Beecher and lalisa!!  I invite you to join us at fatgraftpatients.com forum for support and tips along the way.  We would love to hear your experiences with these PS's and fat grafting breast reconstruction.

    SusansGarden - Thank you for the confirmation that Dr. Chris Nichols does fat grafting, though sounds like he doesn't do it for complete breast reconstruction...yet.  

    On the insurance...it should read "Breast Reconstruction, Other"  with no mention of lipo is how I was told.

     As far as being put under general, that is definitely the norm with Dr. Khouri, though I believe some of the literature says it is done under local.  There might be exceptions...I did have a minor done once under local, but unless you have an extremely important reason not to do general, would advise going with general.  Dr. Khouri told me it is better to have someone dedicated to the anasthesia.  There is a limit to how much local anasthesia can be given and you wouldn't want to have the job half done due to that limitation!   I am no expert though.  Guess it's worth asking about if it is important to you. 

  • tedwilliams
    tedwilliams Member Posts: 178
    edited September 2011

    By banking my fat, I had one surgery to collect the fat and have light sedation for further grafting. A surgeon in Italy successfully reconstructed a large breast with just fat grafting. It took 9 sessions, and the results looked great in the photos. I sent my surgeon the paper and asked how we can accomplish the same....no implants and no Brava.



    I have had two grafting so far and see great improvement in my skin. There are still sections of my skin stuck to the chest wall but they too are beginning to soften.



    Jana

  • makingway
    makingway Member Posts: 799
    edited September 2011

    @PLJ- The Brava clinical trial doesn't eliminate the cost of the surgery. I just called Cindy at Dr. Khouri's office and she confirmed this for me. It's still $10,000.00 for each surgery.

  • PLJ
    PLJ Member Posts: 373
    edited September 2011

    Thanks, makingway. I figured that it would be too good to be true to have a hospital donate surgical blocks for this clinical trial. Will have to see how much my insurance will cover. 

  • Lesley32
    Lesley32 Member Posts: 13
    edited September 2011

    I had a phone consult with Dr. Trott this afternoon. I was told that she wouldn't use the Brava on me, if I went with fat grafting, because I have a TE in place. Instead, she would leave the TE in and reduce the volume with each fat graft. I really enjoyed talking with her and will probably try to set up an in-person consult.

    Yes, I think general anesthesia must be the norm because Dr..Trott asked me about my past responses to it.

  • makingway
    makingway Member Posts: 799
    edited September 2011

    Good to know JLK. Thanks for sharing your experience with Dr. Trott. That sounds like the way to go. Does she use the Brava with other patients? How many has she done using Dr. Khouri's procedure?

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

    Just wanted to share that I am trying to compile a datebase of surgeons who are offering fat grafting as it seems hard to locate them.  There is a thread on here about this but I've been trying to email each physician to find out exactly what type of fat grafting they offer and how they are using it in their practice.

    I recently emailed Dr. Lawrence Koplin in Beverly Hills.  He personally emailed me back and was very informative and helpful.  He is using fat grafting primarily to augment reconstruction (to cover implants when you have thin skin) but is also creating entire breasts for those that want to stay fairly small.  He has been researching and performing fat grating since 1985.  He seemed genuinely kind and caring and is willing to answer any questions someone may have through email or consult.

    His website is drkoplin.com.  I am going to post more information on the thread "Microfat grafting or BRAVA doctor recommendations". 

    I think if I decide to continue with additional rounds of fat grafting he will be one I would definitely consider going to as he is so much closer to me than Dr. K in Miami. 

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

    Jana-

     How do you bank fat?

  • tedwilliams
    tedwilliams Member Posts: 178
    edited September 2011

    Fluffqueen01:

    During my procedure in March, extra fat was collected and placed into containers provided by the storage center....Biolife Cell Bank in Dallas, Tx.  The fat was sent by FedEx to the facility where is was frozen and stored.  In Aug., I flew to New Orleans for round 2 of grafting.  The fat was shipped again by Fed Ex and arrived at the surgery center right after I did.  It took about an hour to prep the fat for injection.  

    My sister just mailed a news article about a doctor from Orlando, FL who is also banking fat for future procedures. In the article there are pros and cons.  One concern is whether the body will accept this fat....so far mine has with no problems.

    The cost for me was $1600 for the first year, and $200 after that.  I am in the process of developing a plan with my surgeon to do the fat grafting for total reconstruction without an implant and without using the Brava.  Due to radiated skin issues my fat grafting has had a few more twists and turns.....but this has been done in Italy with success.  The upside to banking is less OR time for future harvesting and less anesthesia for the subsequent grafting.  The second time, he used a light sedation and I was having lunch and shopping several hours later.

     

    Jana 

  • dancetrancer
    dancetrancer Member Posts: 4,039
    edited September 2011

    That is really cool Jana!  Thanks for being a pioneer on the fat banking aspect and sharing your experience! 

  • beacher4209
    beacher4209 Member Posts: 540
    edited September 2011

    i posted on" microfat grafting or brava dr recommendation" about mu consult yesterday with Dr.Trott!She has studied under Dr.Khouri and very involved with the procedure .Loved her

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

    That is so cool. My PS is young and has not done any complete fat grafting reconstructions. He does do fat grafting around implants and armpit area to fill in and reshape. He says as long as it doesn't absorb or the tiny bits turn hard, it is great. If they harden, the MRI/mammogram people sometimes see it as looking suspicious.

    He said I have one area that he may have to do some revisions to after I get the implants but will know more after it all settles.

  • Lesley32
    Lesley32 Member Posts: 13
    edited October 2011

    Saw my local PS today. She has looked into fat grafting but is also concerned that calcifications will result in false positive readings on a mammogram. However, the papers that I have been able to find on line seem to indicate that this isn't really a valid concern. I wish the surgeons would come to a consensus on this!

    For those of you who have had fat grafting, what did your PSs have to say about this? 

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

    JLK- For those of us who have had MX would we even have mammograms anymore?  I know my BS said they are no longer needed.  As far as the calcifications it really depends on the type of fat grafting the PS is doing.  Some just inject the fat in "globs" and this does have a higher incident of calcifying.  Others, like Dr. Khouri, inject it drop by drop and with this method the chance of calcification is much lower.  If calcification happens it would feel like a tiny hard bump which, of course, would be scary to a former BC patient.  That's why I would look for a surgeon who does the second type of FG.

  • Lesley32
    Lesley32 Member Posts: 13
    edited October 2011

    Hi Kate, I did wonder about that. I have chemo today so I will ask my oncologist what her views are on the subject.

  • leeinfl
    leeinfl Member Posts: 317
    edited October 2011

    My oncologist said I do NOT need any more mammograms.  She knows I had micro fat grafting (said it was the best reconstruction she's ever seen) and had no concerns whatsoever.

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

    robo- Lee has implants, too.  (Just thought I'd chime in since I know the answer!  lol!)

  • leeinfl
    leeinfl Member Posts: 317
    edited October 2011
    Smile thanks Kate!  yep - I have 300cc implants plus FG.
  • EileenKaye1
    EileenKaye1 Member Posts: 469
    edited October 2011

    Leeinfl and Kate--I viewed both your photo's.  All I can say is fabulous.

    I am presently researching for implants with fatgrafting--but in New York.

    You are both quite an inspiration.

    Eileen

  • mormor1
    mormor1 Member Posts: 136
    edited October 2011

    Regarding calcifications....I still do have mammograms on the right side (which had some fat grafting augmentation).  The last time, they wanted to take more pictures as they said there was some calcifications (not what I wanted to hear!), but after he took the second set, he told me he is just super cautitous but it was evident that these nice orderly spots were benign, similar to what happens with trauma to the chest area, not at all like malignant calcification looks. 

    I did have the CD sent to Miami and Dr. Khouri had some radiologists who are used to reading mammograms where fat grafting has been used look at it....said that was normal secondary to fat grafting.  All looked good.

    I will be getting another memmogram in November, am not really concerned, but it will be nice to have confirmation that all is well.  I did used to have some little pea size bumps at injection sites, but they have gradually resolved....have a couple left.  I try to just be aware of what my baseline is (sittin at the computer checking it out as I write!!  aren't we so wierd?...like some of the FG ladies said, at times we just have to grab at our chests to be sure they really are still there.  After three years, I'm finally convinced they are here to stay!  Love it!). 

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

    Eileen- I was going to post this on the dr. recommendation thread but wondered if you have heard of Dr. Sydney Coleman?  I was just reading about him and couldn't remember if he's been mentioned on here before.  He is in New York, NY (Tribeca area).  HIs website seems impressive anyway and he's board certified.  You can check it out at lipostructure.com.  He does the fat grafting but not sure, yet, if he does whole breast or just augments implants.  I have an email into his office and will post his response.  He also has a partner in the same practice who does the fat grafting- Dr. Alesia Saboeiro.

    wisconsin- Just found this site- lipoenhance.com- where they show fat grafting results 6 and 7 years out.  So encouraging to see results like that!  

    (BTW, the offices which are located in KS and MO, are not showing the doctors to be board certified so not sure I would recommend anyone go there.  Just liked seeing "long range" photos.) 

  • christine47
    christine47 Member Posts: 1,454
    edited October 2011

    Kate33,

    I have read several of Dr. Coleman's articles (he appears to be a pioneer in fat grafting, esp. face). He appears to have even written a text book on fat grafting.  Looks like he is all about technique.  Sometimes I think I know more about fat grafting than my PS, although my results (5 days post op) look good.  I am especially pleased with the fill under the arm where I had node disection and a huge hollow pit.  Those of us with BMX will not have mamos again, but we should have MRIs to monitor implants.

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