Has anyone had micro fat grafting?

I have a question if you don't mind. I've been trying to avoid the TE route for the reasons you ladies say. Does a squishy implant stretch the muscle as badly? It's got to do some damage, but is it as bad as TEs?

I had one PS tell me that TEs don't hurt at all, and I must be getting my info from the internet. What a jerk!

I just want to chime in on the TE pain. This is my own experience.

I had a left side mx with immediate tissue expander. PAINFUL . .  . so painful I almost passed out in the bathroom. The fills were horrible too.

I then had my right side PMX with a difference surgeon and different PS. She removed the first TE (she said the positioning was incorrect) and I woke up with two new TE. Exact same size and make as the first TE she removed. I had zero pain. I mean not a single drop of pain at all. When she went to do the first fill I came close to having a panic attack in anticipation of the pain I experienced during the fills with my first TE. No pain during fills.

I questioned how this is possible and she said if the TE is placed perfectly, there should be no pain.

So I'm living proof that with one PS I had unbelievable pain especially during fills. Yet with the other PS I had zero pain. I've already had my exchange and she did an absolutely amazing job.

Having fat grafting next week for some ripples in the cleavage area on one side.

Diagnosis: 7/10/2009, DCIS, <1cm, Stage 0, Grade 3, 0/3 nodes, ER-/PR-

Thanks Lee. @Mantra- I do know what you mean by getting an experienced surgeon. I endured the same pain, and still do. I know it's because my PS lacked experience. He had only done 2 prior reconstructions. Since my reconstruction he has done several other women. Thanks due I'm sure, to referrals from my breast surgeon at the hospital to all the poor women with lousy medical insurance. Get this...He's now specializing in breast reconstruction LMAO! I wouldn't let him touch me with a 10 foot pole!

Thanks everyone for your feedback about Tissue Expanders. I admit I have absolutely no experience of them as I had a small (165g = 165ml?) silicone implant placed under my pectoral muscle at the time of my unilateral mastectomy, and I thought that was uncomfortable enough. 

I do have a question for others.  If a woman who is interested in fat grafting reconstruction has to have a medically necessary mastectomy now, and doesn't have access to start the fat grafting process at the time of mastectomy, what is the best approach for her to take?  Should she have a 'traditional' mastectomy with the excess skin cut away, should she have a skin sparing mastectomy and let the skin 'hang', or should she have a small implant or similar device placed just to hold the skin up?  I thought having a skin sparing masectomy without an TE or implant wasn't a good idea - won't the skin just wrinkle up?

Also, of immediate relevance to me - I have an implant placed now and hope to have fat reconstruction in a couple of years time - either to replace the implant altogether or hide it under a layer of fat (currently this type of reconstruction isn't available in New Zealand).  If I have a nipple reconstruction and aerola tattoo now, will a fat grafting process that involves wearing the brava bra later on distort or damage this? Does anyone have any experience?

Thank you all for your thoughts.

I had BMX with no recon...awaiting access to fat grafting! Opted for skin sparing but the nips had to go as there is breast tissue there, too. The skin tightened up very well and lays flat, nothing hangs, although I wasn't all that large preBMX. Smaller scars, too.

A friend sent me this link   www.dublin-massage-therapy.com/deep-tissue-massage.html  It shows how they use a device similar to the Brava to help with scar tissue.

Lee, did you wear the Brava?  I didn't think you did b/c you had an implant - Dr. K doesn't do Brava with those who have implants, does he?   Trying to get up to speed on everyone's stories! 

Kiwi, I missed this message from you...so glad I looked back, because it may be just what I'll do so insurance will cover the eventual fat grafting.

One disadvantage of having an implant placed at the time of mastectomy is that your insurance company may then say that you have had your reconstruction, and be reluctant to support you if you want it removed for further fat grafting.  Is it possible to have a Tissue Expander placed instead?  This would at least hold out your remaining breast skin and give you some more time to research all your reconstruction options.  You would need a second surgery in a few months time to remove it, at which time you could swop it for an implant, go for fat grafting, or 'deconstruct' entirely.

I will go ahead for now and do the tissue expander. I will continue to look into the fat grafting with the hope of finding a PS soon who can do it. You can change PS? I guess I need to take a vacation to Florida. Is it possible to wait until June for such a procedure ... that is with the tissue expander.I am only removing the infected right breast. On the mri the left breast came out clear. I did have a recent lumpectomy on the left breast in March. There is a little iindentation where I had a lumpectomy. Is it possible, and would the insurance pay for fat grafting to even out that breast...since it to was dx with bc?

Thanks

Dear leeinf - I do think your advice to get an impression kit from naturallyimpressive and take a mold of my remaining nipple just in case is a great idea, even if I don't order the prosthesis straight away. I regret not doing this for the nipple that was lost - of course I had no knowledge at the time.

HAS ANYONE HAD TROUBLE GETTING YOUR INSURANCE TO OK A 2ND RECONSTRUCTION?

Beacher4209 - No, my insurance didn't give me any trouble - but.....every insurance is different and it may depend on how it is billed/coded.

Evebarry - My oncologist said no more mammos for me

Beacher-I had a revision and had no problem getting it covered. It didn't include FG however. I met two Dr's after that who do FG. One is on my plan so I assume it would be covered. The other was not on my plan so that was the issue not the FG. I am looking at a possible second revision as well so I am assuming that is covered. I would always check with your Dr first and make sure that is all set before you go forward.

Sorry to interrupt this important discussion on insurance coverage.  Just wanted to give an update on mammograms and fat grafting.

First of all, just wanted to share my joy at having a clear (benign) mammogram almost four years out from my diagnosis!

If you had a bilateral mastectomy, you no longer need mammograms.  If you had a unilateral, you will have mammogram on the breast that still has breast tissue.  For me, I also had some fat grafting augmentation on that side.  My first mammogram was clear a few months after the fat grafting augmentation.  The next one a year later shoed some calcification.  They did more pictures and he felt very secure that it was benign.  Recommended another mammogram in six months, but no insurance coverage, so stretched it out to ten months.  Just had that done the end of October and they were easily able to tell that this calcification was the type due to trauma (consistent with having had fat grafting) vs. microcalcification suspicous of cancer.  I was very encouraged that two different radiologists (who knew nothing about fat grafting) were able to confidently identify the difference from calcifications due to fat grafting vs anything suspicious of cancer.  The first one talked about how super careful he is in readings and that is why he asked for more.  The second one had a phlegmatic termperment that I got the feeling he was telling it straight and nothing to just please me.  I was glad to get to speak to both of them directly.

 Mina1 did have some problem with CIGNA insurance covering fat grafting. They cited the calcifications on mammograms as one of their concerns...don't really get that in light of my results as well as the fact that many women have bilateral and so that shouldn't matter.  As  Lee, said each insurance company is different, so it is important to check.

Does seem many women end up doing a couple kinds of reconstruction before they are done....I believe there are quite a few (besides Lee!) on Bravafatgraftpatients.com forum who have had implants partially or completely removed with immediate fat grafting and I haven't heard of problems with insurance.   I will step aside though for those more experienced with this specific issue.

 with care,

Randi

That is an important question, sweetie!

I was told it should go under breast reconstruction, other

no mention of lipo should be made or it will be considered cosmetic. 

Had trouble in WI, went fine in MIami.

Hope it clears well for you when you are ready to move forward!! 

Ladies, what is the difference between micro fat grafting and regular fat grafting? My PS says it's the same thing. I know he's familiar with Dr K in Miami because his office partner trained with him. Just wondering if there's something specific that gets done with micro vs. regular.