Has anyone had micro fat grafting?

faithhopenluv- The armpit incisions were only being done by one PS (Dr. Khouri) when he was removing or replacing implants.  There's a lot of controversy about him doing it this way as it can cause complications (not to mention it's not attractive).  Some of us are prior patients of his who were subjected to this and are not happy.  He is the only PS I have ever heard of, though, who does it this way.

Eileen- I want to say the only disappointment I've encountered with the fat grafting experience was the armpit incisions.  The fat grafting itself has made a huge difference and feels so much more natural than implants alone.  Not sure who has had a difficult recovery but I don't think that is the norm.  Like I've said, the pain is pretty short lived and the benefits enormous. 

Here's some articles on why to wear compression garments after liposuction-

http://www.liposuction-alternatives.com/1540/liposuction-alternatives-articles/why-wear-compression-garments-after-liposuction/ 

http://www.liposuction.com/elastic-garments.html 

I just read this on liposuction.com which I thought was interesting regarding pain-

The use of smaller liposuction cannulas (microcannulas) requires a little more time to complete the surgery, but they are associated with less postoperative soreness, and allow smoother results. Because the incisions are smaller, they do not need to be closed by sutures; the open incisions allow more drainage of the blood-tinged tumescent fluid. When incisions are closed with sutures this fluid is trapped under the skin and causes prolonged swelling, and increased pain and soreness. 

Kate,

Thanks for the link regarding compression garments.  I do plan to wear spanx even though doc said not needed. 

The compression garments DEFINITELY help you feel more comfortable for the first few weeks after lipo.  Like Kate33, if I removed them, I'd feel increased pain or was irritated by the numbness.  The garments made me feel much better when I put them back on. 

Hi Kate

 Thanks for the contact info for beacher who saw Suzanne Summers plastic surgeon.

Mina

dancetrance thanks for your words of encouragment.  I think when you have to keep making decisons about what to do it takes alot out of you. Not knowing the best procedure to fix the NSM mess and feeling overwhelmed.  Before my last appt. I was in a much better place.  I think I will go ahead with the fat grafting and if I don't feel good about what he says he is going to do with the areolas I will wait. 

What did they do for the nipple that was removed? 

I keep thinking ok it is ok to be down and cry about all of this.  But as my husband said it is normal to feel this way and be patient with yourself.  Have a good weekend.

Ladies.... please don't give up on fat grafting for fear of pain!!  I had natural childbirth five times, but then had a tubal and couldn't believe how painful it was!  (maybe because I was expecting "band aid" surgery.  I did have a several inch incision.).  Some people think a MX is hardly any pain, some think it's the worst pain ever.  I like DT's point that lipo is a very common procedure.  This isn't anything that mysterious, surgery wise.  It shouldn't be a reason to rule out fat grafting.  I want to join Lee in encouraging anyone who does it though to participate in fatgraftpatients.com.  THere is a wealth of information and wonderful support to get you through each step of the way.  Lee expresses the outcome well.  To have sensate, natural breasts is a wonderful thing.  I almost forget they aren't my "originals"...and actually they are better than my originals and so is the rest of my body!

Dancetrancer - didn't really see that as a thread derail...sometimes it's hard to remember which thread we are all on, but all seems pertinent here.

Hopefulhealing - can feel your pain...your DH is so right. This just isn't an easy journey...there are many losses, uncertainties about future and decisions to make, times of waiting for test results; emotional, physical, spiritual pain; body image changes...and there are some silver linings. Love the new friends I've made even though I haven't met most of them...people who will stand by you through thick and thin, to laugh and cry with...such a treasure!!  For me, the big turning point was when I found out about fat grafting and met Dr. Khouri.  It seemed like even though there was a lot to go through with the Domes and seven surgeries...it all seemed positive somehow.  Glad for everyone bringing in their points of views and different MD's to consider who do various approaches.

mmscullen:  about the red dots all over your abdomen...are they needle pricks or a rash?  I know my body liooked pretty much like a pin cushion in many places, esp. on the breast though.  Is it resolving for you?

whoever asked about recovery time (sorry, can't scan back for name):  my experience was similar to Lee's.  I traveled, so took 3 days off each time, but would say many women would want at least a week or maybe two.  Much of it depends if you need to do heavy lifting on your job.  Again, it varies.  You know yourself and your job best on whether to error on the longer side and come back early if you can, or hope for shorter recovery and get extra days off, if needed.

So I have been following this thread off and on and I am way pre recon (still doing chemo, then I have too wait a year after Rads)  but I like getting all the info early   Anyway.  I was reading another website that was reviewed by a series of doctors on fat grafting.  Some of them, were concerned as it hasn't been around a long time, and they don't know how it will affect breast cancer reoccurance. Have any of  you had these concerns?  What has the PS said in response to these concerns?  THe info you guys have shared has been amazing so far, and my hubby and I are really excited for this as a possiblity.  Also for those of you who have used Dr Ahn, how much does somthing like this cost?  She isn't in-network as I have found for my insurance

hope- Not sure the answer to your first question but I would assume it is as I didn't have any sores afterwards, just some bruising.  As far as incisions- technically it is one but is very small (usually less than 1/8") and is not stitched up afterwards but left open to drain.  It takes about a week or two to close up completely and about 4 weeks to heal completely though the lipo site may be visible for up to 2 years.  (It looks like a tiny freckle afterwards.)  Most of mine are completely gone but I do have a few that can still be seen.  Not sure anyone would notice except me, though.

I am five months out from my second revision which included fat grafting.  I think I have capsular contracture on one side - there is a dip and it is painful.

I am so tempted to get the Dr. Khouri technique done.  Isn't there a doctor in Palo Alto that does this? Anyone go to her and have any feedback?

I am so glad to have found this thread!  In April 2010, I had a lumpectomy with a lift/reduction procedure bilaterally as originally the diagnosis was DCIS...turned out to be a larger area of invasive malignancy, so they had to take more breast tissue than planned.  Because of this, I was left with smaller breasts than anticipated, although I can't complain as I was pretty symmetrical and still had my nipples.  After the chemo, and then radiation, I had quite a change/shrinking of the breast with the cancer.  I opted to try the fat grafting, which I had this past December.  The stem cells of the fat were spun down/separated and returned to the fat to be reimplanted to my breasts.  I have to say, that after the inflammation went down, I didn't really see much change in the size of my breasts, and my tummy is lumpy and bumpy.  I know I'm to have this done at least 1 or 2 more times to get the desired result, but now I'm scared and wondering if it's worth it.  I was not able to have implants because of the radiation, now that I'm into this, I feel I need to see it through.  The co-pays are turning out to be more of a cost than I had realized.  I'm not unhappy with this, just wondering if I should just 'stop' and say enough is enough....Is it normal to have to have this done 3 or 4 times?  I would appreciate any insight or advice.  I'm trying to move on to a life 'past cancer' and wonder if this may be holding me back from just accepting myself the way I am, albeit imperfect.  I'm just feeling uncertain.  The surgeon is very well known and has been highly praised for his work; so I'm just wondering if my expectations are too high for what fat grafting can do.

janny- It's pretty normal to do multiple procedures when you're trying to create an entire breast after MX.  I think it is less so when using the fat grafting for lumpectomy divots, to cover implants and to help repair radiated skin.  When you say your PS is highly praised for his work are you talking specifically about his fat grafting or recon in general?  There are different techniqes for injecting the fat into the breast and some have a higher retention rate than others.  I had fat grafting over my implants last spring and have retained just about all of it and am still happy with the results.  My PS claims a retention rate about 85%, the average is about 50% but it sounds like you may have had lower than that.  Have you spoken to your PS about your concerns?  It's difficult to go through this if you're not seeing a pay off at the end.

lalisa- Glad you had a great consult with Dr. Aronowitz.  Sounds like beacher did, too.  It's just too bad he's not willing to take insurance since any recon patient he will be taking is going to go through their insurance company.  

I just heard on another thread that Blue Cross/Blue Shield is no longer covering fat grafting.  Has anyone encountered this?  I don't have them but I hope it's not a trend that is developing.  I wonder what the cost difference is between fat grafting and TE/implants or flap surgeries.  It seems it would be cheaper than doing some of the flaps.  I just hope this isn't one more thing that women are going to have to fight for. 

Eileen- For some reason I didn't put the thread in my favorites so had to hunt it down.  The title of the thread is "BC/BS Officially Denied Fat Grafting" and it was posted by nolo1098 on 3/3.  She said she got a letter in the mail denying her upcoming surgery saying the fat grafting was "experimental/investigational".  Another member (chrissilini) said hers was denied, too, and she has Cigna.  I really hope this is just a coding error and not a trend that is developing.  One member said how is fat grafting any different than the DIEP that is covered which is a good point.  I will try to post a link to that thread-

http://community.breastcancer.org/forum/44/topic/782131?page=1#idx_24