Has anyone had micro fat grafting?

Thamk Kate i read all the posts.Wow it is still crazy. They should realize when the women complains about pain where the clips are they should volunteer to remove them> It seems like all these Dr.s we have to deal with for breastcancer are just not real bright.  Serious  could they not put 2 plus 2 together or do they just not give a crap about how we are left to suffer SSSSSSOOOOO mad! we need to help the women coming from behind us !!! things have got to CHANGE!!

Will do Karin, thanks! 

If anyone has post mastectomy pain syndrome I thought this was interesting about using fat grafting for it-

http://www.ncbi.nlm.nih.gov/pubmed/21788826 

Kate< That is awsome,where do you find these articles? You are good at it.Thanks HMMM we just have to get the word out to the public and to woman who are getting diagnosed everyday and still not given this option. I swear when i am over recovery i will be making a stand ,calling news, talk shows ect.. Did you ever try that? i think i remember you did. I would love to work with you on this maybe we could make a diffrence?  AMANDA, i remember you ,i have don alot of research on both procedures,i went with fat grafting because i found a Dr. i trusted.  Both procedures is the only way to go if you have radiated skin ,that im positive of. i will pm you take care                                                                                                       

Kate, your suggestions apply to ALL medical conditions!  We are so incredibly fortunate to have bc.org, so many others with other diagnoses are just lost, floundering around trying to find things out on their own.  Impossible.  I would have never had the time or ability to research all my options and make the decision to have a BMX, let alone the mfg reconstruction option were it not for this site.

Beacher, that is unbelievable!!  She actually told you not to go on any websites other than ACS!  I know doctors have to correct alot of misinformation that may be on disreputable sites, but patients should be educated on what sites/sources are reputable, not treated like children who should just be told what to do.

And if she was trying to prevent you from discovering reconstruction options that she doesn't do, does she think she will have a happy patient on her hands when you discover after the fact that another procedure would have been much better for you?

I know many of my doctors in MI were dismayed that I found and chose to do mfg in Florida, but the answer to that is to do what patients want!  If someone has discovered a revolutionary new way to do something, it will push other docs to learn it faster if they know they will be losing patients who want it.  This is what progress looks like! 

Yes she actually said that,i do not remember alot  of that appt. i do remember that. She was my Breast cancer surgeon, not my plastic surgeon but she recommended the plastic surgeons she works with with my hmo and i met with 2 of them and picked on. Know idea of any other options. Also on one of my visits back to her after my exchange i went to talk to her about my pain and i told her i was not happy with my ps and that i thought maybe he was not that qualified ,and she responded with" well i sent you to who your insurance allows" if i had known what i know now i would have gotten only the mx and waited for recontruction till the following year when i was able to get a ppo .....what a waste, but im doing ok now thank god, and dr. Aronwitz, and this website!

Hello everyone:

 I spent the last week reading through all 57 pages of this thread.  Wow.  Just a month and a half ago I knew nothing about anything on this site.  I didn't even know of the existence of this site.  Routine mammo,  DCIS - grade 3, lumpectomy and supposed to have rads.  SOP.  But,  I'm not sure about getting the rads.  Not sure about the possible SE and don't know if that's a good trade off for a lower chance of reocurrence of THIS DCIS, which is what they help prevent.   I gather I have a few options.  Uni mx, maybe the other down the line at some point, or do nothing and get routine screenings/mri's,  get the rads - have to make a decision on that very soon,  or go with meds only, which haven't been prescribed - provided I get rads.  I've read radiation horror stories.  I've read surgery horror stories.  There are so many types of surgeries.  Frankly, this, the fat grafiting,  is the only one that appeals to me - though I've been told DIEP is a good way to go.   I'm still in the educating myself stage and have bombarded my doctors with questions and more questions - which they've answered promptly and I belive honestly.  They've shown a great deal of respect for my need to research and come up with questions and more questions instead of just blindly following sop without question.   

What I haven't  been able to find out much about is fat grafting at the same time as mx.  I'm thinking if I don't do rads - or anything at all -  I can make the decision to do mx and reconstruction at the same time - maybe later this year or down the line.  But is that done with fat grafting? I mean both mx and recon at the same time.   And how is it done?  I've been following everyone's stories.  Kate, dancetrancer, Eileen, dustylady, panda, kitchenwitch and others - and still have questions.  I'd travel - but was disappointed about reading about placement of Dr. K's incisions in the armpits.  Although is that with removal of implants only?   Which I wouldn't have if recon was done at the same time.  And why does it seem no one else REALLY does this procedure?  Not even in NYC or LA?  Or the famed NOLA clinic I read about here.  

Also,  I noticed most of you have families you can rely on for help. I had to smile when I read, I forget where or who, wrote about a friend coming to help to take some of the load of of her husband. But is there anyone out there who is doing this on their own?  Who is single, works in a non-traditional job, or runs her own business - so doesn't have the luxury of taking off weeks at a time - though much work can be done at home.  How limiting is the post surgery/reconstruction if it's all you and just you?  

I also want to applaud all of you who have taken the step to be on the forefront of this new method - to lead the way for others.  How exciting - in the midst of all the turmoil - to be instrumental in advancing new  options for those who follow.   I've been dropped into a world I had no idea existed just a few weeks ago and the courage of all of you on these boards is amazing.  I applaud you - all of you.  

Meny, I just had a bilateral N/S S/S mastectomy with the first fat graft in the pectoral muscle. From what I understand the space where the breast tissue has been removed is not amenable to fat survival + you have drains in that area for the first week or two. One the mastecomy has a chance to heal then you use the BRAVA to expand and prepare the space to accept the graft.

 Am I right dancetrancer, lee?

There is a surgeon in New York City that some patients have had sucess with. Her name is Dr. Christina Ahn and she is trained in Brava fat grafting. If you join fatgraftpatients.com you read stories about the women who have had their grafting done by her.

Meny - myself and rk85 and IrishLuck have had immediate fat grafting at the time of mastectomy with Dr. K in Miami.  As Lizdehart notes, she has had the same procedure with Dr. F in Utah.  

Our full stories are posted on www.fatgraftpatients.com. Pics are there, too, but you cannot see them unless you post your own pics (to protect the privacy of those of us who put ourselves out there.) My pics are also on the picture forum run separately from bco, but you'll need more posts here on bco before they will let you in. So ask again about that later so you can get access.  

When you have immediate recon w/fat grafting, as Lizdehart states, it is just the first step of the procedure.  Fat is grafted under and into the pecs which serve as the blood supply for the initial fat graft to take.   You will wake up with a small mound - maybe an AA or AAA?   After about 4 weeks of healing you will start wearing the Brava to expand the breast area and prepare for the next graft.   You wear the brava I think about 6 weeks and then have your 2nd graft.  At this point you may end up with a small B, I think (mine was smaller like a full A, b/c I could only expand for 4 weeks - I had complicating factors not related to the grafting -see my bio).  RK please correct me if I'm wrong on that.  Again, if you want to get larger, you will need to repeat the Brava and fat grafting process until you get to the size you want to be. 

You will not need armpit incisions - that is related to revision of implants with fat grafting done over them. Your incisions will be those related to nipple sparing - and will depend on how your doc does that.  If you can't have nipple sparing, you would end up with a scar across the breast to remove the nipple.  Depends on your story and your doc.

Few docs do this procedure b/c it is so new and requires significant technical expertise to do it properly.  More docs are learning the procedure, for sure.

Post MX w/fat graft you will definitely need help the first week.  After that you will be fatigued and sore but should be able to manage at home, IMO.  I wouldn't plan on going back to work/into the office for 4 to 6 weeks, though...most gals on my MX thread, regardless of recon, seemed to be out of work about 4 weeks.  YMMV.  I don't push myself super hard - I listen to my body and let it recover as it needs to.

Post subsequent fat grafts you'll be out of commission for the first few days, then will be sore but able to get around pretty good.  I still wouldn't plan on any heavy lifting for 4 weeks, b/c you need to protect the graft as it heals.

Thanks for the kind words.  It is indeed a new world you have stepped into...one I know you wished you'd never entered...but we are here to help just as those before us helped us.  

meny - Sorry you have been dropped into this crazy, frightening, intimidating world.....I recently saw a magnetic "ribbon" that I actually like.  It simply read:  Cancer sux

Pretty much sums it up!  Anyway, you are fortunate to have stumbled on fat grafting because at least you can research and learn about it BEFORE you make your reconstruction decision.  I urge you to sign up at fatgraftpatients.com  You will find the photos of the ladies who had MX with immediate fat grafting to be absolutely AMAZING!  Lots of information and tons of support as well.  

truebff:  PALF is another one of Dr. Khouri's procedures in which he loosens scar tissue using thin needles and injects fat. It's something he developed while working with severe burn victims and applies to reconstruction patients with scar issues/skin adhesions.  You can get more info on his hand center website.  Pretty incredible stuff.

meny- Sorry to hear about your DX but wanted to welcome you to BCO.  This is an amazing site and has been my lifeline as I tried to navigate all things BC.  I'm glad you discovered fat grafting before you made any surgical decisions.  I only wished I had known about it.  (And am thoroughly impressed you read all 57 pages of this thread!)

One thing I'll warn you about is most of the complications you read about are the worst case scenarios.  There are those who had lumpectomies and rads and go on their merry way.  They typically don't continue to post here.  It's the ones with issues (like me post MX/implants) who need a place to vent, research and find others having similar issues.  I guess what I'm trying to say is MX is a huge decision so make it carefully.  Odds are you could do a lumpectomy, rads and possibly fat grafting to fill in any divots and you'd be fine.  I think there are now more targeted rads that creates less damage to the skin and fat grafting has been shown to improve radiated skin, too.

Most choose MX, though, because of the concern for recurrence or the fear of scans every 6 months.  If you choose MX any type of reconstruction is going to have pros and cons.  I would say the biggest con of fat grafting is the multiple surgeries required and length of time to complete.  Saying that there are multiple pros above and beyond any other type of recon- in my opinion anyway.  I wish I had known about it before choosing tissue expander to implants.  

The "luxury" of DCIS is you have time to research and choose wisely what's best for you and there isn't a right or wrong answer- just what's right for you.  If you decide to move forward with fat grafting there is another thread where we have started posting the name of surgeons who offer this.  You may find someone in your area.  The name of the thread is "Microfat grafting or BRAVA doctor recommendations".   (I'll post a link to it.)  Again, welcome to the club no one wants to join, the hazing is a bitch, but the sisterhood is for life.  (((hugs)))

http://community.breastcancer.org/forum/44/topic/769795?page=20#idx_590 

Hi truebff:

I had a sentinel node biopsy (SNB) which left me with tightness in my underarm area along with pain upon raising and extending my arm.  I had MFG with Dr. Khouri in early Jan to correct my lumpectomy defect.  I wore the Brava on the lumpectomy side for 5 weeks prior to surgery. Since the surgery, the tightness and pain in my underarm area has gone away.  I suspect that the combination of Brava expansion, along with MFG to the lumpectomy area, caused a release of scar tissue that had formed following the SNB.  I plan to run this by Dr. K when I see him in April and will report back on what he has to say.

I had mammosite radiation which thankfully spared my skin, but from what Dr. K told me, along with reports of others, fat grafting is very healing to radiated skin. 

If you join www.fatgraftpatients.com you will find a list of doctors, many of whom were trained by Dr. Khouri, who have started doing this procedure. 

Thank you for the answers dancetrancer, and lilli,

Forgive my ignorance , but what is a BRAVA?

I have small breasts and had a lumpectomy and SNB.  I only have a divot and downturned nipple (because of material taken out underneath nipple that, if filled in, would let it come back up) to repair with fat grafting if I decide to do that.

But I am so tightened up since rads.

Brava is  a system consisting of 2 domes you wear over our breast area with a small motor that causes suction.  This stretches the tissue forward over many hours (you sleep with it on 10+ hours). It prepares a space and network of blood vessels for where the fat goes.    It's a big investment of time and energy - but it works.  Still, one needs to know what they are signing up for.  You must be a very dedicated, patient patient, LOL.  

I'll let Lillie speak more about the rads...she had excellent outcomes from fat grafting after her lumpectomy!