Microfat grafting or BRAVA doctor recommendations
Comments
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There are advantages and disadvantages for each kind of reconstruction procedure. Each individual has to weigh those pro's and con's and make the decision for what is best for their particular situation. I decided fat grafting was the best procedure for me, but it certainly wouldn't be the best for every woman. If you are doing full fat grafting from the beginning (i.e. after MX, no implants), you must have a ton of patience to wear the Brava continuously (minimum 10 hours/night, 12 hours preferred) for many months and usually require a minimum of 3 surgeries to achieve about a C cup. You also need to either live near a PS who does fat grafting or be willing to travel and pay those extra costs. I was willing to do all of this, b/c I did not qualify for a DIEP and my other options (implant with lat flap or IGAP) were too invasive for my liking. I also wanted a chance at sensation in my breasts, which fat grafting can give you in many cases (I have sensation in approximately 90% of my skin, but not in the nipple). So, this was the best decision for me, but certainly wouldn't be the best decision for all women. Each person needs to go in eyes wide open to what the procedure entails and decide what is right for them, weighing all of the factors.
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dancetrancer- Well said- thank you!
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We all have to decide what is best for each of us.We all have a different definition of "invasive." I thought fat grafting was going to be the right recon for me.I did a ton of research,had consults with two PS and one phone consult.Then I realized it was going to be too "invasive" on my life....to wear the Brava several hours each day for several months and to have multiple surgeries spread out over that time.Several procedures with general anesthesia.Others are willing to do it,I wasn't.I respect their right to choose.I had to laugh at your comment about being overweight and seeing flap surgery as a quick fix.What is lipo if it is not fat reduction? The body parts that they use for flap surgery(and I am not talking TRAM or LAT where they use muscle) do not use parts of the body that have an "integral function".I know this is a place for us to express ourselves,but I do think it is important that we not spread misinformation.
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Thanks Kate!
pandazankar, I agree. The one thing I wanted to point out is why I did not choose the IGAP (for anyone else who may be looking at it...it's pretty uncommon, but it was the only non-muscle flap option presented to me). Yes, it would only be fat, no muscle, so no functional limitations from a muscular standpoint. However, it would have taken a large portion of the fat away from my "sit bones" in my bottom. Not only would it have caused a marked change in the cosmetic appearance of my rear (oh, the things we discuss), but also, I did a lot of research and discovered that some women have long-term chronic pain with sitting. I also did not want to increase my risk for skin breakdown in that area when I am elderly (pressure ulcers). So although the DIEP and SGAP may not result in functional losses due to no muscles harvested, the IGAP does have some functional and chronic pain risk (as well as cosmesis).
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IGAP is the flap taken where you sit,SGAP is the upper portion of the buttocks.
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Oops, oops, not enough coffee this morning. I'll edit it, thanks!
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Jeskachi I am curiouis. How do you know that surgeons lose money on flap surgeries? Are you a surgeon or do you work for insurance companies? If they are losing money, why would they do it? Doesn't make sense. So where are your facts?
I just don't understand why there are posters who are so against fat grafting on this site. This is supposed to be a place where we can talk about fat grafting, our experiences and doctors who perform it. When did it turn into this?
Kathy
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Hi all, about to begin my reduce/lift/ nipple spare/prophy stuff this year....am looking at some possible fat grafting and lipo to fix some dents/ripples.
had a question if anyone knows the answer..
I had read on here that there was considerable opposition from the medical community to fat grafting as they felt it would interfere with scans for recurrences going forward? Anyone?
thanks all,, (Hi Kate!!!!)
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Anniealso,
Yes, this is still a controversial topic, but I think things are definitely changing and if you find a qualified radiologist, they should be able to interpret mammograms after fat grafting properly. There is still debate, of course, so know that you may face some challenges along these lines. I already have. Note the following editorial comment:
Breast Imaging Considerations In Fat Grafting to the Breast
"There is clearly a need for good follow-up studies on
patients undergoing fat grafting procedures of the
breast and education of radiologists regarding changes
to be expected in these patients. There is no reason to
believe that breast imagers will be less capable of accurately
interpreting the mammograms of these patients
than those of other postsurgical patients. If the
possibility of producing findings that might mimic
those of breast cancer is an argument against fat grafting
in the breast, perhaps all breast operations (and
radiation therapy) should be proscribed."DOI: 10.1097/PRS.0b013e31822b6350
Eva Rubin, M.D.
Montgomery Radiology Associates
2055 Normandie Drive, Suite 108
Montgomery, Ala. 361110 -
chatsworth- I was thinking the same thing! Maybe we should start a new thread where we debate the pros and cons of each type of recon. This thread's purpose, though, is to share information on fat grafting and the names of surgeons who perform it.
anniealso- Hi back! I think most of the opposition comes from doctors who haven't kept up with the latest research and techniques. Fat grafting has improved so much just in the past 5 years. In the past there was a higher risk of calcification and previous scanning wasn't able to differentiate between those and cancerous lumps. I don't believe this is a problem anymore with the new technology in scanning. There are different techniques for injecting the fat and some come with a higher risk of calcification. Some PS's will just inject the fat in "globs" and this has a greater risk. Others inject drop by drop with less risk. You definitely want to go to someone who has a lot of experience- not only injecting the fat but removing it as well. So they should be skilled in lipo as well to get a smooth result.
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When I talked to Dr.Kline/Craigie's (flap surgeons) office in South Carolina yesterday,I expressed my fears about having a bill not covered by insurance.She told me that anything not covered by insurance,they write off,they do not balance bill.I do not know about others, but I would guess they are not the only ones.So sounds like with certain insurances,they lose money.A PS told me that a PS who does cosmetic procedures makes much more from that than from breast recon.Please know that I am not against fat grafting.Just that it is not right for me the way it is done right now for BMX.If I had implants,I would go for fat grafting in a heart beat.I watch the fat grafting threads because you never know what exciting info will be posted.I still have not had my recon,so I figure the more informed I am,the better.Kate33,I think a thread that talked about pros and cons would be great.I also would love to hear everyone's recon stories,from start to finish(or wherever they are now,maybe they could keep updating) especially why they chose it,how it went,anything they might have done differently,anything that made their experience different from others..I have learned so much here,but can always learn more.
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pandazankar I asked questions about billing to insurance to one of my medical providers, a radiology office. What they told me is that due to contracts with the insurance companies there are set amounts that are paid depending on the amount billed, so they bill a larger amount than is actually necessary so that they are paid the amount they actually want.
Believe me, people don't do work they lose money on. The reason they write off what the insurance doesn't pay is because they have been paid the amount they wanted to get.
I have Motion Picture Health Plan which is basically Blue Cross Blue Shield and I have looked at my Explanation of Benefits and can see what is billed and what is paid. For example you can see they may bill $2000 for a service and are paid $850.
Yes some types of plastic surgery are more lucrative but it would be ludicrous for a doctor to do procedures that lost money. How would they stay in business?
Trust me, nobody is losing money.
Kathy
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I have no idea about insurance other than my own. I have an HMO,so I use in network doctors and facilities and they have to take what the insurance pays,they cannot charge more to get more.That is why the one PS said cosmetic surgery made more money,insurance does not cover it,so they can set whatever price they want and are usually paid up front.My understanding from him was that the cosmetic procedures help a doctor to be able to take less for all types of reconstruction surgeries.If I go out of network,there is a one time contract with the insurance company.I really am clueless about this and hope someone that has dealt with it can chime in.I assure you though that there are many doctors who do work they are not totally reimbursed for,the one PS I saw donates a lot of surgeries to children with deformities.
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Chatsworth i am definatly not against fatgrafting at all.That is why i have s done so much research on it and really wanted it, until i finally came to terms there was not a ps in cali experienced enough. I actually have an appt. next week with Suzannea Somers ps ,just in case there's a chance he could do fg on me. But i am comfortable with the diep now and am glad its out there. i want these implants out!!! I will continue to follow the fg trials and hope one day its available all over the country,but what i want most is a cure, so none of our girls growing up ever have to be on this board BUT thank God we have this board now for all of us. take care all....
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Great post beacher. Please let us know how your appt with Suzanne Somers' MD goes - I'm very curious and psyched you got in to see him! Good luck!
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@pandazankar-I think a better word to use instead of what you've described as 'invasive' would be 'disruptive'. Yes you're correct in that this type of fat grafting is no quick fix-months of wearing an obtrusive device on your chest, 2, 3, or more possible surgeries, but in the end micro fatgrafting offers the best results without sacrificing another part of your body. Any bodypart removed did have a 'function' regardless if any muscle was involved. We've already lost something special, why lose anymore than we have to? You may find it funny but this type of fatgrafting's is not to look slimmer. It's purpose is to build a breast. I have read time and time again of women excited at the prospect of eliminating their large stomachs with a flap surgery, as if this would be a quick fix. Flap surgeries take a long time and of course you're under anesthesia the duration. Most of what we learn of the procedures available to us are from 'drawings' which simplify the process. This is extremely misleading because it minimizes the impact of the procedure on our bodies. I think a more accurate description of ALL the procedures available to us should be given by the doctors in realistic photographic images and videos-NOT drawings! I realize some people are squimish, but I for one want to know what's going to be done with MY body! After all, I'm not a drawing, I'm a human being.
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I know virtually nothing about flap surgeries, other than they look scary and barbaric...but that is my ignorant opinion.
I have been in treatment with Dr Khouri for over a year now, and recovered from fg#2 about 12 weeks ago. I am researching other options now, and am quite pleased with a local PS who is actually friends with Dr K and has spoken with him about my case. He called me into the patients room next to mine...she cheerfully threw open her top...I wanted to cry. She looked amazing, 3 weeks out from her bmx straight to gummy implants. This guy does his as an inframammary fold incision. Worst case scenario he says he uses a periareola nipple sparing procedure...which is what she had, and omg...you could not tell she had anything done.
I am flat out not willing to go through more lipo. I hate it. It hurts worse than anything I have had all put together. And now, the areas from my lower back that were done last are STILL numb. I am relatively thin and slightly muscular, so maybe it does not have such a great outcome on me. But with the fg method, I will require several more surgeries.No thanks. I barely made it through 2 of them. I want to simply even things up and move on with my life.
The upside is that my radiated skin is doing well. It looks pink and healthy. I did not get sensation back as others seem to have (90% back from someone...that is wonderful!!).
I am glad I learned about grafting, and I think it probably saved me from talk of some sort of flap surgery since I had rads damage...which frankly I probably would have bailed on. I think its all uniquely personal. We all have a different journey. I get taken back a bit when I hear so many vehement opinions on the "best" way to go. "Best" is highly individualized. Is it realistic to compare radiated vs non radiated patients? Not really. Or what about folks who haven't been through chemo that say they "bounced" right back. Umm...nothing bounced around here for quite a long while, trust me.
The more that post their experience the more valuable the info becomes. I don't want to debate it. After a double bmx, a re-excision, te exchange #1, fg#1, exchange #2 at fatgrafting #2...(not to mention months of chemo and rads)...I pretty much have earned the right to my opinion. And that is LIPO SUCKS. And Dr K knows I hate it, laughs about it and says I am not the only one who says so. About a month ago this thread was getting on my nerves. I called him specifically about this site and some of the conversations going on. I frankly thought he had either paid some folks, gave them surgical discounts etc. Nope. He actually highly encouraged me to stay put and encourage everyone to share ALL their experiences. He REALLY wants it discussed in full and at length. He doesn't want patients coming to him with sugar-coated visions. He wants informed people with realistic expectations. He wants us to present the good, bad and ugly to each other. He loves what he does, is brilliant and caring but he is the first person to tell you it's not for everybody. It's his opinion that sharing it all will make us all wiser of our options and make us demand better care from our doctors. He said he doesn't want people from all over the globe to have to come to him..it's his true desire that women demand more from their own doctors so they have no choice but to learn new techniques to provide better care.
I hope I did this justice and didn't ramble too much...I am tired having just done a 90 minute zumba class for the first time ever. OMG..I do not have a latina bone in my body.
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Geewhiz, that's awesome to hear how he feels about the good, the bad, and the ugly being shared. It makes me respect him even more.
LOL about the lipo - I hate it, too! I seem to have had more pain with mine (well, in the quad area - hamstring area was much more tolerable for me) than others generally report.
I'm the one who reported probably 90% of sensation in the skin (not the nipple) - I am guessing that my results on this line may be extra good since I had fat grafting immediately at the time of the BMX. Who knows for sure though, all I know is I feel very fortunate.
Hope you can walk tomorrow after the Zumba!
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geewhiz that was awsome! Yup why bash others procedures,like you said we are all diffrent and have a our own needs!We need to support eachother we are all in this together.
makingway,i did watch a video of the diep procedure and it was scarey, but i can just imagine what my mx looked like,i need my implants out this is what "I" have to do and instead ofmaking me feel more bad, i would think you would support a fellow breast cancer lady. Also i asked th ps i saw today and what she is taking from my stomach has no business being there anyways its "FAT" and i am not doing it to get rid of my "FAT" im doing it to create a breast. I was an arobic instructor /jazzercise instructor and taught upper and lower body strength and core so i am not worried about this "fat" i do know how to work it off and that was my plan and not an issue for me.My issue is implant free breasts and getting back to the gym as soon as possible.Please do not judge others choices...
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@geewhiz-I appreciate your honest and thoughtful post. I do dread the lipo pain and bruising
@-those who disliked my honest, objective post. Please don't critisize me for what I believe. I am not here to bash, or judge anyone, for what they decide to do with their own bodies. My hope is that every woman contemplating reconstruction be fully informed of their possible results. Many reconstruction patients aren't happy after the fact because they didn't 'know' enough.
@beacher-I'm sorry you feel bad. My intention was not to 'make you feel more bad'. I share what I know, it's my nature... Each of us has to make choices and some have fewer than others. Did the PS actually say that the fat on your stomach has no business being there?! If she/he said that to me I would be offended. It reminds me of how Dr. Oz talks to his audience, as if they're in kindergarten...wikipedia DIEP Flap and read what is written there. It's not much but it does describe that in addition to the fat, blood vessels are also removed. Is there a DIEP topic here on bc.org? You might find some helpful info. there. Good luck and best wishes in whatever you choose
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I came across fat grafting post mastectomy and was interested in learning more. Plan to visit PS that does this procedure. However, in researching on-line, there is some controversy re: safety of injecting fat cells into breasts and the possibility of it causing dormant cancer cells to grow or possibly induce new cancer cells. I currently have saline implants, with significant encapsulation. Onc. suggested seeing PS to discuss options. I like the idea of not having implants, but now am worried about possibly jeopardizing my health. I'm a 3 time breast cancer survivor... different types of cancer in each breast, all were aggressive, so I am nervous. Has anyone read about this potential issue?
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Hi luvmy3cuties and welcome to the board.
Yes, the risk of fat grafting with cancer recurrence was a concern for me as well. One of the biggest things I learned is that the unknowns with this are greatest if you are looking at doing stem cell-enhanced fat grafting, b/c they still don't know for sure what having a concentrated number of stem cells might do in the breast. This is the kind of fat grafting Suzanne Somers had done, and it is being done in an ongoing clinical trial to study the effectiveness and safety.
It is felt there is less risk with non-stem cell enhanced fat grafting - really, if you think about it, if you are just transferring lipo'd fat that is not concentrated, how is that different from transferring fat via a flap? Neither one is concentrating the stem cells, the fat is just harvested and applied to the new area in a different mechanical fashion. Here is one article I found that gave me some peace of mind. Of course, one never knows anything with 100% sureity, do we? Keep in mind that more studies, especially long-term, are needed, so you will need to do your due diligence to determine if you are comfortable with the research that is currently out there.
Abstract
This study compares the incidence of local and regional recurrence of breast cancer between two contiguous time windows in a homogeneous population of 137 patients who underwent fat tissue transplant after modified radical mastectomy. Median follow-up time was 7.6 years and the follow-up period was divided into two contiguous time windows, the first starting at the date of the radical mastectomy and ending at the first lipoaspirate grafting session and the second beginning at the time of the first lipoaspirate grafting session and ending at the end of the total follow-up time. Although this study did not employ an independent control group, the incidence of local recurrence of breast cancer was found to be comparable between the two periods and in line with data from similar patient populations enrolled in large multicenter clinical trials and who did not undergo postsurgical fat tissue grafting. Statistical comparison of disease-free survival curves revealed no significant differences in relapse rate between the two patient subgroups before fat grafting and after fat grafting. Although further confirmation is needed from multicenter randomized clinical trials, our results support the hypothesis that autologous lipoaspirate transplant combines striking regenerative properties with no or marginal effects on the probability of post-mastectomy locoregional recurrence of breast cancer.Also, here is another recent article done by the researchers at Emory in Atlanta. It is focused on lipofilling (fixing defects with autologous fat grafting, not full fat grafting from MX like I had), but it is quite encouraging that a National Cancer Center is putting out an article encouraging fat grafting for secondaring fat grafting:
Autologous fat grafting in secondary breast reconstruction.
Abstract
Autologous fat grafting has become a common technique for revisional breast surgery. The purpose of this series is to review our experience with fat grafting for the correction of acquired breast deformities. A retrospective review was performed on 107 patients with a history of breast cancer between 1996 and 2010, who had autologous fat grafting at the time of secondary breast reconstruction. The indications were for improvement in contour, shape, and volume of the breast following transverse rectus abdominis myocutaneous (TRAM) flap reconstruction (n = 55), latissimus dorsi with or without implant (n = 20), implant reconstruction (n = 20), and breast conservation therapy deformity (n = 12). The average volume of injection was 40 mL (range, 5-150 mL), the most common location being upper and medial quadrants. Fat was harvested mainly from the abdomen, thighs, and flanks. Complications occurred in 11% of the patients, and included fat necrosis, erythema, keloid scarring, and pain. Complications were higher when performed with implant reconstructions. Repeat fat injection was performed in 25% (n = 27/107), which increased with the length of follow-up. Patients with a history of radiation therapy had an increased incidence of repeat injections (36% vs. 18%). Patients with >6 months follow-up reported an improvement of about 83%. Autologous fat grafting is a safe and effective tool for secondary breast reconstruction. It is helpful in all types of reconstructions to improve contour, volume, and overall breast shape and symmetry. Repeat injections are often required and this is more common in patients with longer follow-up and in those with a history of radiation therapy. The popularity of this approach in reconstructive breast surgery will likely continue to increase.P.S. Note that I bolded the lines above.
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makingway,It is hard for me to get my meaning across sometimes.So just to clarify: what I found funny was your statement that women see flap surgery as a quick fix for being overweight...but you did not feel the same about fat grafting which uses lipo to remove fat. geewhiz, thank you so much for your post,sorry the lipo was too much for you.I want to hear all about each recon procedure from those who have had it done.I still read about implants even though my brief experience with TE's kind of made up my mind for me.But until I am on the operating table,I am still looking at all options.I sometimes wonder if I should just accept being concave.
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makingmyway, no my ps did not actually say that i would have been ok if she had though because its true. I have watched and read and researched so much about both the diep and fg, i actually had a small break down from constant research from a morning to late into the night. Yes i was obsessed with getiing the best surgeon for wich ever procedure i decided on. I had to to be hospitalized for anxiety and deppression,im good now got my mental strength back and made my decision,but like i said i still have 3 more consults with ps's, 2 that do fg checking out there actual procedure experience. Like is said i love the fatgrafting, would do it in a minute if it were available here in cali by i ps who has alot of experience id o not want to be a first,i know someday has to ,but at this point in my life i cannot,but will continue to support and follow the fg procedures as they grow. For our youung ladies behind us. thanks
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I'd like to know more about how bad the lipo is. Geewiz, Dr Trott told me she would take it from my lower back/upper hip area because that is where I have the the fat to spare
Is that a really painful place? How much pain are we talking about and for how long? Did painkillers control it? Did you try stronger painkillers?I would love to have boobs again but am not sure if the pain of lipo is worth it! Any advice is welcome. I have had lots of surgeries associated w bc and reconstruction so I would say I am used to surgical pain. I found the meds made it bearable. Is lipo really all that different in terms of pain?
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Lalisa - my experience is that lipo from my the front of my thighs was very painful - couldn't straighten out my leg completely the first day (from a sitting position - couldn't extend the knee). This was worse on my left leg, which I already have chronic nerve damage in, so take that into consideration when you think about my experience. It was very painful getting up and down from chairs and beds and the dreaded toilet, LOL. HOWEVER, the worst of the pain was in the first 48 hours. After that, my symptoms markedly improved on a daily basis, and I was just very sore for several weeks. Oh and I also was numb for several months - but almost 100% full sensation in my legs now, about 3.5 months post my first grafting...but again, the numbness was worse in that L leg of mine that already has nerve damage - so you can't really apply that to your own situation.
My most recent second procedure took fat from the back of my thighs and the saddlebag areas. This area was markedly LESS painful than the front of the thighs. It really did feel like a very hard workout, and felt very bruised. Again, this has been markedly improving on a daily basis. I am now almost 2 weeks out. Sitting down on a hard surface is still pretty darn sore (ouchy - sitting on a bruised area), but it is only momentary. And I'm stiff and sore when I first get up from prolonged sitting or when awakening in the morning. However otherwise it doesn't bother me much. I don't feel ready to go back to real exercise yet (I do aggressive dance aerobics, hence the name), but I can ride the recumbent bike and a relaxed pace for 30 minutes or so. Walking/biking followed by lots of gentle stretching and exercises really helps move the lipo soreness along. I've also had my DH start massaging the area this past week, which really hurts, but wow do I feel better afterwards and my improvement the next day is even more marked.
I haven't had lipo from the tummy or back. I've heard tummy is not bad, but that lower back can be pretty ouchy - but that's just what I've heard.
With the anterior thigh lipo I also had a BMX, so I was on prescription pain meds about a week - after the first 3 days or so, the BMX pain was worse than the lipo pain, and that is why I stayed on the meds.
With the posterior thigh lipo, I went off prescription pain meds too early (switched to Tylenol the next morning after my procedure), and then the soreness set in more - went back on prescrip pain meds for 1 more day after that. After that, just Tylenol as needed.
All in all I'd say yeah, it's pretty sore, but you can manage it well with pain meds and proper activity levels...but I wouldn't be signing up for it if I didn't need breast reconstruction. I'd rather lose weight via diet and exercise, but that's just me.
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Hi LALisa,
I had interior thigh, tummy, and lower back. Tummy was not much of an issue and overall I would say inner thigh was the absolute worst with pain and bruising. Lower back wasn't as bad.
I also had a bmx and really that pain was quite tolerable comparatively. For me the lipo was worse by far. And I agree about the elective lipo. I'd rather be hogtied and run up the closest flag pole than do this simply for elective cosmetic reasons. People are nuts. I just saw on the web where England has a lady called the Living Barbie Doll...she has had tons of surgery to look like Barbie. For her daughters 7 th Birthday this week she gave her a coupon for lipo at age 18. That woman needs serious help, good grief. Warm a seat on the therapists couch for the daughter eventually too. Geez!!!0 -
I chose an implant due to that I have very little fat on my body for fg. Now that I have a expander in and it's polking a nerve, I wish I could take it out. I don't like the idea of something foreign in me. I don't like the idea of having nothing there either. I would love to remove the implant and do fat grafting. Is it possible later on to take the implant out and do fat grafting? I have thin legs, no real fat on them or on my arms. I can develop a little tummy..right now after surgery it looks as if I have a tummy. I hate the idea of more surgery and pain. I suppose whatever you do its going to be painful.
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I had a bilateral mastectomy with no recon because I wanted to get the whole shebang including chemo over with before I considered recon. My choice is fat grafting.
Now, regarding lipo. Suzanne Sommers had it in order to fill in the breast that had the lumpectomy. Did she discuss the pain from lipo? Every day people have lipo for that reason and for other cosmetic reasons. I realize that there is pain involved in this procedure but I can't for a minute believe it will be more painful than my mastectomy experience. I had mine months ago and I still have soreness all around the endges. My surgeon said it would take at least six months.
Also, the pain from a diep flap procedure must be pretty intense. I was told by my onc's nurse that women who had the flap done from stomach tissue walk around bent over and the surgery itself is quite lengthy so you are under anesthesia for a long time. How long are you under for lipo?
Kathy
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lalisa- The pain is pretty intense, but like dancetrancer said, it's short lived. I have to say the first 48 hours are pretty bad but each day gets a lot better than the day before. Everything dance described is pretty much what I experienced. I'm 8 months out and have no pain or residual numbness. I had the lipo done on my inner thighs, hips and stomach. The worst pain was the thighs and it also had the worst bruising. I had very little bruising on my stomach. To me it seems the thinner women end up having more pain. (Maybe with less fat to work with there is more trauma? I don't know.)
evebarry- Dr. Khouri's plan was to eventually take out my implants and do just fat so, yes, it can be done. I don't think, at least with his technique, that you need to have much fat to make it work. I am 5'4" and around 120 and he didn't express any issues with doing 3 rounds of fat grafting.
chatsworth- I think the reason the fat grafting is perceived as more painful is these are areas of our body that are active. Surgery on our breasts hurts but it's not a moving part that we're using as we're up and about. Lipo on our legs, back, hips and stomach are all areas that we feel when we get up, move around, go to the restroom, etc. The parts that are moving are the parts that get the lipo so therefore more pain with each movement. Just laying in bed doesn't hurt. It's the getting up and moving around- yikes! But the pain is really short lived. For me, the pain from my MX was much longer though less intense. As far as how long you're under for the lipo- I had my implants swapped out which added to the time but was under for about 3 1/2 hours I believe. I don't think it would be nearly that long if you were just having the fat grafting.
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