Microfat grafting or BRAVA doctor recommendations
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Yes rk! I decided to put them there b/c I wanted people who don't have access to them on the FG board to still have a chance to see them when trying to make a decision. I hope it helps someone.
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dance- Thanks for posting your pics on the other site. I think it really shows an honest representation of what is involved with this procedure, the committment it takes and the pay off in the end. So happy for you that you were able to have this done straight from MX. You look great and it must be wonderful knowing you never have to have implants replaced down the road. Continued good luck with the grafting!
My pics are on there, too (one round of fat grafting over implants), but posted pretty far back. I should probably update them to show I have lost very little, if any, fat to re absorption.
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Thank you so much kate!!!
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I am envious of those of you who went from mx to fg. I asked for a small implant hoping to fat graft over it due to not having enough fat to create even a good size B. I have no hips and thin legs and arms. I can barely pinch my tummy. If it ever happens that I can I will gladly remove the implants and go for complete fg. I don't like the idea of a foregin object in me but hate worse of having no breast.
Good information pro and con...benefitial to those of us considering fg.
Wish I could put pic up on the foregin but my computer blocks me from the forum.
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I'm helping my mother research various reconstruction methods, including fat grafting (we just met with Dr. Khouri last week). How can I access the picture forum run by Timtam?
Dionne
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Evebarry, I can understand your feelings - it is indeed TOUGH when you have minimal fat - your options are limited usually to implants, as you said. This is the one time I was thankful for having a pear shape - skinny on the top, but just enough fat on the legs to let me do this procedure.
Dionne, you have to PM one of the following to ask for permission: nowheregirl, timtam, estepp, lilah, or MBJ. They do look at your post count to make sure you are a legitimate poster and to protect the privacy of those of us who are posting our pictures. If approved, they will PM you back with instructions for how to access the forum.
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I want to chime in here, I registered to get more info about prophylactic mastectomy recovery.
I am going to have a nipple sparing PBM with fat grafting to be done with Robert Ferguson in Utah on February 16th. None of the other options seemed remotely appealing to me,
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lizdehart- I don't find the other options appealing either- and I had one of them. I really wish I had found out about the fat grafting before I did the TE's/implants.
Just found out that Dr. Joel Aronowitz (Suzanne Somer's PS) in L.A. will do recon using just fat or will do fat grafting over implants (for those that may not have enough fat for both breasts or don't want to go through that many procedures). The exciting part is if he places implants he will put them over the pecs (so no weird flexing or pulling of the pecs) and then do the fat grafting over the top. He will also use your original incisions unlike Dr. Khouri. I found all this out by a member on here who just had a consult with him. It's so great to see other options becoming available.
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That's wonderful Kate! He is much closer to me. Do you know if he has much experience in this type of procedure? I don't want an implant. I also don't want the fat placed under the pec muscle.
Does anyone know; for the fat-grafting only, if Dr. Khouri injects the fat under or over the pec muscle?
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Dr. Khouri injects the fat both under and into the pec muscle itself for the first graft. And then I assume for the later graftings the fat is going over top of the pec muscle, but who knows, some may be going into it again. I'm not 100% sure.
He uses the pec muscle as an improved source of blood supply - like it's own little flap.
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makingway- I'm not sure but he's been a PS for 20+ years, was (or is) Chief of Division of Plastic Surgery at Cedars-Sinai Medical Center for 10+ years and is currently participating in a clinical trial for "Cell-Assisted Lipotransfer for Breast Restoration". I did find this article about him-
http://www.lef.org/magazine/mag2011/dec2011_Cell-Assisted-Lipotransfer-Breast-Restoration_01.htm
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Thankks Kate. I read that the trial only accepts those 5 years out from their diagnosis or surgery...don't recall which. I think I might schedule a consult.
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I recall listening to a video of Dr. Khouri and another doctor discussing fat grafting. Does anybody know who the other doctor in the video is? Could it be Dr. Aronowitz?
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hello,i am comimg back to this site to let the ladies looking for a ps in cali know i am the one Kate is talking about using Dr.Aronowitz for my fatgrafting surgery. My surgery is Feb. 24th, at 11:30 he will be using my love handles which i have plenty of ,he is not using my pouch just saving it for backup.I am hoping for a small B nothing larger. I have decided to take out my 500cc implant out (YAY) but will be putting a smaller 200cc in .The reason i am using an implant is because i do not want multiple surgeries for more fg. He was willing to go all fg ,but this is how i am going , If the implant really annoys me i can always take it out a then go all fg. We spoke about having to replace the implant in 10 -15 years cause that has also been a concern to me,he said he does not replace them unless there is a need or u want them replaced,so hoping when im 70 it ok and he said he has alot of women who are. He is the kindess, well spoken, surgeon i have met and i have consulted ALOT! If it fails i always have my pouch and will do diep,that is a procedure he highly has respect for. He does not do them himself, says only very skilled microsurgeons are able and woud refer me to one if i need. BUT i doubt i will i trust him 100 % . If anyone has anything negative to say back to me please pm me i got off this thread because of all the bashing of diep and fg ,I STILL consider them both great choices for the right bc lady. God Bless p.s. he is putting the small implant over my pec muscle
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p.s. thanks Kate33 always talking with you is nice i hope you get some relieve from your discomfort.
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Beacher, I am so psyched for you to have found a doctor you feel so comfortable with and to have made a decision and have a plan. I know you have researched this thoroughly; it sounds like you have done your due diligence and have an excellent plan AND back up plan. Yahoo! I know you must be thrilled to have made this big step forward.
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Thanks Dancetranc and Robo,Yes he is using my original scar ! yay again
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I have a question.... i looked all over the insurance thread but could not find the answer. Does anyone know if all insurance companies have to cover revisions is you are not symetrical? whats the deal on that? The insurance lady at Dr. Aronowitz said they may not cover my nonmx side wich is going to be about 3 sizes bigger and way lower. It already is about 2 sizes biger and hangs wierd and lower .... so Anyone know about this or can u suggest where i look Thanks
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Beacher, federal law requires reconstruction, including the nonmx side to achieve symmetry, to be covered by most insurance plans. Read the information on this page and then double check your plan. It should be covered.
Under the WHCRA, mastectomy benefits must cover:
- Reconstruction of the breast that was removed by mastectomy
- Surgery and reconstruction of the other breast to make the breasts look symmetrical or balanced after mastectomy
- Any external breast prostheses (breast forms that fit into your bra) that are needed before or during the reconstruction
- Any physical complications at all stages of mastectomy, including lymphedema
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@Beacher-That's great!! I'm happy that you found a doctor that you like, and I do understand what you mean about not trusting any doctor 100%... It's always smart to have a plan B. It sounds like it's all finally coming together for you. Good luck! I think I will schedule a consult with Dr. Aronowitz also. Does he charge for the consult?
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Great for you beacher! Keep us posted. I am having more lipo and fat grafting sometime in the next few months, was also thinking about mini tummy tuck, but deceided to save, just in case I ever need a diep, funny how we think post BC. sorry you have felt bashed by some on this thread, I don't have time to go back and read. We all make choices based on what we know and think is best for us at the time, there are not any right to wrong answers.
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beacher- I'm really happy that you finally have a plan and a PS you feel comfortable with (and one you don't have to travel all the way across country to see). Having smaller implants and fat grafting made a huge difference for me and I know it will for you, too. I really think any issues I'm still having are coming from the pecs being stretched and you won't have that if your implants are over them. I really hope you continue to post and let us know how it goes with Dr. Aronowitz.
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Hi Again! i have read that dancertranceand sent it to dr. A"s office. things are taking a bad turn here maybe some of you ladies that had revisions and insurance covered it can help. The office just called to add on another 7,500.00 for augmentation of non mx breast???!!! THATS ON TOP OF 4,000.00 for stem cells (no insurance covers that) plus 3,000.00 for mastoplexy on mx side and 200.00 for anastesia. omg this is close to15,000.00 and i changed to a ppo i thought it covered 80 % somebody help me figure this out! he is out of network but is this normal???
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Beacher - it depends on what your specific policy says the out of network coverage is. You need to know what your out of network deductible and max out of pocket is. Beyond the max out of pocket, you need to find out if your insurance company allows out of network providers to balance bill you the difference. And then, you need to find out if Dr. A's office is going to balance bill you the difference beyond your max out of pocket and what your insurance company sees as "reasonable and customary". It's confusing, to say the least.
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yes it is ssssoooo confusing! My out of network deductible is 500.00 and my out of pocket is 4000.00 i thought then they would pay 60% instead of the 80%in network. They keep saying they are going to bill my insurance and see what they pay,but i need to know before i have it done is that possible? I am starting to lose confidence in this dr now
if his office has not done this before and know how to code it ect.. then how many patients has he had???? of course suzannes somers never looks at her bills but im not rich paying for a ppo this year is already a burden on me. Maybe cause he is in Beverly Hills he never has come across this,a middle class breast cancer patient. 0 -
I don't know beacher - everyone's insurance plan is so different! You need to pull up your plan's policy and look at the out of network coverage, in detail...as painful as that is. You need to know if it pays 100% after your max out of pocket or what...I hate insurance stuff...don't give up - many times the support staff know less than you! Attack this just like you researched docs and become an expert in your own insurance plan. That's the best advice I can give, since all the plans are so different.
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On Dec. 12th, I underwent a fat graft procedure, nipple reconstruction and breast lift all in one surgery event. I did the procedure in December since I had already met my deductible and all out of pockets for the year. It was a wise move as it was completely covered by my insurance. It was a TOUGH recovery though - harder than the BMX because my "good" side had the lift work and they took my fat from both the front and the backs of my thighs. The legs were killer. But now, all has healed well and the only discomfort I have is from the under crease of the lifted side as the incision that's healing along there rubs against my bra all the time. The fat grafting made a huge improvement in the appearance of my reconstructed side which has a silicone implant. It looks much more natural - but still puckers a bit when I move my arm.
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beacher- Sorry about the insurance stuff. I wouldn't equate a doctor's experience with the staff's ability to deal with the insurance. Dr. Khouri has a lot of experience but his office staff and billing department were a nightmare to deal with. I kept trying to find out ahead of time what it was all going to cost and could never get a straight answer. Then they overcharged me and I had to wait forever for a credit. Basically, though, by swapping out my implants and doing the fat grafting I maxed out my out of pocket costs for the year of $3200. My insurance covered the rest. They should not be charging you for the other breast. Federal Law says they have to pay for reconstruction to give symmetry. I am surprised that Dr. Aronowitz's office doesn't know this. Not sure I understand why they're saying insurance won't cover the stem cells. Isn't the stem cells the fat grafting? That should be covered. And why would you have to pay for the anesthesia or the mastoplexy? I would try to get everything pre-approved and if something is not being covered I would appeal it with your insurance company. I would stress to the doctor's office that they need to be really careful in the codes they use as there are different ones for recon vs. augmentation and liposuction.
ILBoys- The recovery from the lipo can be tough, huh, but so worth it in the end. I never thought I'd get excited about fat but for once some of it is in the right place. lol!
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beacher.. I replied to you on another thread, but wanted to add here...
Most doctors will balance bill unless you have an arrangement beforehand. I would get the bottom line from the doctor, and if they aren't calling the insurance company for pre-cert for you, I would call yourself and get something in writing. So if the procedure is $15,000 and you have a $4000 max out of pocket and $500 deductible, you pay the first $500, then if you are covered at 60%, they will pay 60% of reasonable and customary, and you pay 40% up to the $4000 BUT if they balance bill, then you get stuck with what is above reasonable and customary... So Get the bottom line from the doctor with all codes, call the ins co, and get them to tell you what is R&C... If the doctor is charging more than that, ask for the doctor to waive that difference.
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Wow Beacher... I was told by several P.S.s that the new laws re: breast cancer reconstruction mandated insurance co to cover the costs is surgery is related to mastectomy. Maybe it's different from State to State. I did have cancer in both breasts (at different times), so I'm assuming my procedures will be covered.
Good luck!
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