Microfat grafting or BRAVA doctor recommendations
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Try Dr. Peter C. Neligan. Hei's with University of Washington and right in Seattle, WA
Had some contact with a woman who had him for fat grafting reconsttuction after mastectomy and failed DIEP....don't know a lot of details, but I would contact his office and ask your questions. Hope that works for you!!
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bump
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I had a consult with Dr. Said at UW, he works with Dr. Neligan. I was told that Neligan is not doing breast recon much anymore. UW was just approved to use the Brava system and they seemed pretty excited about it. He thought it was a viable option for me, however I decided to go with a gap flap. Nice guy, great consult. Good luck.
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Hi everyone, I just found this about Micro fat grafting. Is this covered under the Breast Reconstructive Law? I hope so and would appreciate any responses. Thanks so much.
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hbcrdreams
Yes, fat grafting is covered by most insurance plans although some plans still consider it experimental. My surgeon coded it as breast reconstruction - other and insurance paid.
I see you are in MA. There is a Dr. Daniel DelVecchio in Boston that does fat grafting. Consider joining fatgraftpatients.com to read our stories.
Currently the BRAVA device is not covered by the FDA as it is currently being evaluated in clinical trial for total breast reconstruction.
Good luck!
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Hi I have been looking into FG to solely create my breasts. (This would be the only reconstructive to the breast.) I started a thread and posted in another. I feel frustrated because I don't seem to be able to find a definitive answer or backup literature being that this is still new. My big question is detecting recurrence and how do we know the fat being transferred wont cause a problem/cancer. My PS has done the FG procedure and is comfortable doing a bit at a time with several procedures so that it doesn't absorb. He doesn't use Brava. If anyone knows facts about safety/recurrence/lumps, please share. Thx.
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Antecdotally, I'll say that last year my BS was opposed to the idea, because she said we couldn't tell if the lumps were cancer or not. But this year she had changed her mind about the feasibility. She said that she was more comfortable with fat grafting, but I should know that if any lumps developed, she'd have to take them out.
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Oh and here is an article from Emory saying that lipofilling (for defects, to make implants look better) is safe. Soooooo...to me I don't get why that would mean full fat grafting would present any higher cancer risk. YMMV, but that is my interpretation.
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I'm 3 days post op from my FG procedure. I did a lot of research on FG (I was not comfortable w/stem cell enhanced FG). I also researched PS in my area (I live in CT). I chose to go with Dr. Beth Collins, as she is in network with my ins. co. Before following thru with surgery, I consulted with a Phd researcher/scientist friend of mine and asked him to review the studies and cases where a patient developed a recurrence post FG. He felt comfortable with the procedure since the stem cells in your fat are so primitive compared to the 'enriched' cells. PS did state that abdominal fat cells contain aromatase, which produces estrogen. My first breast CA was highly receptive to estrogen and progesterone, so this concerned me. I underwent a hysterectomy and oopherectomy and am taking Femara daily... the last thing I wanted was to add estrogen. But, she explained that since I had a double mastectomy, I didn't have breast tissue/fat left. Those who had lumpectomy do have breast tissue/fat cells and MAY be at risk. I consulted with my oncologist (who is very conservative with me) and she agreed that the procedure is relatively safe in terms of risk of recurrence. Although, it's fairly new in post mastectomy patients, the preliminary studies indicate there is no increase of recurrence risk. I hope I've helped with your question.
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Luvmycuties - congrats on your surgery!!! Did you decide to go with the Brava or not? Happy for you to have made a decision and be moving forward!!! You did a great job with your research, so glad you found a local doc who could do the procedure.
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Please forgive me if I asked this already. I have had a rough time lately about several things and I am not functioning as well. I am following up to find out if everyone is still happy with their FG decision? Have you found any lumps that were worrisome? Was there pain either in your breast or where the fat was taken from? How many FG procedures have you had and what size are you? Any afterthoughts or additional info is always welcome. my plan is to have recon this summer (still deciding between FG and implants). Thx again.
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four weeks post fatgrafting with smaller implant. My PS wants me to try the Brava. Tried it for one hour--My skin in quite thin--and I have fears of causing undo irritations to my reconstructed Breast. Also--do not think I will be able to wear it for extende periods of time. Please let me know--how it worked on your reconstruction. Eileen
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I started my BRAVA 10 weeks post mastectomy. I have tolerated it better than I thought I would. Is it the pressure bothering you or the ridges on the domes?
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lizdehart--no problems as yet--was afraid to increase my time--might cause skin irritation without my realizing it. eileen
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I'm on week 4 and so far so good. It is important to properly prepare the skin for the best result. Only now, on round the clock use, am I having minor problems.
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EileenKay1 - I think some people have developed blisters when using Brava with implants. Proceed cautiously. I think Dr. K no longer uses Brava with patients who have implants.0
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Has anyone done fat grafting after a lat flap? I have a small implant in, but I am still experienceing so much pain a year and a half out, I need to do something! I hear they can take the implant out and let the pec muscle go back to its original position. What would happen to the moved lat flap muscle? I assume fat could be grafted into the stretched skin from the implant removal. Anyone have experience with this? Anyone know anything about having the Thorodoscal (sp?) nerve in the moved lat muscle cut? I have had chronic shoulder issues since recon. Any chance those will improve with pec back in place & implant gone?
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Lizdehart--
other issues with Brava include--number of required hours. Should be using Brava 12 hours a day--more than a full time job.And, of course, the problem is --that my working hours are long and do not leave 12 hours left in the day.
Cannot see how I can possibly wear Brava for 24 hours--as I do have to go to work. Brava is huge and cannot be worn out-of-the-house. How did you manage the 12 hour days--with your job? Eileen
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Lizdehart: another note:
My PS seems to feel that use of Brava--makes a world of a difference. Eileen
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Eileen, I work part time - M,W,F. The days I had to get up early for work I started the BRAVA in the early evening. I am fortunate that my boss is very understanding and allowed me 3 days off preop.
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Lizedehart--hoping you will have recommendations. Spoke to my PS last nite--she is working with me on the time issues.I am now required to wear Brava 8 hours daily for 8 weeks.
Could not sleep last nite--6 hours--felt too tight on the rim. Today--area is red with terrible itching. Any recommendations--the itching is driving me crazy.
Before surgery--I will be using Brava 10 hours a day--I will try for more.
I am convinced that Brava will make a difference. Would appreciate any recommendations you have for me. Eileen
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EileenKaye -- for the itching, try Sovereign Silver gel if you have access to a natural foods type store. If not try Benadryl first aid gel.
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kareenie--will try your recommendations. thanks.
Could not sleep last nite--with the brava on.--felt too tight on the rims--perhaps it was. any other recommendations? eileen
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Just wondering how you are doing, Eileen. I am almost 48 post op and doing really well. Now that there is a little more fat in my breasts the BRAVA seems easier to wear.
Hope that helps!
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Lizdehart--glad your surgery went well.
Perhaps I cannot wear the Brava because it is over an implant. Feels as though my chest is tightening up. Tissues have not healed from the irritation. I definitely cannot continue with totally sleepless nites. Eileen
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Just an update. This forum has been a tremendous help to me. Replacing the 410 implant with a 213 and fatgrafting has changed my life. People--who do not know about my surgery--have been making positive comments--gee--"you look great"
The 213 implant has relieved most of my discomfort--left with a very mild tight feeling--definitely acceptable.
My lymphedema is gone( after removal of 33 lymph nodes-incredible)
My legs look great. I lost 6 pounds-already--the pain forced my to overeat.
Have received many suggestions on Brava from the Forum--will try again after the skin irritation is gone. Just hoping I can sleep with the Brava on.
If not--will definitely go to a smallrt implant again with more fatgrafting. Fatgrafting took quite well on me--even without Brava-perhaps because I have extra fat to spare.
Thanks to all of you on this website who have guided me. Will let you know how I do. Perhaps Brava will be improved in the near future. Eileen
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So glad to hear it, Eileen.
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Eileen, do you mean you'll consider a smaller implant with more fat grafting, and then stop there? IE, still with implant in?
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Perhaps Kriserts--I responded on the fatgrafting website. I can see how brava expansion would give the proper shape for a reconstructed breast. I do not think you can get the same cosmetic results without the dome. But, it gave me a terrible irritation, and I just could not sleep. Meds do not work for me. Anesthesia from surgery did not wear off for a week. Terrible fatigue.
I will try brava again. But, perhaps I am best going to an even smaller implant with additional fatgrafting--the fatgrafting took quite well without the Brava. Perhaps I could go to total fatgrafting with 4 surgeries instead of three. Just having fatgrafting without a breast reduction on the other side--should be a much easier surgery. Hoping that brava will improve the domes--and adhesion methods so as not to be so irritating ( purchased the additional items that they recommended)
But as stated--I will try again--as I can see how brava expands the breast into the correct shape for total fat. Eileen
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