Microfat grafting or BRAVA doctor recommendations
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kareenie and lee- If you scroll back farther on this thread "momofthree2011" mentioned Dr. Koplin. Since I saw he had fat grafting listed on his site I just emailed him through the link. He mentioned he is doing a big upgrade on his website in the next few months so I'm sure this will be something he'll expand upon. I think he would definitely be someone I would consider consulting with if I move forward with more fat grafting. So much closer to me!
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Kate - You are good! Wish all the docs were better at keeping their websites updated - it would make it so much easier for all of us. Just goes to show (AGAIN!) that we have to be pro-active and ask questions. The more we ask about fat grafting for total breast reconstruction, the more the medical community will realize that we demand better results and this is it.
Can't wait to see his updated website!
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Kate - Dr. Koplin sounds AMAZING!!! You are indeed a super sleuth, and so professional in your emails - no wonder he is willing to talk to you. You are such a great patient representative for the fat grafting world.
If you need any help in gathering your information or super-sleuthing, let me know, and I'll do my best to help you out. LOL
Lorraine
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Thanks Lorraine! I can use all the help I can get! You have to be super slueths to find these guys (girls). Don't know why doctors don't make it easier with internet searches to find them.
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You got it - send me a PM anytime you want me to research someone!
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Go Kathy!!! I'm with you. I'm having my fat grafting (unilateral) secondary to mastectomy and failed DIEP, this coming Monday. I'm the first case at the Univ of Washington under care of Dr. Peter Neligan. As he put it, the fat transfer has been going on in plastic surgery for decades and the growth of tissue using negative pressure is not new as well., its just that now we have the 2 applications being used in breast reconstruction; Brava bra expansion and fat transfer. It is the way of the future and what a phenomenal choice vs implants etc. I told Dr. Neligan women need to look at the process of wearing the Brava bra as a pregnancy (analogy). At first when you find out your pregnant, you have an immediate aversion to having your belly expand and wearing big clothes etc., but then once you get into it and learn more about what's going on from a physiological standpoint, you accept and own it and within no time, you have something great on the other end; something from your own body. Well, wearing the brava bra is an aversion at first, but once you commit and own it, It becomes a part of you and you get to watch the changes and understand the physiology and within no time, you give birth to a boob from your own body. Its wonderful. I find myself actually educating everyone I come in contact with as I figure they all have someone in their life who's had breast cancer. This is the way to get it out there and we can't be shy or embarrased about it as its a phenomenal option and such a great alternative from choices of long ago. Go ladies!!!!
J
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jseda - love your post! I will do the same to educate others. This is the only way to get local docs to listen up, learn, and start offering this procedure so more can benefit. This is the wave of the future.
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Met With Dr Trott Yesterday in Beverly Hills. She spent over an hour with me and is so know so very much about fat grafting all she has learned with her time with Dr. Khouri and her own patients she has done this procedure on. I will most likely go with her,but will not begin till jan when my new ppo insurance kicks in. It will take 4 -5 surgeries removing fat and placing it in breast area (a bit more complicated than that) but she explains it all in consult . I would not use the Brava im already expanded and would prefer smaller breast,besides don't have alot of fat to harvest.She is using my back muffin top area and leaving my tummy pouch alone incase of failure(that rarely happens) but i will have that for diep as last resort ! West coast ladies give her a try too, along with Kate33's dr.
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That is great Beacher! Looking forward to following your progress in january:-)
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@beacher-Does Dr. Trott ever use the Brava system? How many patients has she constructed doing so?
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I don't have the numbers, but Dr. Trott will use the Brava if you haven't been expanded.
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JLK- I'm still debating trying to do another round of fat grafting before the year is out. I may schedule a consult with Dr. Trott and Dr. Koplin. Maybe we can fly in together! lol!
Just found this one, for those of you in NY, and wasn't sure if he's been mentioned-
Dr. Sydney Coleman and Dr. Alesia Saboeiro (Both board certified)
Tribeca Plastic Surgery
44 Hudson St. New York, NY 10013
lipostructure.com
Not sure if they do whole breast fat grafting or just augments implants. I have an email in to them and am waiting for an answer. The website looks impressive, though, and Dr. Coleman has appeared on "The Doctors".
I got a couple of PM's regarding Dr. Coleman so am editing my original post. There were some concerns about the negative reviews of Dr. Coleman. I had seen them but the majority seemed to be from 2007 with a few from 2009 (the same year he was on "The Doctors". There was a recent one from 2011 but she was reviewing her facelife from 10 years ago. Obviously, none of us can "vet" these surgeons so if you are considering having a consult with one of them you need to do your homework and check them out. If you still want to consult with them follow your gut. If you get a bad feeling about a surgeon, or don't feel respected or valued, move on.
I think the hard part about online reviews, particularly of plastic surgeons, is if the surgery is successful most patients do not bother leaving a review. It's the ones where someone goes wrong, which can happen, and the ones that are never satisfied with their plastic surgery that usually get written up and posted. But there do seem to be enough negative reviews that it does cause some concern regarding Dr. Coleman. I wanted to leave his name on here, though, because we're trying to compile a list of all FG surgeons and our experiences with them- good, bad or indifferent. Any information is helpful. So thank you for those that wrote to me with the links. I appreciate it so much.
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Beacher429
Have you decided to go with Dr Trott for your masectomy with reconstruction? Do you have radiated tissue? What will she be using to expand you?
Mina
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Mina! I have one more consultation with a ps that does fat grafting . Then i will decide who i will use.
i have already had my mx almost one year ago nov.2010..,had expanders put in then,then radiation,then exchange to implants. of course this was all over months my exchange was in June 2011.
She wanted to use expander , as scaffolding while doing the fat grafting procedures which could take about a year. She actually called me last night and left me a message,cause i was already asleep (9:00 p.m. busy day for me bed early) she is suppose to try me today and we will discuss the expander that i do NOT want to use . take care hope u find a good fat grafting ps
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Hello Everyone, Hoping you can help me out with this.... Yesterday i went to see my bs, for a few reasons one of them being my reconstruction using the fat grafting procedure. She was completely against it,with her explanation being i would over time get calcification ,little hard bumps. I gave her one of my research papers the one titled "Autologous Fat Grafting in Postmastectomy Pain Syndrome" from www.PRSJournal.com she actually took the time to read over it and came back with the" mean follow up time was only 13 months i would like to know what happens in 5 years? what are these women's breasts like then?' Darn it she had me!!! So now my mission is to find women or studies, research papers on this amount of time after fg. Now because she feels this way still has not made me change my mind on the fg , i just would like her on board with me. She is a very up to date surgeon,not an older women,very strong minded though and really cares about her profession and that everyone knows what they are doing she is going to give my pt an ear full.... So if anyone can send me in the direction to collect this info or know anyone over 5 years please let me know thanks
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Beacher - what I have read is that yes, you will find calcifications after fat grafting, but a radiologist who is qualified in reading these types of films (experience with fat grafting) can detect the difference between a fat calc and a suspicious calc. Here is one article that you may find helpful:
Radiographic findings after breast augmentation by autologous fat transfer.
http://www.ncbi.nlm.nih.gov/pubmed/21364429
Your bs is correct in that this is still a relatively new procedure without long-term studies. You have to make your own determination as to whether you want to be on the forefront of something new, or if you want to wait 10 more years or so. It's a tough call, I know!
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Just booked consults with Dr. Koplin and Dr. Trott on Nov. 3rd. Lucky for me they both had an opening on the same day since I'm flying in from Phoenix. It will be interesting to compare the two and see what they recommend for me.
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That is awesome Kate - so excited for you!
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beacher
I was exactly where you are in regards to the fatgrafting not having any long term studies. There are women who do feels lumps and cysts. We are basically going to have to train the radialogists to see the difference and there will be some biopsies that may need to be done. It is a chance and a personal decision. Can you wait 5 years to see how others do or do you want to do it now?
I wanted to ask you with Dr Trott did she say that she will only do it with an expander to create a space for fatgrafting? Are you radiated and did she say how that might affect that with expander? Did she say how many surgeries she has done before on radiated skin to have a good out come?
Will surgery anesthesia etc all be covered under the insurance with her? Has she had an issue with insurance covering the procedure since it is so new?
Who is the other plastic surgeon you are going to see and what is the recommendation there?
Mina
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Yay Kate, I talked to Dr. Trott today,she called me to answer my question about having to use a t/e ,and she said no idid not and i did not have to even use an implant if i did not want one YAY! But i will use a small implant otherwise i think i would be really small and i have to consider the other breast to size also. I really like her though,i asked if you used the fat droplets like Dr K and she said yes everyone that does fat grafting should try to do it that way. I have my appt. still next Thurs.with Dr. Koplin also. I can't wait till we can compare notes.
Hi Dance, yes you are right ido have to decide if i want to be on the forefront of this procedureand i am 99% sure ido. I looked so hard to find these dr.'s so i am pretty sure this is the right way for me to go,and if anything i do not think it will hurt me in anyway. I will get a smaller implant and really what could go wrong? I have not heard of any problems yet! thanks for you post
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Kate
Since your last fat grafting with Dr Khouri you have developed some returning pain even with the smaller placed implants? What is your course of action now? How many total fatgrafting sessions have you had?
Mina
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Hey Mina, i talked to dr.trott today and i do mot have to have a tissue expander,That was one of your questions for me earlier
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Mina- I have only done one round of fat grafting which was with Dr. Khouri. I have had the pain return and there's a few possibilities about what is causing it. (1) The implants are causing my fibromyalgia to flare. (Sometimes women who have auto-immune diseases find an increase in pain when they have implants.) (2) I may be developing capsular contraction again. (3) I have scar tissue that has formed and it is pulling on the implant. (4) The pec muscles have tightened up again. (5) All of the above! So it will be interesting to see what each PS thinks are the causes and what (if anything) can be done.
beacher- It will be interesting to compare notes! Glad Dr. Trott is willing to try no expander! That should be soooo much better.
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Hi Kate
Hope you get some good news in regards to seeing the plastic surgeons and see if they can help. Yes Fibromyalgia can ceate quite a problem.
Beacher
If Dr Trott does not use an expander what will she use to for expansion so she has a place to put the fat? do you know how many pt's she has done without an expander?
Repeating questions:
Did she say how many surgeries she has done before on radiated skin to have a good out come?
Will surgery anesthesia etc all be covered under the insurance with her? Has she had an issue with insurance covering the procedure since it is so new?
Who is the other plastic surgeon you are going to see and what is the recommendation there?
Mina
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robo47 -
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Mina.she said she could use an implant otr nothing at all. I am not exactly sure how many she has done ,but she has done a few....I am not sure how my insurance is going to work,been worrying about that myself .I was going to post something to see how all the other ladies got there revisions covered.
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hi Everyone, not sure where to post this ...Did anyone have trouble getting your insurance to pay for your revision?
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Nope - I have BCBS and I had no trouble whatsoever to get my revision covered.
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I have Aetna...there was no problem with either fat grafting procedure. I did talk to a rep, she said the problem comes in when there is a question of the procedure being more cosmetic than part of reconstruction. So far I have spent around $3000 out of pocket after meeting my deductible for all procedures....mastectomy w/TE; DIEP; removal of flap; lipo and first grafting and the second grafting. Banking the fat was not covered by insurance and was $1600.
Jana0 -
someone here warned about how to list the lipo for the insurance company so it won't be considered cosmetic, but I can't remember what they said...
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