Follow my Brava and Fat Grafting Day by Day
Comments
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H24: Do you mean a "wound vac?" Is that where it suctions away excess fluid? And may I ask, do you have less feeling in the diep breast than when it was flat? For you (and I know it differs from individual to individual) is it a lot or a little less feeling than when it was flat?0 -
When people use Brava for augmentation, do they not use fat grafting? I read in other places on the internet how people are not happy with it, saying it's ineffective, but they never mention anything about fat grafting. It leads me to believe that the Brava device is being sold on its own without the help of surgeries.0 -
The Brava device has been sold for augmentation only, without fat grafting, but IMO it is not really effective for that. I know of one person who wore it for months and months, many hours, with very minimal increase in volume that was lasting. Brava causes swelling and brings blood flow to the breasts, but the growth is not permanent, from what I have heard, without fat grafting. She eventually had fat grafting done with it in order to have lasting increase in volume.0 -
That's what I thought. Thank you for the clarification! And I want to say thank you to everyone for sharing your stories so generously! I realize that you don't have to do that. It is very helpful to me. There is so much to consider when making such a huge decision about reconstruction and I really do appreciate all the discussion here. It's good to know about all the pitfalls as well as the upsides.0 -
Can anyone clue me in on how to post, how to submit pictures, and how to tell your story on the fatgraftpatients site? It is so hard to figure out!!0 -
write to the moderator-Alexandra-she will guide you thru the process.
Many of our stories are posted. Photo's can only be viewed by those who submit. . Eileen0 -
Do you have to wait long before you submit photos?0 -
I E-mailed photo's to Alexandra. You can submit pre-opts while you post. She will organize it for you, and allow you admission to private areas. You should also check Dr.Khouri's website., He has a variety of pre and post-opt photo's You are definitely doing a great job on researching this. The best. Eileen0 -
rdgc if you are in CA check out dr lauren greenberg in palo alto. she learned fat grafting from dr khouri and some of her patients post at fgp. they all seem happy so far.
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Hi Everyone: I just talked to Dr. Kline about fat grafting and Brava, as well as SGAP. He definitely recommended Brava for me, since my size requirements are so small (somewhere between AA to AAA cup). Fat grafting without Brava is not as effective as fat grafting with brava, he said. He was saying that fat grafting is good for the health of irradiated tissue. When my radiation is done, I will do one fat graft and see if it stays. The general rule of thumb, and I've heard this from Dr. Dellacroce as well, is that whatever fat stays after 3 months will stay indefinitely. They know that because they judge by looking at the implant and flap patients who have had fat grafting to fill in. So even though Brava is a new method, it isn't new at all to use fat grafting in conjunction with implants and flaps.0 -
rdgc-I've seen your photo's -and agree. fatgrafting would work well for you. I've used fatgrafting with brava-- and seem to be getting excellent fat retention. Some areas have over-retained and will require lipo with additional shaping. Eileen0 -
Whoa! You mean to say you want to take some of the fat off?..Well, I guess I can understand if you want to shape it a specific way...0 -
rdgc, you are correct, fat grafting around implants and flaps is very well established, it is just over the past several years that they are starting to do it to reconstruct an entire breast.
I, too, saw your photos and agree with Eileen. You look like you would be a great candidate, especially since you want to stay small - you'll need fewer surgeries. Your story reminds me of mine, as well as your body type.
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Hey Brava people: My HMO PS said I could do Brava on my own. She said she would do the fat grafting, but won't help me with all the Brava details. I was going to perhaps try fat grafting without Brava, but Dr. Kline siad that he would definitely recommend Brava along with fat grafting. The problem is I am low on cash. Would it be possible to do the Brava without a doctor telling you what to do, i.e., how to wear the "garments," how to use the machine, etc...0 -
Eileenkay: I just saw your photos. You look really good. I am amazed at your progress. Am I correct to assume that you did not receive radiation? Thanks.--rdgc0 -
I had BMX in April due to DCIS in only one breast, but am also BRCA-1 positive so every oncologist I saw suggested a double mx. I had immediate DIEP Flap reconstruction. My Flap worked with my left breast, but the fat "liquified" from my right. I'm still healing and looking toward next steps.
My fear with Brava is that the fat grafting won't take and will liquify like it did with the Flap. I don't want to resort to implants, but if the grafting doesn't take, that will be the next course of action. I am a small woman, so there isn't much fat to take to graft, but I also have small breasts, so there isn't much needed for an A cup.
I love my PS who has lots of experience and success with Flaps, but he has only done two other Bravas before me. How common is it for the fat grafting to not work if I follow the correct Brava procedures?0 -
thanks rdgc--I did not post photo's after the last surgery on September 10. This surgery definitely did show quite a difference in symmetry. I am extremely happy with my results post surgery number 5, but will be requesting just a bit more symmetry in February 2014. No doubt--fatgrafting has done wonders for me. Hope it does the same for you. Eileen0 -
ForMom--I would suggest looking at the fatgraftpatients.com website--as there will many fatgraft patients who have had flap failure. You would certainly have more responses to your question--and a wealth of fatgrafting information. Eileen0 -
Thanks EileenKaye1. I didn't know where to go.0 -
Hi all,
How soon after your fat grafting surgery do you start to wear the BRAVA again? A few days? Week?0 -
PinkHeart: From what I understand, you should do brava the whole way through. Don't quote me on this, but I thought it was that you wear it every night for 10 hours a night for three months, then 24 hours a day pre- and post- surgery. I could be totally off. I too, am curious of what is standard procedure.0 -
PinkHeart--By the way, I talked to Dr. Kline and he did mention that I consider all my options, including Brava. Is Dr. Kline guiding you on how to use it? And are you getting fat grafting from him? We also talked about hyperbaric oxygen therapy. You are so lucky to have had that!!0 -
The doctors who do this all have slightly different protocols, and even vary the protocol per patient depending tolerance/response - so it varies. Dr. Ahn's protocol for me was 10 hours a night (more if possible) for about 6 weeks prior to surgery and 24/7 the 3 days just prior to surgery. Hand pumping/cycling is started as soon as you get to 10 hours (you work your way up over a few nights if it is your first time on Brava). This 6 week time prior to surgery is the most intensive. You really have to limit your lifestyle.
36 hours after surgery she had me start Brava sport box only pressure (no hand pumping) for 3 days 24/7. Then you go to 8-10 hours nightly for a minimum of 3 months - longer if you have had radiation.
If you are having another procedure you then start the whole 6 week pumping cycle all over again.
BTW, here's a cool article written by a journalist who is going through this process at the University of Washington.
Reconstructing Hope
http://www.washington.edu/alumni/columns-magazine/june-2013/mapes/0 -
Dancetrancer,
I came across that same blog googling the other night! It is a great article.
For sure, protocol will vary doctor by doctor and then for each individual patient.
Darlene, my BRAVA coach saw all my pictures with implant failure and extrusion as well as radiation damage and cording running from axilla into flap. So we had a long phone call with discussion how to strategically position dome over this problem areas. I even sent her before and after flap pics so she could see how much magic Dr Kline was able to do already and what our hopes were to achieve from BRAVA.
This is a one time shot for me, and I am my highly skilled, mega experienced microsurgeon's first BRAVA patient, so just take my story as informational but not to be same for others.
Being unemployed and going through divorce is really rough right now, but it is a little easier dealing with this BRAVA treatment severely limiting my lifestyle.
You all have been so helpful and understanding and I truly appreciate you sharing your stories and taking time to call me.0 -
has anyone seen dr khouris from Miami?0 -
Dr. Khouri did my first two fat graftings. Dr. Ahn did my 3rd and will do my 4th (hoping 5th not needed, but I doubt it).0 -
Hello, everyone. Question...
Could someone please explain the purpose of wearing a girdle after fat grafting?
I had fat grafting over implants, and the post-op instructions said to wear a girdle for a week and then Lycra or spandex for five weeks. Two weeks post-op, my PS said I don't need to wear a girdle because I didn't have very much fat grafting done. So, I stopped wearing one every day. Now, three weeks post-op, I'm wondering - Is the spandex simply for comfort/support while walking? Or is the spandex supposed to contour the legs somehow?
Thanks!
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So I made an appt with dr khouri and they do not take my insurance.. So I spoke to my oncologist and he said that was an experimental so I cancelled my appt .. My skin burned from radiation and I have no TE ... Has anyone had brava with type situation0 -
Re: spandex/compression garments - from my understanding the purpose is to help shape the skin/mold it back to the body after lipo so you have nicer results. Some say wear them a week for every decade of your life. However if you are really fit and active you can get away with wearing them less time. I wore mine about 3 weeks (I'm in my 40's). I weaned myself from them gradually. I could tell when I needed to put them back on - my legs felt achey without them and felt much better when I put them back on.
Patricia you could try Dr. Ahn. She is out of network for everyone, but they will apply to see if your insurance will allow an out of network exception. This allows her to be treated as in network. I have been fortunate that this has worked for me. She is in NYC but her office will arrange for you to stay free of charge at Hope Lodge in the American Cancer Society. It is a beautiful place - such a blessing! So then if the insurance stuff works out the only cost is the flight up/back. And you can try for a corporate angel flight (although that is never guaranteed).
I am doing Brava on a radiated breast. It takes a long time to heal (5 to 6 months) between multiple surgeries. It is working, though - my tissue is softening. It takes incredible patience, though. Brava every night for who knows how long. It's been since last June for me so far. But I am thrilled to have this option, and I can really see how it is healing my radiated side and helping improve my shoulder flexibility. But you must be committed to the process. It is not for everyone. I was too afraid of S-GAP and didn't qualify for DIEP, and implants were a definite no-no due to my extensive radiation damage - so I am very thankful for this option!0 -
Thanks for the info, dancetrancer. After I read your response today, I cut an old pair of nylon stockings and used them as the "spandex" under my clothes. Wearing compression garments for a few more weeks is a good idea, just to be sure the outcome of the surgery is successful.
Patricia - I did not do Brava, but I did have capsular contracture after radiation on the one side. So, the first TE was removed, scar tissue cut away, and a new TE put in place. Later, the TE's on both sides were exchanged for permanent implants. Recently, I had some fat grafting around the implants - especially on the radiation side - to make the reconstruction appear more natural. The radiated side is still tight, but it looks and feels a bit better.
I did notice that physical therapy helps a great deal with the tightness and the appearance. I had to stop PT (due to the cost), but I hope to start again. In the meantime, I need to start doing some of the PT exercises myself at home again. Anyway, I hope all of that information helps you somehow.
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