Follow my Brava and Fat Grafting Day by Day
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Lily,
I did have one procedure under local. It wasn't too bad (eyes tearing type pain,nothing terrible). I think it would depend on how much needed to be done. Feel free to PM me if you have other questions.
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I just had my 5th procedure with Dr. Khouri on Wednesday. And, my scar tissue (RB mast plus radiation 5 yrs ago) is not releasing as he had hoped. At my consult in July 2012 he had not had to do more than 6 procedures and now he says mine will "probably" take 7 which I take to mean it could be more.
Quite frankly I'm very discouraged right now and 2nd guessing myself about not doing DIEP. I'm worried about so many surgeries even though the anesthesia doesn't seem to affect me much and I have almost no pain, just stiffness. I know this was a long process but now I'm starting to think - what if it doesn't work?
I would really appreciate hearing from some of you who have 6+ procedures. Did you take more than 3 months between procedures? Did you do anything else to help release the scar? What happens with an abscess, if he just cuts the scar tissue (he has said he doesn't intend to do that).
I'm so afraid right now of just gamely continuing and in the end having it just not work, and then maybe not being a candidate for DIEP. I really don't want any chance of muscle involvement and am not willing to have an implant. If it fails I would probably just end up getting the other one reduced to an A cup (was a D/DD but he already reduced it to a C/D) to match the little mound I could end up with.
Any words of wisdom would be appreciated, and if there are any of you out there who had these issues I'd love some encouragement. But, I would also like the brutal truth if that's what I need to hear.
Thanks!
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i had adhesions cut or lasered during fat transfer as they were too firmly stuck for fat alone to work
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I haven't had 6+ procedures so I'm not sure if my feedback applies. However I wanted to share that I am waiting 6 months plus between surgeries plus I am taking pentoxyphylline and Vit E per my rad onc's advisement to help bring more blood flow and reduce fibrosis. The area is softening, slowly, but surely. Wishing you all the best and wish I had clearer answers for you.
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My extreme radiation damage, both internally and externally, required that I needed a flap. (Radiation also caused implant failure) I now have breasts from SGAP flaps, which were created by a highly skilled microsurgeon with many, many years and number of surgeries behind him. He only does free flaps such as DIEP, SGAP and PAP, that do not compromise muscle. His practice works only on breast cancer patients and accepts all insurance. Too many surgeons out there not accepting insurance because they focus more on their cosmetic patients -- IMO. My surgeon and his partner only do BRAVA on patients who don't have much spare fat such as me, who need fat grafting along with flaps and need BRAVA to optimize the percentage of fat to survive.
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Thanks so much for the feedback!
Lilly55, did you have any problems when they cut/lasered your adhesions?
dancetrancer, I'm going to ask Dr. K about the pentoxyphylline and Vit E, and about whether waiting longer could help. The procedures are covered by my insurance as out-of-network (so I pay the out-of-pocket max each year) and I'm already resigned that I'll be going into a 3rd insurance year with my 7th procedure.
pinkheart: thanks for the referral - if I do decide I might need to go DIEP then I will definitely check out your doctor.
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goodrhue,
Sorry you are going through this. It gives me a new perspective on BRAVA. I had radiation and am having adhesions since my mastectomy. Can you please pm me the cost of each procedure? I doubt I could afford it but wondering.
Thanks.
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no problems post cutting adhesions - surgeon described these as super stuck - but infection after second fat transfer made me seriously ill, and i lost all fat transferred before then......
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goodrhue,
This isn't my personal experience (didn't have radiation), but things I have learned by following quite a few other women doing Brava + AFT. Two women persevered through probably 6 or 7 surgeries and it seemed like "all of a sudden" the radiated tissue bloomed into a lovely breast and the "grand canyon" in the center of their chest was gone. Quite dramatic. Pictorial documentation on fatgraftpatients.com (sorry to be broken record....you do have to post your own pictures to have access). Seems for women with larger implants, would be best to do step down smaller implants with increasing FG, so not too many stubborn adhesions form.
Everything is harder with radiated skin, It takes a tremendous amount of perseverance. Each women will need to decide how long to keep going. Do know one woman who hadn't been a candidate for imp;ants due to much radiation from Hodgkins. Had two FG, ran into some complications with insurance coverage (some states are tough!) but then was able to have an implant which she is happy with. Maybe she'll run into complications down the line, but for now, she is enjoying what she has. Maybe after the implants, it would be easier to do FG again in the future? So many different ways to do this!
Wishing you all the very best!!
Lily55....wondering who your surgeon is? Haven't heard of that approach for adhesions. Interesting. So sorry to hear of the infection and fat loss
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Sorry to report that I developed an abscess and had to go to a surgeon yesterday to get it drained - now I'm into wound care and will not get any fat transfer from this last procedure - I just need to clean it all out and hope it heals with no infection. It seems that he was a bit ambitious in trying to release the scar tissue. I also heard that many patients with radiation average 8 procedures and some take 10-12 - so now I'm even more discouraged than I was on Saturday. After I posted here on Saturday, I emailed Dr. Khouri and asked him many questions, and he's supposed to call me next week to discuss. I'm also going to get a consultation with Dr. Zenn at Duke (where I had my treatment) - I met with him in 2008 after I was done with treatment but I just couldn't handle the thought of reconstruction at that time. I don't know if I can handle 2 or 3 more BRAVA+AFT procedures, much less 5-6, especially after having this experience with the abscess. I'll keep you posted.
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goodrhue - so sorry to hear about the abscess. I totally get why you would be so discouraged. Hugs!
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Goodrhue,
Drs Kline and Craige in Charleston have started using Brava to supplement their flaps after training with Dr. Khouri last year. That is where I have chosen to have my reconstruction, and have been very pleased with them. I considered Dr. Zenn after meeting with several UNC plastic surgeons and have also met with Dr. Khouri; but I love my Charleston decision. I wanted to give you another option to consider. PM me if you want any other details.
Beth
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Goodrhue,
Good you are getting a second opinion. If you go for a third opin, you may want to consider Kline and Craigie that I Pmd you about and now Beth who has a wealth of information. Sorry about the absyss
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Just to update for everyone....
I've stayed off the sites because I'm trying so hard to just deal with the end of this all. I ended up back in the hospital for IV antibiotics after another infection following my 1/3 fat grafting. I had to take a cab to the hospital with 101 fever. I was home alone for two days and couldn't find anyone to come over. That's how isolating this has all become.
It's just all so endless. My daughter wouldn't speak to me for a month. We're finally communicating but she doesn't want to hear anymore about these "cosmetic" surgeries I'm having. I tried to explain that I just want two even breasts. She said I shouldn't expect my family and friends to be going through this for a year and a half when I don't currently have cancer (I do have cervical cancer, but that has nothing to do with the breast surgery, she reminded me.)
Last week, I started BRAVA again for my 3/28 surgery (No. 9 in 1-1/2 years). kriserts mentioned how it doesn't interfere with her life. Well, it IS my life. I started wearing it at night and ended up feeling horrible after three sleepless nights. Then, it's back to the days and I can't even answer my door or go anywhere. Perhaps it works on two breasts with people just thinking you are huge, but there's absolutely no way to hide it on one.
I have found a friend willing to go with me to the next surgery (I was alone for the last one). it should be the last one before the nipples. Then, I can put the worst decision of my life (BRAVA) behind me and write the book that every woman should read before making reconstruction decisions. I only wish I had all the information before I started this. My body is exhausted, my immune system is shot and I am filled with so many scars and nerve pains that I feel like a permanent pin cushion.0 -
Hopeful,
My heart goes out to you. Your comment about your daugther's lack of support, respect, compassion, and literally brought tears rolling down my face. My daughter and family have done the same to me about my breast reconstruction surgeries and complications, which has been a nightmare as well--rotted hole in my chest, etc. So this is not about "cosmetic" surgery! (BTW, every BC survivor should have as many surgeries as necessary to get the best cosmetic result possible. There is a federal act mandating this right and insurance companies have to pay until they are.)
My X husband (divorce final last week), poisoned all of them saying I was having "unnecessary" surgery. I am in a lot of pain physically and emotionally from all this "you only have stage two breast cancer." People should NOT minimize anyone's BC and ALL surgeries involved whether it it for Prophylactic, Stage 0, 1 , 2, 3, 4, etc.!
Then on top of this to have to wear the Brava system again before my next surgery (which was going to be in May, but I think pushing to September). You are right, I don't have a life when I wear Brava. I work during the day so cannot wear it then. Can't wear it in public after work or even to grocery store. I am an A-B cup. The domes sent to me are either a Large or XLarge (not home to check), and waaaaaaay to big for little skinny me. I suspect something was wrong with order. It's ridiculous enough to have to wear domes, but also that are too big. The Brava coach said wouldn't matter or hurt anything. What??? What about my rightful self consciousness and being a prisoner in my home? At the very least, I should have sent the domes back for smaller ones -- so I could at least walk to the mailbox to get my mail. Sorry to rant. Sending you hugs and support from my heart to yours for your last surgery!
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Thanks for your note, Pinkheart. I agree that part of my problem has been the BRAVA size too. I was also given the large and tried numerous times to exchange it, but was told "you'll need it." I have never come close to filling it, nor do I want to. It's just made it more difficult to "hide."
I have a cousin (only 38, with two little kids
) just going through chemo with Stage 3 BC. I know she is a long, long way from being to this point. It's hard for me to watch all the support she's getting (she set up a secret facebook page like I did). All I keep thinking is about how much support I had from friends and family at the beginning too. All the cards, gifts, food, offers of rides and people just calling and stopping by.
With every surgery, the support gets less and less. I know people have busy lives, but it does hurt that everyone thinks we're fine when the cancer is gone. The only thing I can do is try to be a better friend myself in between surgeries when people need something. Maybe pay it forward does work somehow.0 -
Will be having touch-ups for scar reduction and additional symmetry. My reconstructed breast is wider than my natural breast., Final surgery is set for March 11. It certainly has been a long journey, brava being an ordeal--My results are looking good to date. Eileen
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Goodrhue- just a quick synopsis to say I completely understand. I have spent several years undergoing fat grafts with Dr K. I do really like him. But for me, 6 surgeries was all I could take. When I woke up from #6, he said it might take 2-3 more to get my radiated side to a B cup. I wanted to cry. I'm in my 40's with 3 kids. I'm otherwise fit, strong and healthy, but that fat grafting kicked my butt. And the BRAVA drove me nuts.
I found a doctor who put a larger implant in me, and fat grafted at the same time. It looks WAY better. Not ideal. And still need nips done but I just needed some time to heal and get to a place of peace over it all.
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Geewhiz-this will be surgery number 6 for me. I so agree. 6 surgeries with brava are a bit to handle. My PS often stays with implants plus Fatgrafting. It was my choice to opt for total Implant removal. One of the good things about Fatgrafting iis that you can stop for a number of years, and then continue with total Fatgrafting.In a few years the techniques should be considerably more advanced. Wishing you the best with your decision. Eileen
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Last surgery was on Tuesday, march 11,2014. All went well. Recovering comfortably. Will be interesting to see what my PS was able to accomplish regarding symmetry. She calls them sisters. I am a uni-but I want identical twins. Will keep you posted. Eileen
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My BRAVA equipment has arrived, its been here 24 hours and I have put the box in a little used room, I am scared to open it, wimp dot com is me
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Ha ha ha. Come on Lily. Show the Brava who's boss!
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As stated before my last surgery was on march 11. Still have bandages, but breasts do appear to be more symmetric. Feel quite fatigued.I am a bit depressed, as I was hoping to go to work on Monday.Recovery is always so slow for me. Eileen
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hey Eileen how are you doing? Better I hope...
Where are your bandages? I never have them after a transfer........just one week off sounds enough but it never is for me either.........take your time
My Brava is still unwrapped ........ I think i am in denial about needing it
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Lily-brava made quite a difference for me. This surgery was for recontouring, with mild Fatgrafting so I did not need brava. Nipple position was adjusted on both sides, fold adjusted, etc-so bandages were required.
Brava will make quite a difference in fat retention, so I certainly would recommend following your PS advice.
Thanks so much for the encouragement. Eileen
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Hey Eileen - didn't realize you didn't need Brava this time. Do you know how many cc's she grafted? Just curious. I've heard < 150 cc's you may be able to get by without Brava. It's encouraging to me to think perhaps after my next grafting (4th one) I may not have to do Brava (if I even have enough fat left for a 5th surgery...that's why I'm thinking the amount that will be grafted on my 5th one would be just touch ups like you had).
What did she do to adjust your fold? You have the external fold excision type under the breast...right? How painful is that?
Hugs to you!
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Lorraine-surgery #5 was for contouring and minimal Fatgrafting-no post-opt brava.
Surgery #6--involved Fatgrafting for more nipple projection and to fill in cystic areas that dr. Ahn eliminated. Absolutely no breast pain-minimal pain in donor site. Anesthesia was twilight--.
She refined the under breast and side folds with tack down sutures.(right now I cannot tell if there are excision lines as it is covered with bandages). Absolutely no pain-but as I said--fatigue. As I had said-will post photo's soon as possible. The best. Eileen
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Well I finally opened the BRAVA only to find there is no skin cleanser included AND the cups are MASSIVE, I am a D cup and they have sent me L and its at least double the size of my remaining breast, which surely cannot be correct? Anyone know what I need to do now? I guess I need smaller cups but does that mean an M or an S given that the area involved is flat......??
I have not unsealed the special plastic covers..........
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Lily - your physician typically tells you what size domes to order. I am in a medium-wide and this was ordered for when I was flat after MX. They should say on the box what size they are.
Also, ask you doc if you can use Johnson and Johnson baby shampoo to cleanse the skin. That is what I use.
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mine just say L and look narrow i have never been shaped like that. I am my surgeon's first BRAVA patient and feel really unsure of everything, it also seems damn expensive for what it is!
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