Follow my Brava and Fat Grafting Day by Day
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OK. Thanks for that. I'll try again a little later. Many thanks.
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Ladybird-dancer - As you consider fat grafting, I strongly encourage you to consult with at least one other doctor who is very familiar with fat grafting, not just Dr. Khouri. When I did my consult with him 2 years ago, there was hardly anyone else with any experience that I could find. Now, however, there are many doctors using a similar approach (see fatgraftpatients.com for some lists and discussion). I have had 6 procedures with Dr. Khouri (my radiated skin failed after the 5th) and am now consulting with other surgeons to assess whether DIEP is no my best option - it appears the fat grafting has not improved my radiated skin, which is just too tight even with BRAVA . Dr. Khouri is great, and, now that I've been his patient for a year and a half, I don't believe he gives complete objective information about options since he believes the flap surgeries are archaic and is 200% committed to fat grafting being the best reconstruction option.
I've had a phone consult with Dr. Kline in SC and an office visit with Dr. Hollenbeck at Duke (I leave near there in NC) to discuss DIEP, and am scheduled to talk to Dr. Ahn at NYU (she does both DIEP and based on the discussion boards probably does the 2nd highest number of BRAVA+AFT next to Khouri).
I'm now taking a vacation from all of this until at least November. Some of the edges are filled in nicely from the fat grafting and I'm a little mounded instead of just skin and bones, but I still need a prosthesis. I'm trusting that I'll figure out what I want to do next, but I don't want any surgery for a while and not during bathing suit season
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goodrhue... Good points. I can't say my experience with Dr. Khouri was great (it actually bordered on horrendous), but he does seem to know his way around radiated skin (which I DON'T have). He is also very anti-flap (which I DO have on one side, and it's fantastic).
As far as doctors doing fat grafting, I was in a very unique position last summer when my doctor was in an accident the day before my first BRAVA with fat grafting surgery was scheduled. I can't tell you how many calls I made before going to Khouri. Doctors that were previously doing it stopped. Before I got to the point where I myself wanted to stop (BRAVA, not fat grafting), I had this conversation with a lot of doctors, including two at high profile hospitals treating friends. They felt that the majority of women weren't willing to put the time, money and discomfort into BRAVA so they stopped.
This is not about fat grafting, though. I'm finding many more doctors doing grafting with other types of reconstruction, even implants, and creating breasts from scratch.
I totally agree and seeing someone who has done more than one type of procedure. I love my doctor (Saint-Cyr at Mayo) and one of the reasons is because he's experienced in flaps and fat-grafting with and without BRAVA. When something doesn't look like it will work any more, he has no problem switching gears.0 -
Thank you both for these insights.
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i agree you need a plastic surgeon who is open to the best procedure for you and who you feel the most comfortable working with.
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Thanks for all the replies, ladies - I don't know what I would do without these forums!
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I need help in understanding what BRAVA is. Can it be done without TE's and implants? Is it multiple fat transfers without huge incisions? I've had a bmx with several lymph nodes removed - is BRAVA less invasive than lat dorsi? I have only small amount of LE under my arm and don't want it to be any worse.
Thanks!
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yes, yes and yes, peacestrength. Hard to explain BRAVA google it with words breast reconstruction with BRAVA. But it takes time, and commitment and fat transfer can be done without BRAVA
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Lily - Thank you! I'll research it more.
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Bosumblues,
A second flap can be added to get volume to match natural side.
I was too thin for DIEP and had bilateral SGAP. Does your PS do only DIEP? He/she could add a SGAP or TDAP or PAP flap. I did not have to have one added but have read of other women on these boards having one added. My PS does all microsurgical flaps and fat grafting. I met one of his patients that had a uni SGAP and her breasts match perfectly which i think is harder with one being natural. Gook luck with your decision!
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Had to put my research on brava and fat grafting on hold as I had to have an MRI of the brain due to numbness of the face. Should get results Monday. Interesting things said about Dr. Khouri. I got that feeling just calling his office and haven't even met him. His staff was less than pleasant. They always say go with your gut. So I may need to look into other options.
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I wrote a long reply a few days ago and it disappeared into the ether....
Someone asked about using Brava for skin sparing MX. I got beautiful results on my prophy MX side with SSNSMX with immediate first fat grafting. Of course Brava not used before this first surgery but used it for my following surgeries. Remember Brava does not just stretch the skin but expands the tissue between the skin and chest wall as well as pec and other muscles. And creates blood supply for the new tissue. So yes Brava and FG can definitely be used with SSMX. There is a photo on Dr Khouri website of a lady with D breasts who had a double SSMX with Brava and fat grafting and very nice results. Patient number 2 http://www.miamibreastcenter.com/reconstruction/prophylactic-photos
As far as the fatgraftpatients website I do not find it hard to navigate. Try it; it is a good place for research. IF you want to see pictures you have to submit your own pictures even if they are just before pictures. Peacestrength even if not planning to use Dr K his website miamibreastcenter explains the process very well.
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Thanks Kareenie, it was me! If only this was possible in the UK, but it simply doesn't exist. AAAAaarrrgh!!!!!! We are so backward here!!!!!!!!!!!!!
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Fat transfer is established in the UK but not the BRAVA Lady-bird Dancer........
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Another question: Once fat transfer is complete, does the suction device or special bra have to be used forever to keep the breasts formed?
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No it doesn´t, you retain the fat and it helps to counteract damage from rads if, like me you have that.........and the new breast shape stays as that, post menopause most natural breasts are largely composed of fat anyway........I was told not to use BRAVA post op only pre op which makes more sense to me..........but I have a long way to go with this process
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In the UK you can get a TE and the fat injected into the remaining breast "pocket" whilst at the same rate they deflate the TE. ULtimately they then take out the totally deflated TE with, yes, you guessed it............another operation! But as Khouri says, a TE puts pressure on the tissue, whereas the BRAVA does actually expand the tissue. Hence it's a much better system
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I don't know if you can travel, but there are doctors in Germany, Spain (?), Italy who are doing fat grafting with Brava.
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yes to Spain........i am there
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hello all.... I am new to this thread but so thankful I found it!! I had TE's exchanged for implant's Jan 2014. Waited 2 months and have healed well. No rads with this diagnosis.(mantle rads with lymphoma as young adult).Feel great but unhappy with rippling on both sides! PS didn't seem hopeful. Told me noone could fix this? 2nd PS said he could.Has anyone heard of Dr Delvecchio in Boston? So confused!! Or anyone else in Boston? I am in CT so I can go to NY as well. I think I will look up Dr. Ahn. I am going to go with Brava as it makes a lot of sense to me. Thanks for all the info here. I am so grateful to those who have been willing to share. Women rock!!
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Ladybird, BRAVA does not eliminate operations of a TE. You still have to go in and have the fat taken out and put in -- just as you would with a TE. Yes, Dr. Khouri makes it sound easier, but you need to remember one very important thing. HE owns BRAVA. Every system that is sold brings him more money. He also rents out the turbo machines ($40 a day!) that he "suggests" everyone needs 10 days before each surgery.
Please be careful distinguishing what you are reading from people who have really had BRAVA vs. Dr. Khouri's website. I'm not saying there aren't some benefits to some people over TEs, but it's nothing like it's advertised -- just like everything else in the world.
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Thanks for suggestion of Dr Ahn. I called her office and made appt for September consult. She is 4th PS I will have consulted. Wish I had done all this legwork before! Felt terrific to speak with her staff member already. I am determined to get this right. Hope I can be helpful to those who follow.....
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I have only heard good things about Dr. Ahn. My current doc, a Saint-Cyr at Mayo is also incredible. Both do flaps, brava and fat grafting without brava so they can give you an honest answer about what's right for you.
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Thanks Hopeful...Mayo and your PS sound great. I realized I can find the right PS. This will be my fourth consult. I feel like such an educated consumer!! Hope all is well for you.
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I am resting up. After 9 major surgeries in 15 months as well as numerous infection, my body really needed a break. I'm giving it a full six months before finishing up in sept.
I'm totally done with brava. The hematoma was the last straw. I sold the sports box and threw away the domes. It was such a huge sense of relief
We'll do the final fat grafting without it. Dr. Saint-Cyr will then even the breasts. I will also have to have skin removed from where all the fat is gone on my thighs, and nipples made with it. I'm expecting another 6 hours, but it will be the last one!!!
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Hopeful, you have been through so much. Hope you enjoy every minute of the summer and come September be one step closer to putting all of this behind you. Your doctor sounds like a perfect fit for you....
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Dr. Saint-Cyr is great. I really appreciated him after two surgeries with Khouri!!
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Hopeful...I am inspired to find the right PS! Just read some terrible reviews about PS I was considering. So happy to be doing my homework. I hope it pays off!
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I met with 2 different PS today and was surprised to find out that they both would do BRAVA. I'm so glad I didn't rush into recon right away. I was a D cup size before bmx and surgeon said if I did just BRAVA and fat transfer, they would only be a size A cup. I weigh 138 Ibs and carry most of my weight in my hips and butt - that's where the fat would come from. Does that sound suspect that he'd only be able to create an A cup? I said an A cup is better than what I have now - he said that he's concerned that I wouldn't be happy with an A cup and recommended that I do a TE and implant with the fat transfer. I really don't want TE's and implants but he's willing to do that instead of the first recommendation of Lat Dorsi Flap - I am not doing the LD, too invasive for me at this point. Your input is welcomed!
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