Follow my Brava and Fat Grafting Day by Day
Comments
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Dnice, thanks for the support. Also for the other doctor referral, but the only reason I'm talking to Dr. Ahn at NYU is because she does BOTH BRAVA+AFT and free flap surgeries, and based on reviews from her patients I trust that she will give me the straight scoop about whether there is any hope with more fat grafting (which I seriously doubt, but so far the other PS's I've talked to don't do fat grafting for full reconstruction so I want her opinion). As for Dr. Khouri being "on board" he has not yet replied to the email I sent him a week ago telling him I was not planning on going forward. And, based on all our past discussions, I'm pretty sure he will be supportive but will also say that BRAVA+AFT will work...BUT he also can't guarantee it or tell me how many procedures it might take. At this point I just don't think I'm willing to continue with that level of uncertainty.
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The list is official in that anyone can send the name of a surgeon.She then contacts the surgeon for info and if he /she wants to be added to the list they are.
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goodrhue, I completely get it. You have been through so much. Dr Ahn sounds very caring and honest. I see her on Sept 3. If you want to know anything about her office/staff/or my impression, just let me know. I read your story and wish you the very best outcome. You are a trooper! XoDnice
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Hi Ladies!
Good! I see you are in NC. There is a doctor in Atlanta at Northside Hospital that does full recon with AFT and also uses BRAVA. His name is Dr. Namnoum. I met with him and he was great. I have also talked with a couple of his patients and they were very pleased.
There also is a lady on the cold cap read that saw Dr Khouri but switched to Dr. Ahn and had a lot of good things to say about her. Dancetrancer is her name. She was really helpful when I had questions. I am having my 2nd AFT on Friday and getting a TE placed.
Don't know if that helps anyone! Best of luck to you all.
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4sewwhat, hi! I am curious about your recon steps. On your signature it says you have implants? Now you are having 2nd AFT and a TE placed? I am so confused about the many approaches! Is your story posted somewhere that I might read it? Thank you so much...xDnice
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Hi Dnice!!
I do have an implant on my left, non-CA side. I did my MX one at a time because of a broken ankle! I had TEs places with each MX. Then I did rads with a fully expanded right side. After I was done with rads we expanded the left then let things sit another 6 weeks. I had my exchange to implant surgery on 12/30/13.
I have mild LE in my right arm and hand. losing 32 nodes I am lucky it is as mild as it is! To keep it under control though I do a lot of stretching and massage. Well 6 weeks post exchange all was well. Atlanta was having it's second snow/ice storm in two weeks so we were just hanging out watching a movie and I was stretching and massaging since I had not done it much since surgery. Well I felt this little pop, and dumb me pushes again thinking it is scar tissue or something. Well my incision on the rad side opened less than a 1/4 inch. I immediately got antibiotics on board and my DH cleaned and bandaged. I texted my doc a pic the next day and we all thought it was superficial. Plus neither of us could get to the hospital because of the ice and closed roads.
Long story short, I ended up with an infection and they had to remove the implant. The infection cleared quickly once we tested and got the right AntiB going. I didn't know until after that because it was the rad side he would not want to go back with an implant. I did a TON of research and took it too him to help me twist his arm! I also consulted with 4 other PS. Dr Ma and Dr Wang suggested DIEP, Dr. Namnoum said BRAVA and Dr. Miller said HBO (hyperbaric). I ended up back with my tried and true Dr. Woods and we are giving the AFT a try because other than some thigh and belly fat we had nothing to lose!
There are several studies out saying that AFT into radiated tissue can reverse or improve some of the rad damage. We were planning on doing 2 grafts and then placing the TE, but it softened and improved so much with the first one he has agreed to place the TE tomorrow and then we will leave it mostly empty until everything has healed and this round of fat has a chance to work its magic! Good to know all this flubber I have is good for something :-)
The way the do the AFT for this is different to the way they transfer the fat for the BRAVA. Instead of inserting the fat between layers of tissue they actually inject it into the muscle, chest wall and scar tissue. In fact tomorrow he is also going to graft into the scar tissue my node removal caused and see if that helps my LE at all. My LE therapist has been following my progress through this too in hopes that it opens options for other ladies that have been through rads but don't want or can't have a flap procedure.
There are a couple of other threads for fat grafting ladies. A few others around the country have done what I am doing and so far having good success with TEs or implants not being "rejected" and failing on the rad recon.
Hope that helps! I know it is confusing out there when you see all the different approaches and treatments!
Have a great weekend ladies!!
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thanks for sharing 4sewwhat. So the fat is helping to heal the radiation damage. Then the TE will expand to make room for an implant again? Or will you have your breast made of fat alone? And does your Dr consider Brava would help you? I cannot figure out all the differences of opinions. I know everyone's case is unique. Maybe my next consult will shed some light. Xo Dnice
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P.S. Sorry about LE. I know that must be painful. Hope your Labor Day is great as well.
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I have heard of him. I believe I have read some literature he has published in the plastic surgery journals. So glad you are asking lots of questions! Is his practice primarily face lifts? Or is the bulk of his practice breast reconstruction? Sounds like you are doing your homework. I am still in the midst of recon and have four differing opinions. I completely understand wanting to get through this as quickly as possible and fat transfer seems so promising. Keep us posted! Xo Dnice
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hi Bosom, sounds like you are feeling really comfortable with your Dr. That is huge! Will you use brava and have implant?
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also, I thought brava should be about $2000? I haven't purchased it yet so some of the other women know better.
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So happy you found your PS. Sounds like a great fit. I found the article he authored with Dr Delvecchio. Is his first name Louis? He did a study on preexpansion and fat transfer and it was published by ASPS. The co author, Dr Delvecchio is someone I'm considering. He is in Boston. Glad you are so close to his office too. And Brava for three weeks/6 hrs seems doable. Wishing you the best! Keep us posted about your progress. Xo Dnice
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Hi folks. I am in Houston, TX and was just wondering if anyone knows of any surgeons who do Brava out here. I had a consultation with a PS and he discouraged the whole idea of Brava. I still want to explore the possibility though.
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hi una2008, I am researching BRAVA as well. In my journey, I have found that docs will discourage you from anything that they cannot offer? Are you on fatgraftpatients.com? I am on that site and will see if there is someone close by for you. I live between Boston and NYC so all my consults have been in the northeast so far. ....Dnice
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Thanks Dnice. You are right. My doc didn't have anything bad to say about BRAVA but he pointed out all the cons..like having to wear the device for many hours, the device is ugly and uncomfortable etc. I am just not keen on a 12 hr surgery and all the down time associated with it. Not to mention all the complications that may follow.
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yes. This is quite an education in the politics of Plastic Surgeons. I found Dr Laura Greenberg in CA which is not close to you I know. But I asked on my fatgraftpatients post if anyone knows of Brava doc in TX. These women are so helpful. I will let you know if they know of someone close by to you. You deserve to have what feels right to you. Other women will help you get there.xoDnice
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I had a mastectomy in Feb., sentinel nodes only, no chemo or radiation. (I was a very lucky BC patient - could have been worse) I chose Brava/AFT for my recon. PS who followed BS installed a TE and 100cc fat in Feb. 2 weeks later, I developed an infection and had TE removed 3/7/14. Began Brava use in April, 350cc fat transfer May 7. Next was 7/17, 250cc, which failed 2 weeks later and leaked out an injection hole (weak spot). I took an antibiotic after the failure occurred, but I did not have any infection symptoms. Feeling discouraged with these two setbacks (infection and fat failure), but not giving up.
4sewwhat: I am very interested to hear about your experiences with Dr. Namnoun and your progress. I am only using Brava on the left (single mastectomy). Not terribly uncomfortable, easy to get used to once you get the hang of it. Skin care is tricky, but Tegaderm helped me protect irritated areas. AFT has been done under general anesthesia with only abdominal soreness (from lipo) which gradually goes away. Up to normal routines within 2 days of procedure.
To all the other amazing women in this 2+ year discussion that I have been scanning and reading this afternoon, WOW. I definitely have had a comparatively easy road with plenty of support. My heart goes out to all of you. The BC journey will definitely test one's mettle. At times, it has felt like a 24/7 process with little relief - all the thinking and research trying to cover all the bases, comparing options, making lists of questions for different Drs., Dr. appts, procedures, expenses, etc. I am 63 and retired, so I have had the luxury of time to deal with all of this. I can't begin to imagine doing all I have had to do related to BC and still having to go to work.
This is my first post. Won't be my last.
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Hi Everyone,
Just a quick update...
I took six months after the last fat grafting. The hematoma and infection as soon as I started BRAVA after surgery was it. My body needed rest and I happily sold my machine and burned (well, not literally) the domes! And, guess what? I kept more fat and in my breast than any of my previous BRAVA post-ops!After all these months of rest and then exercise and getting my body strong, I'm heading in tomorrow for what should be my last surgery. It's going to be a painful one, with fat grafting, evening out breasts, removing excess skin from my thighs where they took the fat (in case no one mentioned it, yes, you can get stuck with a lot of skin), and giving me nipples. I can't wait until it's over.
If there's one thing I've learned over this two year journey it's not to rush into anything. For me, the mistake was starting the BRAVA and going to Dr. K when my doc was in an accident. I think my experience could have been a lot better -- and over a lot quicker -- if I had done it differently. Then again, I didn't have radiation.
Just don't rush your decision and make sure you are comfortable with your doctor and the office. I am a writer and I will be documenting my entire experience in a book when I get back on my feet.0 -
intheatl2014, 4sewwhat, hopeful, I hope you are all doing well. Intheatl2014, I am so sorry to hear about the failed fat grafts. It is such a discouraging thing. It's hard enough to gear yourself up for each hurdle/procedure....and then to have such diasppointing results. Don't give up. I have felt the same way. So many of us have. THIS IS REALLY HARD.
4sewwhat, you are SO right. It is a 24/7 mind game. Figuring out which route to take, which surgeon to trust, which hospital, insurance concerns, blah...blah...blah. I cannot believe the tenacity of these women. It is the one thing that keeps me going. I'm glad things are going well for you. Can I ask who your PS is? You can PM me if you like. Will you be finished soon?
Hopeful- So glad you gave your body a break. Sounds like it was needed. And thrilled for you that you were able to return to the PS you liked so much. I wish you the best tomorrow with your surgery. You are in the right hands. Keep us posted about recovery.
Best to all, xoDnice
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i was told a MINIMUM gap of 3 months between procedures, after my infection I waited six months until I felt fit, and had one in June and one two weeks ago, both went well. I have to use the BRAVA for a lot longer before the next one in December.
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I have heard really good cancer killing things about a ketogenic diet and IV Vitamin C to kill cancer. I wish I had waited to do the surg like you. I am having a really miserable time since they cut me up. I hate what I look like. Ihad my arm twisted by myhusband and doctrs to be chopped up and have had 7 reconstuction surgeries since that first terrible day they mast me.I have another 5 to six to go to have 2 breast and 2 nipples thatare roughly sy
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Hi, after every one of my reconstruction surgeries (7 of them, 3 fat grafting), I had an infection start up 1 to 2 days after the procedure, despite getting vancomycin during surgery. So after having one huge infection (300 cc's pus taken out of my chest) last September, I now get IV Vitamin C from my Naturopath at the first sign, you know like reddness, swelling and pain. I haven't had to take anymore antibiotics since I have done this with the IV Vitamin C, it makes hydrogen peroxide in your tissues and blood stream which kills everything. Including cancer. AND has NO Side Effects. Definitely can't say anything good like that about antibiotics. They don't always work anymore, lot of resistant bacteria out there now. That is why I had that huge infection..
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do you have a link to a ketogenic diet? I am unfamiliar with term.
So sorry you have had so many infections macb04. You sound so determined about recon. I am still researching all of this. Did you use the Brava method? Or just FG after recon? This is not an easy road.
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Lily55 Thank you for your encouragement.
Between my TE infection and the next fat transfer was only 2 months (I happen to heal well and quickly). Most of the fat went to the upper and outer areas, and scarring in the lower inside area was released. It held. 9-10 weeks later, I had the next procedure, much of which was transferred to the lower half of the breast pocket. Seemed good to go, but lost it 2 weeks later. Now I am in limbo, seeking a second PS opinion, and awaiting biopsy results on the other breast. Also looking at the time frame. After Dec. 31, new deductible and new out of pocket insurance-wise. Possibly, diff. ins. co. as well. Truly thought I would be done with all before then. Brain on overload!!
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as i understand it three months is time frame to allow fat to really settle and to do it closer increases risk of infection. I think most AFT surgeons follow the three month rule as its about more than initial healing, its a challenging road isn't it?
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Hi bosom... Yes I was told three weeks of Brava/ 10 hrs/day. Only one procedure. This seems the least invasive to me but reading everyone's stories makes me realize any procedure can have complications. I no longer want to open the incisions again to exchange the implants and have pocket work done. I fall in the highest risk group for complications. So this is where I am at too. I know our Drs authored a paper together on "Composite breast augmentation/reconstruction" in one of the journals. Maybe you could ask him for a copy? The entire field of reconstruction is changing and many different procedures are available. Drs don't go over all the risks. It's forums like these that are most informative. I'm still unsure of which surgeon to go with. 😒
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BosumBlues - my friend had fat transfer over her implant and was delighted with results, and had no complications. Complications are more common in people who have had radiotherapy. The information you were given is the same as I was told and it is true it is a much more natural result. I asked to see photos of women who had breast reconstruction using fat transfer only and I honestly could not tell the difference at all, they looked totally natural and there was no scar! My mx scar is so fine as to be almost invisible now and I think it will be invisible once there is more tissue underneath .......
If i remember correctly you don´t need a lot of elevation and your tissue is pretty good already? So therefore your BRAVA timings would be right but you need to feel comfortable too.......
To reduce risk of infection I shower with chlorhexidine every day for a week before surgery.....and a week afterwards too......anfd if you are really worried about infection ask for IV antibiobics during procedure. As I had an infection in the past, purely as prevention I now have that, plus two lots of antibiotics to take for a week afterwards........
I hope this is helpful
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I need to get to a D cup and had damage from rads and serious infection, but I now look more normal in a dress as my upper chest area looks almost the same (I lost tissue up to me collar bone and that has needed to be replaced) and there is the tiny beginning of the shape of a possible cleavage, nothing you could measure other than perhaps one mm but it offers optical illusion there is tissue beneath..........I have to use BRAVA a LOT before next surgery to try and get a maximum fill of the area that would create the actual breast shape so in my mind is the one that will make the most difference. I have a base now it seems.........timing is just around one year from my disastrous one so I am nervous about it!! And doing BRAVA a lot will be a huge time commitment but I am telling myself its an investment in shape!!! Without the infection I would be finished now! Instead its another two minimum if all goes well..................
when is your big day? Its really not that painful, the area where fat is taken from hurts more but I only took one tylenol then nothing..........what matters is wearing compression garment on area fat was taken from afterwards as that helps with comfort and avoiding saggy skin a lot.....
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Damn biopsy was cancer. I will opt for mastectomy. My priority is no rads or chemo. At 63, I do not want to conserve anything that could host recurrence.
Getting my second opinion on the other side's Brava/AFT recon's progress tomorrow. Has anyone else done second opinion while in progress?
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BosumBlues Yes, it is true. SUCKS!!! When I saw the biopsy and mammo films last Fri. after the tissue was taken, I was pretty sure the report would come back positive. The calcification cluster looked the same as the one in Jan. on the left breast. I won't know full details on the cancer until 2 weeks after the mx, just like in Feb. As it was then, my priority is to avoid rads and chemo. The final pathology after surgery will tell the tale. While I am having that surgery, I hope the PS will be able to lipo and lay fat in both sides. Will know more in a couple days.
Like you, insurance and timing are considerations. I am a retired teacher on the state health ins., of which there was only one choice for 2014. Another choice will be added for 2015. Might have to switch for 2015 if rumors prove true that my current ins. co. will increase premiums by 300-400%. That means making sure all doctors and hospitals are on the other plan. And, Jan. 1 starts new deductible and out-of-pocket. Another year of writing lots of checks!!! I have no clue how long it will take to get both sides done and settled. Until today, I had hoped to be done by Dec. 31. That ain't happenin'. Definitely NOT a sprint. Slow and steady marathon, I guess.
Lily55 I am following your progress as well.
Ladies, until the next post! Meanwhile, got some more cancer butt to kick over here.
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