Follow my Brava and Fat Grafting Day by Day
Comments
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To update. Breast looks and feels better on a daily basis. Range of motion is close to 180 degrees. Started brava a few days ago. Scar wants to pull up, and is doing so rapidly.
Perhaps I will only need one more fat grafting surgery. Very happy. Eileen0 -
Eileen,
Do you have pictures posted on the picture forum?
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PinkHeart--haven't posted, as I will need additional surgeries. Thus far, I am quite pleased. Still I will need at least one more fat grafting for the incision line, and touch-ups for symmetry.
Nipple was completed years ago with a tissue graft. I am happy with the results. Others, who completed fat grafting have posted.
Just want to restate. Suffered pain from implants, and scar tissue for 16 years. I am just thrilled that the pain is almost totally gone. So happy with fat grafting, as healing time is minimal. Eileem0 -
Back at work--at a meeting--so wearing a great outfit--I have had for years. It does look great. Legs have
waist have been trimmed from the lipo. Just so happy about my results. Eileen
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I had my first fat grafting procedure with Dr. Khouri on Jan. 25, for total reconstruction of RB after chemo, full mastectomy and radiation. It went very well, and I have a little booblet! (ha ha - meaning it's very slighlty mounded now instead of just skin and bones) The BRAVA procedure, as many have said, is a chore but is do-able. I wore the BRAVA again (and compression garments for my lower back where he took the fat) for 4 weeks and very much enjoyed my "vacation" for the past 3 weeks before starting the BRAVA again last night in preparation for my 2nd procedure on April 17.
Now that I've been through one full "cycle" here's my summary for anyone considering or just starting this. And, realize that Dr. Khouri is constantly trying to make the process shorter and more efficient.
- 2 weeks BRAVA
- 2 wks BRAVA+hand pump 1 hr before and 1 hr after
- 10 days BRAVA w/turbo which is an automatic pressure cycling maching to replace the hand pump and do it the whole time you're wearing the BRAVA (this was not being done when I had my consult in July but was introduced before I did my procedure)
- Procedure, followed by a few days of leaking and lots of soreness, post-op
- 4 weeks of BRAVA and wearing compression garment (I settled on spanx) (and, my understanding is at some point when the new breast is big enough, instead of wearing the BRAVA you get the "splint" which is just what it sounds like)
- 3 weeks of vacation - no BRAVA and no compression garment!
This isn't for everyone:
- it is expensive (insured for me/BCBS, but out of network + travel + BRAVA + turbo rental, etc. etc.)
- it's time-consuming (for total reconstruction of a 34D, it will take 5 or 6 procedures, so 15-18 months total)
- it disrupts your schedule (on work nights, to get in 10 hrs of BRAVA, it's 8 pm-6 am. once I get the turbo I work up from 10 hrs to 24 hrs the day before procedure. luckily I can do some work from home as needed).
The thing I didn't expect was the scar tissue around all the little holes where they took fat and then injected fat. I practice and teach yoga and had worked really hard over the last 5 years to get my full range of flexibility back. Now I know I'll be doing that after every procedure, and probably for a few years after the whole thing is done, but for me it's worth it all.
I struggled with whether to have reconstruction at all. I was clear I didn't want implants and DIEP seemed so invasive and traumatic I just couldn't work up the motiviation to do it. AND I hated shopping for clothes and especially bathing suits - and forget about excercise/yoga tops - they just don't exist for prosthesis wearers. So in the end when I read about this I decided I would do it and now I'm focused on the end result.
I'm happy to see this as an alternative and I hope it works as well as I've heard. Knowing that I'll never have a "natural" breast back - this seems to be a great direction.
I hope this is helpful to anyone out there with questions - I really appreciate all who post on this board!
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I'm doing it without the "vacation" breaks, because I want to get it done as quickly as possible. So: surgery, one day w/o the brava, start the brava for 2-3 weeks, then add the pumping, 8 weeks later ready for the next surgery.
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kriserts, wow -I have lots of questions! how many procedures have you completed and how many total? This sounds like only one day off for the surgery - so how has your skin tolerated the constant brava use (mine was starting to have a rash in a few places before my break) ? I'll have to talk to him about this when I schedule my next one...although now I've scheduled some vacations around my "vacations" when I don't want to have to carry all the brava paraphenalia with me - LOL. faster would definitely be nice. Thanks for sharing your experience.
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I've had 3 surgeries, hopefully one more to go. Surgery 1: implant swapped for smaller, with some FG, but no Brava. #2 was about six months later, as Dr. Ahn went on sabbatical. I can't remember how long I did the Brava before. She took the implant out, so the site had to heal, maybe 10 days before I started the Brava again. She recommended 3 months apart, but I'd heard the PS up in Boston does them 2 months apart, and pushed her for that. It was actually about 10 weeks later, #3. Break for a day, then almost continuous use for 3 days, then back to regular schedule. I'm a bit itchy, no real rash, and I use the aloe gel, it really helps. Are you on fatgraftpatients.com? I'd really suggest you join that board, there's a lot of people there who can really answer questions better than I can.
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TO UPDATE MY BRAVA AND FAT GRAFTING PROGRESS--
All has gone well. The fat from fat grafting has softened up. Discomfort continues to diminish. Although I add no additional pressure, the nipple continues to come up and is looking much improved. My next fat grafting surgery will be in May. I so look forward to it as I know this will make quite a difference in the nipple area. I think that the post-opt should be easier, as I am only having fat grafting this time. After this I will need an additional fat grafting in September and touch-ups. So glad that fat grafting is an option today, as it was not available 16 years ago when I was diagnosed. So happy that my implants are out. Eileen0 -
Glad to hear such positive thoughts. I am still in limbo. The PS would not even discuss the details of fat grafting my breast until the wound from the stomach was healed and I had a full bill of health.
The wound is basically closed -- the wound care doc expects to "dismiss" me next week -- but my internist says my lungs are still a bit crinkly from the collapse after surgery. At least all my pain is gone and I'm hoping walking more to get those lungs in shape.
I wish I had at least an idea whether we were doing the fat grafting surgery or BRAVA first (or BRAVA at all), but I understand my health comes first. After 4 major surgeries, lung collapses, blood transfusions and staph infections since Dec, I too am cautious!
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So excited. Was given a date for my next surgery. The date will be on May 6. Using brava without an implant is far easier. I have expanded my use of brava to include more hand-pumping for maximum expansion. I am a uni. The RC breast continues to improve. I can just tell that this next round of fat grafting will take quite well. As stated before, feel so happy to have found put about total fat grafting, as the post-opt is minimal(does not interfere with my work schedule-is within my tolerance for surgery). Breast looks so good at this point that is a matter of just filling in the defects. Will need additional touch-ups, but again, what a difference so far. So glad I found this website, and was able therefore to pursue fat grafting as a BR option. Eileen
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Eileen,
Does BRAVA actually improve the survival rate of fat grafted to your breast?0 -
Brava has multiple purposes. First it expands the breast into the correctly shaped mold for a breast., It also expands the size for tissue surface area--another words --you need plenty of skin for the shape and folds of the breast.
In addition, it aids in maintaining circulation until the natural circulation of the breast is sufficiently ready for the graft to take properly. In general it increases the circulation for successful fat grafting. I have used brava from the beginning. My fat grafts have all taken quite well. I also used brava over my implant--and all I can say is that my results are coming along quite well. I expect to have improved results at my next surgery.(you can just see how well everything looks and I still have 3 weeks to go with brava) --so brava on --I will. What an improvement over the implants --for me. ( some implants do look good-but mine were painful). Will certainly be back on the forum for an update after my next surgery. Eileen0 -
Another update:
I just had my 2nd procedure Apr 17. After the 1st one (Jan 25) I actually had a little "booblet" (I was just ribs and skin before) which was quite exciting! This time there isn't much of a visible difference. And, Dr. K was clear up front that because of my radiation, it would take the 1st three procedures before I really see results. Because the skin is still very tight, they didn't transfer much fat this time and so the lipo recovery is easier. They're having me shower 3-4 times per day this week to help stimulate blood flow, then start the BRAVA again. Next procedure July 26...can't wait! This is such a long process, but I'm happy to have this option and not be doing major surgery with DIEP. At first Dr. K told me it would probably take 6 procedures for me, but now they're saying probably 5, I think because of the turbo. And, I'll likely get a slight reduction and lift in my LB so that it will match the new one better.
EileenKaye1 - I like what you said about maybe being able to return to a more normal life. My eye is on the prize - bathing suit shopping a year from now! (No more Land's End mastectomy suits for me!!!!)
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Does the turbo BRAVA device cost more than the standard device?
My insurance pays 100% for everything but the device.
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Does this FDA decision have any effect on those of you using the BRAVA device? Are you in the clinical trial?
My microsurgeon is considering BRAVA for me to help with survival with fat grafting as I am so thin and any fat to be found is quite precious. Also have rads damage to right breast.
Dr. Khouri answers this question on link below.
http://www.realself.com/question/aft-brava-lost-its-fda-approval
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The turbo is an additional $10 per day so about $400 since they've had me use it 10 days before my procedure a (2 so far).
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goodrhue - how many hours a day are you using Turbo?
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dancetrancer: they have me starting the turbo at 8 hrs, 10 days before procedure, and working up to 24 hrs right up to procedure. So I aim for ramping up 2 hrs a day with the turbo from 8 to 24 hrs.
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Surgery number 4was on Monday, May 6. PS took fat from my upper and lower abdominal area. Small amount was taken from my left outer thigh. Started Brava on Wednesday at 4 AM. 8 hours on, one hour off for three days. The breast is absolutely HUGE. Discomfort is diminishing , still quite fatigued. Hope to go to work on Monday.
Plan is for one more Fatgrafting surgery to fill in the defects. Must admit, my lower abs. Could use a little more lipo.
My PS loosened the muscle, which was tight from prior surgical damage. Feels improved, but I have to stretch it out when brava is not in use--or it will tighten up again. Certainly trying to be compliant.
So far, all is going as planned. Eileen0 -
Eileen,
Thanks for the update. I'm glad to hear you only miss one week off work. Have you heard any feedback on the BRAVA study on hold while FDA reclassifies it as a higher risk type category? I haven't found any recent updates.
Awesome that your breast is HUGE.
Take care.
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Called Brava yesterday, as I need some extra tubing. ,Did not ask about the domes, as mine works quite well. I am not in a study, so I am not sure that it pertains to me. Anyway, suppose I am lucky, as my dome should hold out thru my next fat grafting surgery in September. Will need a small amount of additional nipple projection and shaping. Eileen
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Eileen,
So is September the finish line?
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Will have small amount of Fatgrafting the first week in September. Will next need contour refinement, and tattoo refinement.The rough part is complete. Surgeries should have a much easier post-opt. Looking forward to beautiful, perky breasts. Eileen
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Just want to clarify--regarding number of surgeries. My case is not the usual. I presented with continuous pain over the last 16 years. I had implants replaced multiple times in hope of better cosmetics, and pain relief. My PS had to 1.remove extensive scar tissue 2.repair expensive muscle damage. 3. Loosen the tight muscle post repair. I am finally pain-free-- and, of course, this complicated my situation. Others may not require this amount of work.
I am not sure that doing a flap would have relieved my pain, due to these complications. I am so thankful to be pain-free, and feel confident that the cosmetics will be exactly what I had hoped for. Eileen,0 -
Eileen,
I also dealt with severe pain from implants and radiation damage and scar tissue and alloderm chunks adhered to chest wall, trashed pecs, you name it.
I lost the rads side implant when it extruded suddenly, and then had it removed surgically next day. Two months later had bilateral SGAP flap surgery. I woke up from surgery with a feeling of total freedom from the intense pain I had been enduring for 18 months. Now, of course I then had butt pain, which went away by 6 weeks.
When my microsurgeon PS came in to sit down and talk about surgery, I was smiling big at him telling him I can already feel the difference since his meticulous excavation work on the craters of scar tissue and removing fried alloderm sling that had failed and bunched up in my breast fold. He had his work cut out for him on both, but especially the radiated breast. So the BRAVA is being considered to compliment my rads healing and higher chances of fat survival.
I so wish I were a straight from BMX to BRAVA patient. I wish everyone the best who choose BRAVA!
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I'm so happy for you Eileen!
For anyone who wants more info on the Brava/FDA issue, see this link:
http://www.fatgraftpatients.com/forums/viewtopic.php?f=98&t=1488
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Feeling so much better.Finding it difficult to wear Brava for my third day.Trying my best. Reconstructed Breast is so large. Perhaps I will not need additional fat grafting.This was surgery number 4. I am a 36 C. Seems as though fat grafting takes well on me. Eileen
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That is wonderful Eileen!
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So glad it's going well, Eileen! I'm still waiting to hear from my surgeon on insurance coverage for BRAVA and his final opinion after looking at my photos. Hope to get started soon.
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