Follow my Brava and Fat Grafting Day by Day
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Eileen,
That's great that your fat hangs around!
Hopeful,
Do you mind sharing what you find out from insurance? Does your insurance cover procedure but not device? etc.
Thanks!
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Still feel quite fatigued. I think much of my feeling tired is from the anesthesia.Hoping I will be okay at work tomorrow. Just have to go back as I am planning another surgery in September(but, of course --each surgery is easier and shorter so far as post-opt is concerned). No pain, just fatigue. I have a large deductible. My insurance does cover much of brava. As long as I am over the deductible, might as well do as much as possible. At this time my reconstructed breast is three times the size of my natural breast. I do need a little more projection. This is why I think I will need one more Fatgrafting surgery--but it should be an easier surgery regarding post-opt. After that, I will need shaping to match my natural breast. I stretch daily, so that muscle repair does not scar-down. With all of this, must say I am pleased with my progress. Still soo tired. Eileen
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Eileen
Thanks for your update. Sending you energy for your first day back at work. I go overboard on my PS suggestion of high protein diet. Need it to keep up with all these surgeries. What we go through!0 -
Hi, does anyone want a copy of Dr Khouri's book? Lots of color pictures detailing his fat-grafting procedure. I spent $40 on it last month, but by the time it arrived, I was sure that I wouldn't be doing any such major intervention. If you want it, make a contribution to your favorite BC organization, and contact me offline kitketchum at hotmail dot com
Best wishes to every one. Kit
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Would appreciate your input. Using brava for first thee days, next 8 hours nicely. Started on May 8. Breast is red, but I assumed it was from the brava use-increases circulation. Sent Dr. Ahn photo's. She increased my antibiotics. Temperature is 98.4-normal. Anyone had such an experience? Eileen
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Eileen,
You mentioned Dr Ahn increased your abx. Why were you already on abx?
Glad no fever and hope redness resolves soon. Do you have pain?0 -
Thanks for getting back to me. No fever, no pain. I thought that perhaps, I do not have pain because the breast is a reconstructed breast. Dr. Ahn uses antibiotics routinely. I was on clindamycin and keflex. She changed the dosage of clindamycin and replaced keflex with flagyl. I have been sending her photo's. She was nice enough to call me, and spent over 30 minutes discussing my situation. She wants me to continue brava use, and send additional photo's. Are you saying that Dr. Khouri and others do not use antibiotics routinely?
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My PS spent 45 minutes on phone with me explaining the situation-reasons for redness, other variations regarding my case. I sent photo's. Change of antibiotics. Situation is already resolving. Eileen
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Eileen... I'm glad you are feeling better, but a bit nervous about the infection possibility considering that I'm doing fat transfer to avoid the infections that come with implants since I've already had my share. Are the antibiotics a precaution? Or, do you have an infection?
Whatever it is, I hope you are healing quick!
Marcia
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Marcia-went to see Dr. Ahn today. She did an aspiration. It did look like fat to me. Area is mildly warm, more pinkish--not as red as before. She wants to follow me more closely--and I am to continue on antibiotics. Still feel fatigued. Think it is from the antibiotics--perhaps it is because this is my fourth surgery and it is wearing me down. Still planning on another surgery in September. So hoping that it will not interfere with my job. They say okay, but still seem to resent it, as at times I must leave early. Eileen
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Eileen,
My surgeon has me start antibiotics one day before surgery and continue until I have drains out.
However, my next surgery will be fat grafting only so shouldnt have drains. So wondering if Dr Kline will keep me on abx. He will not be ready to do BRAVA on me until October when he works again on my badly damaged radiated right breast.
When you have your lipo-fat grafting surgeries does Dr Ahn work on you under General or MAC anesthesia and how long do your surgeries generally last?
Do you take narcotic pain meds after these surgeries?
Take care and sending you energy to get through.0 -
Pinkheart--Dr. Ahn did a lot of surgery on me. Muscle repair plus fatgrafting. This last surgery was 4 hours, this surgery was 2 hours. General Anesthesia.
Start antibiotics the nite before surgery--for two weeks. Used narcotics in the hospital--at home used tylenol. Started brava day after the surgery--perhaps I should have changed the tubing--been using it for quite come time. Dr. Ahn upped my antibiotcs---and will continue to follow me. The continuous use of Brava does become a drain after a while. It does have an impact on my ability to do other things. Do still feel a little tired-I think it is from the antibiotics. Of course--my workplace is now 92 degrees--not air for three more weeks. Perhaps that is what is wearing me down. Also four surgeries over one year might do it as well. Anyway--still planning on more fatgrafting in September. I just want to go for it. Eileen
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Hi there:
I'm new to the board (although I'm very active on Twitter @double_whammied)and have been following the discussions of those of you who've been doing Brava/fat transfer reconstruction.
I had my first fat transfer procedure two weeks ago (May 8) after wearing the Brava for about 4 weeks. I had a nipple sparing double mastectomy in April 2011 followed by chemo and rads (on my L side). Waited 1.5 years to heal post Tx because I know how testy radiated skin can be when it comes to recon. Also wanted to do something less invasive than traditional recon (TEs and implants weren't an option due to rads). Hence, my choice re Brava/fat transfer.
Anyway, I had my 2nd post-op follow-up appt with my PS y'day and things are not looking good. The R side seems to be doing fine. Nipple is black and crusty but the scabs are starting to come off and there's pink underneath. The skin has some redness, but it appears to be healing okay. Fat is sort of hard but I'm hoping it'll soften up.
The L side is a different story. That side actually looks much more like a real boob (size/shape-wise - like a small B cup), but the skin is tight and taut and red and mottled and the nipple is black and not really crusting up like the right side. Doc said he is worried about it and put me back on Keflex (I was on that post-surgery for a week). After 1st post-op (last Tues), he advised me start using Brava on Sat, 1.5 weeks after surgery (I got in touch with Darlene and used it conservatively for three days) but PS has now advised me to stop Brava. He says I'm not healing properly and is advising me to sleep, rest, eat well, not exercise (probably more about the lipo than the breast) and that's about it.
As you can imagine, I'm frustrated and concerned and wondered if anyone here has gone through anything similar. Eileen, I noticed you posted about having some redness after your latest procedure and going on antibiotics. Did you get the same kind of redness with your first procedure?
I apologize for barging online like this and asking for help without previously introducing myself, but I could really use some expertise from women who've been down this road. As you know, there aren't that many of us doing Brava/fat transfer. The Brava/fat transfer procedure is new for my plastic surgeon, too (although he has years of experience doing fat grafting as part of traditional recon).
Anyway, if anyone has any ideas, similar experiences, insights, I would be most, most grateful.
Thanks,
-d
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Hi Double, I am also currently doing Brava + AFT and have not experienced any problems, so I can't help you there. I can direct you to a web site that is all about brava and fat grafting though. THere are plenty of ladies there going through recon this way. www.fatgraftpatients.com
I hope this helps.
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Hey Tisthyme:
Thanks so much for the note. I've actually been trolling fatgraftpatients.com, as well, but find that board much more difficult to navigate and use. Plus, so many of the patients there go to Dr. Khouri. I'm in Seattle and don't have the funds to fly to Miami for recon. I went with someone who trained with him instead here in Seattle.
I noticed that you went through radiation. You've not had any issues with the radiated side with your fat transfer procedures? Can I ask how many procedures you've had? And how much fat the doc injected in you each time? I'm wondering if my guy was too ambitious. Also, did you have nipple sparing?
THANKS so much for responding and I am happy to hear you've had no trouble. Gives me hope!
-d
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doublewhammied - I had 2 fat graftings w/Dr. K. Had some redness/purplish discoloration on one side that took several months to resolve after the 2nd graft.
I think Dr. K recommends injecting no > 150 cc of fat during each graft session, in order to improve the graft "taking".
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Thanks so much, DanceTrancer.
I don't know how much my doc injected, although he said he injected the same amount on both sides and R side seems to be doing okay. L side is definitely swollen and red and troubled, though.
Just talked to the nurse and she said they've seen this reaction before with traditional recon (DIEP flaps). Said I just need to wait and see. Advised me to keep taking antibiotics, to eat more protein, take multivitamins, rest, and also to try to get my mind off of it and go have fun with friends (as if that's possible).
When you had your purplish discoloration, did Dr. K put you on antibiotics? Did you have swelling/tautness along with it? Did he take you off Brava? Thanks for any and all info/help.
-d
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I go to a PS that is in Austin, TX that was trained by Dr. K too. I went and had a consult with Dr. K and loved him, but decided it would be in my best interest to stay close to home. I have no regrets, I love my PS, Dr. Kerr.
I have had 2 procedures and my left (radiated side) is much tighter and a bit "tan", but the improvement is dramatic! Before FG, it was like skin draped over ribs with a little shriveled muscle I could see when I flex. Now, it is still tight, but there is some form and I can grab and jiggle the breast mound. The whole area has improved in appearance AND I can now feel in that area.
I am not sure how much he injected in each one. And no, I didn't have NS.
I hope with a little time and TLC (and those dang antibiotics) that you will heal up soon and be ready for your next session.
xo-A
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Doublewhammied-a radiated breast is always more difficult to treat. I think that my infection is actually from my workplace environment, as I work in a hospital--and the ventilation system is not working properly. --people have been ill in a variety of ways. I have improved with antibiotics.,,Hoping the same for you. Eileen
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Hey Doublewhammied. I'm in Seattle, too. Would you be willing to share the name of your PS? I'm at least 6 months away from any kind of reconstruction, but I'd like to know who I can meet with here to learn more about my options.
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Thanks for the note back, Eileen. No change in Lefty's redness or that smashed prune of a nipple. Although I think my spirits are a little better tonight.
Listened to the recording of my PS appt. FYI, he injected me with 200ccs. But I can tell that he's actually not worried abt the fat. Just about the nipple. Says the redness is stemming from that area. Nurse confirmed with me today that there's no infection. Yet. am hoping Keflex will stave off whatever might be lurking in there.
Thanks again so much to you all for listening and helping. Recon is not for sissies, I'm afraid. It helps so much to hear that u all are getting through this okay. Xoxoxoxoxo -d0 -
doublewhammied, I had purplish discoloration after surgery on both breasts due to Dr. K doing a scar release bilaterally via his multiple needle point method. He was not concerned. I was given antibiotic cream to apply to my breasts after surgery over all the injection sites. No antibiotics by mouth. After about 6 weeks on Brava, I noticed my left side was no longer looking inflamed, but the right was still red (moreso after Brava) and some slight purplish color remained. I stopped Brava at that point due to needing rads. I did not mention the redness to Dr. K b/c I was stopping Brava. I was also far out from surgery, and it was gradually improving, so I didn't think it was infection. Oh, and I had overdone it on my R side with vacuuming at the 2 week mark, so I attributed the extra inflammation that remained as being due to that. The vacuuming really flared it up, increased pain, and required me to ice the area for a day or two. So I assumed that was why righty was staying purplish/red (mild) for a prolonged time period.
Also, I had nipple sparing on my R. The nipple looked awful after my 2nd fat graft - it had been nice and pink and normal, and after surgery, it developed brown slightly crusty stuff all over it. I was petrified I was going to lose it. But I didn't! After a few weeks the brown stuff flaked off and the nipple returned to it's normal pink color.
Yep, recon is not for sissies. That's why I haven't decided if I am going to go back and finish my recon! (It was interrupted by rads and chemo.)
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Thanks for the note back, TisThyme.
Looks like we both have radiated L breasts. What is it with the L side? I have so many BC buddies who had to have rads on that side.
Very encouraged to hear that you haven't had any problems with your fat transfer procedures. Even MORE encouraged to hear that you have sensation back. That was one of the big reasons why I chose this recon route. It's very exciting to hear from someone who's experiencing that.
No change in the new boob department that I can see. No better, no worse. Still taking antibiotics and trying to eat as much protein/sleep as much as possible. Wish I could exercise (which to me, cures all ills) but the docs says no, thanks to these stupid seromas.
Hope ya'll are doing well and staying strong and healthy. Again, thanks so much for all of your input.
-d
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Thanks so much for the info, DanceTrancer. It helps SO MUCH to hear what all of you have been through. This recon method is still pretty new and there aren't that many plastic surgeons offering it. My PS has done plenty of traditional reconstruction - and plenty of fat grafting as part of traditional recon - but I'm one of his first Brava/fat transfer patients.
I'm going to ask him about the antibiotic ointment for my skin/nipples. And will try to be patient re crusty gross nipples. Hopefully, they will both rise again, like the phoenix. ; ) But I need to be prepared in case that doesn't happen. Doc has already said I may lose all or part of the L one. At this point, I have to just wait and see how this all shakes out. Am praying I don't lose any of the fat (although I know it's natural that some dissipates).
Good luck with your decision re further recon. And very exciting that you saved your hair with cold caps! I looked into them before I went through chemo but ended up just making a wig out of my own hair. Would love to hear about your experience, though!
Best,
-d
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Hey KM:
I'd be happy to share info with you. You can send me an email via my blog, www.doublewhammied.com. Take care and hope you're enjoying the gorgeous Seattle sunshine today!
-d
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You are most welcome doublewhammied. I hope the nipples do ok, but I agree - best to prepare for the worst mentally, just in case. I know how scary it is!
My cold cap experience was great! It is cold, a lot of work, and expensive, so it is not for everyone, but it was the right choice for me. I shed, but no one ever noticed any hair loss. My hair is doing great and has even survived being highlighted 4 or 5 times since chemo last year! I am thrilled with how the caps worked for me.
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Doublewammie,
I lurk on this thread because my PS may do BRAVO with me.
You mentioned you made a wig with your own hair. Do you mind sharing where you had it done and the cost?
My daughter and I have almost waist length hair. When I thought I was going to have chemo I went to a wig shop at Mayo and the saleswoman said the cost would be astronomical to make my own.0 -
Has anyone had any problems with BRAVA (the company)? First, I find out that they ordered me the Sports Kit without the charger or drying rack. So, I have to get these things separately and probably pay more postage. In addition, they told both my doctor and I that the clinical trial was closed, but I checked with the FDA and (after I paid for and received the BRAVA), it turns out that's not true. It is still open.
Is Dr. Khouri behind the BRAVA company? Everyone is entitled to make money, but I'm concerned about being lied to for profit.
It's too late for me (I'm being fitted by my doc today with it), but I'm hoping someone else can use this info and save some money.
Marcia
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Happy to share wig info with you, PinkHeart.
I'm in Seattle and had it done by Anton's Hair Company, which is in nearby Bellevue. Here's the website: http://www.antonshair.com/
I went there about two weeks after my first infusion. My scalp had started tingling (a telltale sign of chemo hair loss) and I was starting to lose strands. It was hard for me figure out when - exactly - to have my head shaved (I loved my hair), but one night I looked down and saw a strand of hair was stuck to the pen I was using to write about the whole issue. I figured that was a sign.
I took my hair out on the town the next night. The next day, I went in to Anton's with some friends, some wine, some chocolate, etc., and had him shave my head. He kept all the little sections in order and put my "hair" back together into a wig within two days. I'd waited a bit too long because the hair was pretty thin in spots; he had to supplement with other human hair. But you couldn't tell a difference. In fact, a lot of people (the ones who didn't know I was going through BC and chemo) told me how much they LOVED my new haircut. Irony of ironies, right?
As for cost, the wig was $1400. My friends and family all chipped in to pay for it (an incredibly touching gesture).
One last thing: I wore my wig everywhere (except when running) and clung to it like a lifesaver from mid-June 2011 until the first of the year (2012). After that, I'd had enough. My new hair grew in VERY slowly, but I still ditched the wig and went "commando" with a micro pixie in Feb of 2012. And I have to say it was kind of freeing. The color grew back in darker, grayer, but the longer it got, the blonder it got (my natural shade). Also, I had wild chemo curls which was very fun. I'd always had long hair (stick straight that I kept trying to curl) and have to say I actually enjoyed wearing my hair at various short lengths. It took MUCH less time to get ready, too! Before, I was always late because of my hair. ; )
Good luck and I hope this info helps you (or others) who are looking at chemo and trying to figure out how to get through it without losing yourself. That's very important. For another interesting route, check in with DanceTrancer, who saved her hair by using "cold caps." Here's a link to a story about those: http://www.nbcnews.com/id/40718154/ns/health-womens_health/t/cold-caps-may-help-cancer-patients-keep-their-hair/
Take care and all the best,
-doublewhammied
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Hey Hopeful24:
I'm not a patient of Dr. Khouri's, but I've interviewed him for a story I wrote about Brava/ fat transfer a year or so ago (I'm a journalist). He has a vested interest in the company, yes, since he's the creator of the Brava device. And in my dealings with Brava, I can see that it's very much a for-profit company. I think by reaching out to other women who've been using Brava - and the various accoutrements associated with it - you'll figure out exactly what you will and won't need. I quit wearing their scratchy black sheath after about two days, for instance, after shelling out about $70 for it. A T shirt worked just fine. Lesson learned. As for the 'drying rack,' your Brava Sport shipping box should have two cardboard 'tiers' that hold the Brava. These work just fine as drying racks. You don't need to order anything separately.
As for the FDA ... there was a hold put on new participants joining the clinical trial as the FDA re-assessed the Brava. But then they completed their review and lifted the hold on the clinical trial. Here's a blog post from a plastic surgeon who writes a lot about fat transfer for breast recon. http://www.laurengreenbergmd.com/breast/brava-back-fda-completed-the-review-and-it-may-now-be-covered-by-insurance-for-breast-reconstruction/ Hope this information is helpful to you.
Best,
-doublewhammied
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