When doing a search on the internet yesterday I found a Dr local to me who does the BRAVA procedure and was trained by the Dr who developed it. He gives a free initial consult and his wife is a breast cancer survivor who is supposed to call me today with some info. I think I will probably go in and meet the doc in the next few months and consider it. I was pretty sure I was not going to ever do reconstruction but this procedure seems like a better match for me. However, I know that sometimes things look better than they really are.
I'd want to get rid of my excess weight before proceeding anyway and am not in any rush to do reconstruction ...something for me to think about anyway.
More info for anybody else who wants it:
http://www.breastreconstructionandau...tion.com/brava
What is BRAVA®
The BRAVA® device consists of two plastic domes with a silicone edge seal that fit over the breasts. They are held in place by a custom made bra. Attached to the domes is a small electric suction pump that applies continuous suction to the breast skin and underlying tissues. This suction actually stretches and expands the breast skin and underlying tissues, analagous to expanding a sponge.
This process also increases the blood supply and flow to the tissues and allows much greater volume of fat to be grafted successfully and maintained. A similar concept is used successfully to apply suction to healing wounds to rapidly increase the rate of healing.
It is recommended that the BRAVA® be worn 8-10 hours a day for about 3 weeks before and 3 weeks after a fat grafting procedure. Most women apply the BRAVA® when they get home in the evening and sleep with the device.
The inconvenience of wearing BRAVA® is far outweighed by the improved fat grafting results obtained. For breast reconstruction the benefits are a completely natural reconstruction without any additional large incisions or scars, and far fewer complications than those associated with other reconstruction procedures.
Why BRAVA®?
For the breast augmentation patient, BRAVA® is strongly recommended to allow the maximum amount of fat grafting in a single procedure.
For the breast reconstruction patient, BRAVA® is essential in the breast regeneration process to prepare the tissues for optimal fat grafting.
Preparing breast tissue with the BRAVA® device promotes satisfactory and long-lasting results from
breast reconstruction and augmentation. Without the use of BRAVA®, most studies show that the most a breast can be enlarged with a single grafting procedure is about 150cc.
In the US, the average breast implant size is at least 300cc. Trying to introduce too much fat at one time is counterproductive as the fat is under too much pressure and will not survive. By using BRAVA® before the fat grafting procedure,the tissues are stretched to accommodate more fat, and it has been shown that maximum final increase in size is up to 300cc or more.
The Bougainvillea Clinique is one of a select group of plastic surgery practices that participate in a nationwide study protocol using BRAVA® and fat grafting for breast augmentation and reconstruction.
Tissue Expansion for Breast Surgery
BRAVA® is an external tissue expansion device that expands breast tissue in preparation for fat grafting. Tissue expansion is especially important for breast reconstruction cases, in which a significant amount of tissue is removed in mastectomy. Before the BRAVA®, the only way to expand the tissue for breast reconstruction was with an adjustable saline breast implant – the volume of the implant is increased in stages, expanding tissue over time. BRAVA® provides an external means of tissue expansion, without the use of a breast implant. External expansion with BRAVA® is very different to internal expanders used in other reconstruction techniques. Whereas with BRAVA® the tissues are expanded like a sponge to allow more fat to be grafted and survive, internal expanders creat a space under the skin to accommodate a breast implant and actually stretch and thin the skin in the process. Internal expanders are associated with a high rate of complications, particularly in radiated patients. BRAVA® on the other hand has been shown to actually improve the quality of the underlying tissues.
Combining BRAVA® with fat grafting is a true tissue regenerative process. Breasts reconstructed with this procedure is the closest we have yet come to truly regenerating a breast in the mastectomy patient.
Advantages of BRAVA®
The survival of fat is a primary concern in a
fat grafting procedure. Some percentage of fat always dies, but tissue expansion promotes the survival of greater percentages of fat.
When fat is grafted to your breast, survivability of the fat is affected by a decreased blood supply, which is brought about by blood vessels that are constricted by the pressure of the newly injected fat. By expanding the tissue before the fat is injected, circulation to the tissue is increased, creating an environment in which the fat can better survive.
Tissue expansion also makes room to accommodate the fat graft, providing the possibility of a larger augmentation.
How big can you go with BRAVA® and Fat Grafting
Generally the amount of fat that can be injected at any one time is dependent on the amount of expansion achieved with BRAVA®, and we use the two-thirds rule. The rule states that your final breast size will be about two-thirds of the size you achieve with BRAVA® expansion. This means that if you want to double your breast size, you have to triple the breast size with BRAVA® before the grafting. The success of the grafting procedure and the amount of fat retained is directly proportional to your commitment to wearing the BRAVA®. The more you expand the breasts before the grafting procedure, the larger the final result will be.
The more committed the patient is to using the BRAVA®, the better the results with fat grafting.
It is important to note that the BRAVA® device is presently FDA approved only for breast enlargement, and is used off-label for combined expansion and fat grafting. Dr. Hartog is a participant in an IRB approved multicenter study with Dr. Roger Khouri, the inventor of the BRAVA® device, combining fat grafting with BRAVA® expansion. A recent published study has demonstrated the safety and efficacy of the BRAVA® expansion with fat grafting process, as well as a significantly higher final fat graft volume and survival.
http://www.healthline.com/hlvideo-5m...ment-517326632
http://journals.lww.com/plasreconsur...&type=abstract
This is the part before the liposuction and injection of fat into chest (some women who have not had mastectomies stop after this point and don't do the liposuction and fat transfer)
http://www.prweb.com/releases/breast...web4605124.htm
Breast Reconstruction Groundbreaking Procedure Gives Cancer Patients Hope
A revolutionary, minimally-invasive breast reconstruction alternative using an external expander called Brava, followed with grafting the expanded mastectomy area with liposuctioned fat . The procedure allows women to recover their natural breasts without another surgery and with the enormous benefit of near-normal sensation in their new breasts and nipples.
Breast Reconstruction with External Expander and Fat Grafting
It allows women to recover their natural breasts without another surgery and with the enormous benefit of near-normal sensation in their new breasts and nipples
Miami, FL (PRWEB) October 6, 2010
The last thing a woman who had a mastectomy or lumpectomy wants, is another major surgery. Dr. Roger K. Khouri MD, FACS has developed a way to give breast cancer patients who have lost their breast(s) or part of their breast to cancer, their breasts back. The technique is a revolutionary, minimally-invasive reconstructive alternative using an external expander called Brava, a comfortable soft gel-like bra, followed with grafting the expanded mastectomy area with liposuctioned fat . The procedure allows women to recover their natural breasts without another surgery and with the enormous benefit of near-normal sensation in their new breasts and nipples.
Although nearly 200,000 women in the US are projected to get breast cancer and suffer a partial or total mastectomy this year, Dr. Khouri’s groundbreaking development in reconstruction offers women an alternate path to recovering back their lost breast which is less painful, less stressful and much more natural.
Dr. Khouri invented Brava almost 10 years ago. However, Brava was solely used for cosmetic breast enlargement purposes in the past. Since then 70,000 women have benefited from his invention. Now Dr. Khouri is revolutionizing
breast reconstruction for cancer patients using Brava. “I was performing a breast augmentation on a small-chested patient and it occurred to me that if I could build larger breasts for her, I could build an entire breast for a breast cancer patient”, states Dr. Khouri. “It has become my passion and I see how it is changing women’s lives.” Dr. Khouri also uses this same new procedure for cosmetic
breast augmentation with fat transfer.
This new micro-fat grafting procedure begins with the patient wearing the Brava bra, to prepare the recipient breast. The patient wears the Brava, while sleeping, for 3 to 5 weeks prior to the first grafting session.
Not only does Brava expand the skin from the outside, it also has the effect of regenerating an edema-like breast mound through the stretch expansion of tissues and nerves.
Brava also increases the blood flow to the mastectomy scar and improves the radiation effect. This does two important things, which are unique to this technique:
1. It creates an adequate vascular matrix into which the liposuctioned fat is later injected.
2. It allows the patient to keep almost normal sensation in her breasts and nipples.
The procedure is done as outpatient, often under local anesthesia and sedation, and has minimal recovery time. Unlike traditional methods, it involves no incisions, no new scars or foreign objects, yet it recreates an entire, natural feeling breast.
Although liposuction and fat transfers have for years been used to tweak or fine-tune implant or tram flap surgery, this innovative procedure is the very first that facilitates reconstruction of an ENTIRE breast from fat with no major surgery. No longer are the alternatives now limited to the traditional surgery-intensive implant or flap methods which inflict major trauma and scars.
Dr. Khouri conducts
fat graft courses where he trains plastic surgeons from around the world on his innovative breast techniques. His upcoming course will take place in Miami on October 30, 2010.
Dr. Khouri has the world's best documented experience on the subject. Dr. Khouri's work was just awarded the best scientific achievement at the Annual Meeting of the European Association of Plastic Surgeons (EURAPS) and he will be delivering his presentation and receiving the award at the 2011 Annual Meeting of the American Association of Plastic Surgeons.
Patients are available for Interviews / B Roll is available
http://www.MiamiBreastCenter.com
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