I have been dx'd with IDC and will be having a bilateral masectomy in March with reconstruction. I love the idea of BRAVA as a more "natural" option however information is limited and are the results worth it or are implants the safest best option? Please advise. Thank you.
BRAVA or Implants: What Do You Feel is Safer and Has Best Results?
Doctor Answers 4
Fat stem cell safety in the breast
The Brava System with Fat Grafts is very controversial and new. The idea of placing fat grafts into tissue where you are concerned about breast cancer recurrence has not been resolved yet. The fast grafts are a stem cell and the fear is cancer can be reactivated by the fat stem cells. This really experimental medicine, it will take a generation to determine the real results and safety.
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Using your own tissue for breast reconstruction
The BRAVA system coupled with fat grafting is in its infancy and only being done at select places for immediate reconstruction after mastectomy. I know that Dr. Roger Khouri in Miami, FL does it. I do not know of others.
DIEP, TRAM, and muscle-sparing free TRAM are also possibilities for breast reconstruction in women who do not want implant-based reconstruction.
See several board-certified plastic surgeons in your area to discuss what might be right for you. I hope this helps.
The use of the BRAVA is done for delayed reconstruction, and the research using them is very limited. I would go with a more reliable reconstruction either using autologous tissue like a TRAM or DIEP or tissue expanders/implants.
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BRAVA still experimental for breast reconstruction
With an implant for reconstruction, you will know exactly what dimensions are needed in order to get the size and shape just right. With skin-sparing mastectomy and immediate reconstruction, it is often possible to get it all done at once. With tbe BRAVA system, you would need to wait until you are completely healed from the mastectomy; then wear the appliance for several weeks; then have liposuction and fat transfers, and likely another round later, depending on the size. Make sure you have talked with your breast surgeon AND your plastic surgeon before the mastectomy so that you understand the pros and cons of immediate reconstruction with implant, immediate reconstruction with expander, as well as other options.
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