BRAVA and fat transfer to breast

I am a big fan of Breast Nexus and Real Self. I...

I am a big fan of Breast Nexus and Real Self. I have been thinking about a "boob job" ever since I stopped breast feeding my third and last child (about 5 months ago). I am not worried about size (I was always an A/B cup before kids), but the appearance of my breasts just made me sad (saggy and wrinkly with a deflated feel them). I am not a fan of implants and was not willing to explore that option at all. I finally decided on an autologous fat transfer augmentation and have started the BRAVA about a week ago. Below I am going to go over the preliminary stuff I have already done.

PS: Dr. Hartog located in Orlando, Fl. Dr. Hartog has done the procedure for a bit now and was trained under Dr. Khouri from Miami. He is also participating in the AFT study.

Initial Consult: Because I have stable weight (120lbs) and am not looking for a large enhancement I am considered an ideal candidate. My breast tissue has already stretched out nicely (I was a 34D with all three kids) and I have enough fat. I was hoping for local anesthesia for the procedure, but because Dr. Hartog needs to harvest fat from multiple sites I will require general anesthesia.

Diagnostics: I had a breast MRI done in Orlando with a radiologist who is also participating in a study and also had a 3D ultrasound performed. Total cost $450. Results- normal.
Screening blood work will be performed at my preoperative checkup.

BRAVA: $850 through Dr. Hartog's office. It took over 2 weeks for it to arrive. In my mind the BRAVA is a bit intimidating, but it does become manageable over the course of 7 to 10 days. I had a consult with Darlene, my BRAVA coach, and begin wearing it last week.

Week 1: I use the BRAVA cleanser for my skin and Life Aloe Vera Gel from Whole Foods (recommended by Darlene). The first night was 6 hours. It was total torture and I was itchy and sore in my armpits and sternum. I was up every one or two hours. I was really anxious the second night (7 hours) but have found that each night is better than the last. You get better at repositioning and learn how to deal with the itching and discomfort. So the first week I basically added an hour each night until I reached 11 hours. I had absolutely zero skin issues and the BRAVA rarely looses suction at night. My breast are getting heavier (fuller… it is hard to describe) and are definitely bigger in the morning. I religiously apply coconut oil and Aveeno's baby moisturizer with colloidal oatmeal two or three times a day.

Week 2: I have started cycling and am slowly increasing the length of time I wear the BRAVA. My goal for the end of Week 2 is 12 hours, 2 cycles, and hand pump. I'll post in a few days with the results of Week 2.

Week 2: So I have finished 14 days of BRAVA and am...

Week 2: So I have finished 14 days of BRAVA and am doing it full tilt. Whenever I talk to the BRAVA coach or the Surgery Staff they keep emphasizing that I should wear the BRAVA as much as possible. I am not sure how much "as much is possible" is, so I have been wearing the BRAVA 14 hours per day and cycling 3 times a day and also increasing pressure by hand pump while not cycling. Honestly, it is completely overwhelming and BRAVA is all I think about. There is no way to prepare yourself for the work needed to wear BRAVA. That being said, I am looking forward with positive mindset and take each day as it comes. I have had no problems with my skin beyond itching (which everyone experiences) and I really think it has to do with the Aloe Life Skin Gel I use instead of the skin wipes. I still use the BRAVA cleanser before wear and let the Aloe Life Kin Gel dry for at least 10 minutes. I have also started using Tegaderm between by breasts and the areas of the skin where the plastic edges dig in. I have also started taping my nipples with the Tegaderm, so they won't be sensitive when I take BRAVA off. It is important not to pull off the Tegaderm, as that will irritate your skin. I wash my skin with goat's milk soap and apply coconut oil and Aveeno Baby Moisturizer, by then the Tegaderm falls off. I do not wear underwire bras during my off hours and make sure to re-moisturize midday. By 4pm I am putting the BRAVA back on and attempting my life chores with 3 young kids climbing all over me and asking to be picked up.

I have to say that the swelling I see in the morning after wearing BRAVA is really impressive, close to a large C at this point. I need to get the swelling up to a full D cup before surgery (if I want a chance at a small C). I heard that the 3rd week is where you really see enlargement. I have my preop appointment coming in 2 days. I'll let you know what pearls of wisdom I get from Dr. Hartog and staff.

Week 3 goals: 14-16 hours wear, 3-4 cycles, hand pump pressure above sports box

Week 3 was completed and I am now wearing the...

Week 3 was completed and I am now wearing the BRAVA 14 hours a day. It was recommended to me by Dr. Hartog to try a negative pressure motorized pump to increase expansion of the breast material. Dr. Hartog said that "they" are finding that the expansion achieved before transfer to the breast was a major determinant of how much final volume you can get for a single transfer. The higher pressure is intense and acts to replace the cycling I had been doing with the black suction bulb. My skin was doing well, but my nipples are not so lucky. I am now taping my nipples to help keep the sensitivity under control. My surgery is about one week away and at this point I am just anxious for all this to be over. I am beyond sick of wearing BRAVA and look forward to a BRAVA free future in about 4 weeks. FYI, the automatic pump is made by Medala and cycles up to 70mmHg for 5 minutes and releases pressure for 1 minute. It makes my skin itch like nothing else, but that is probably due to the stretching.

Week 4 goals: BRAVA 14 to 16 hours per day, 4 to 6 hours of automatic pump at high pressure. Continue 1000-2000mg Vit. C supplement, B-complex and probiotics.

Surgery is 2 days away. I'll try to post a day...

Surgery is 2 days away. I'll try to post a day after surgery.I have been wearing BRAVA 24 hrs for 3 consecutive days (this is day 2) and it really isn't as bad as I thought it would be. I had some serious pain on my sternum, probably because I was staying at high pressure for way to long. I have backed off on the high pressure (giving myself a break at sportbox pressure) and the pain has significantly reduced. I started taking protein supplements as well as continuing my high dose Vitamin C and B-complex. I thought about taking arnica preop, but decided against it because I don't know if it will affect the fat transfer. I plan on taking arnica when I wake up from surgery and continuing for 5 days post op. Beyond that I have arnica cream and I bought a Veronique compression garment as well as some Spanx (high wasted tights). I'll review the Stage 2 compression garments when I have worn them for a few weeks. I am not nervous about surgery, thanks to support from two ladies from this site who already had this procedure. I'll plan for the best and look forward to starting the recovery stage :)

Home from surgery. Tired but feel good. Pain is...

Home from surgery. Tired but feel good. Pain is 2/10 with pain meds and 4/10 when it wears off. Recheck in one week. In my girdle and have no leakage yet. Liposuction incisions were closed with 5-0 catgut and 6-0 catgut. This is tiny and will dissolve quickly. Not sure how the boobs look yet, but they are not huge right now. Liposuction was everywhere. Abdomen, hips, inner and outer and back of thighs. I post pics in a month or two. So far no regrets.

I just got the BRAVA on. Was not fun washing a...

I just got the BRAVA on. Was not fun washing a prepping my skin, but I want all my fat cells to live and so I popped a pain pill and stuck my boobs on! I have to say my breasts look amazing and I can't believe how slim my waist is! Minimal bruising. I'll try to post a picture one week out.

Ok. Two weeks post op. My bruising and swelling...

Ok. Two weeks post op. My bruising and swelling has come down significantly and I now fit into by regular clothes (but no skinny jeans for me). The original Marena garment I had post op was starting to dig into my skin so I have started alternating with my stage 2 compression garment (Veronique). The Stage 2 is really tight but I find that my skin sensitivity is less annoying when I wear the tighter garment. I have also purchased 2 Spanx high waisted tights that hit at the knee. I wear them inside out to avoid seam imprints. I take Arnica (oral) twice a day and Arnica massage cream every night. I also apply Aquaphor to the liposuction punctures to keep the scabs soft and not itchy. Almost all the scabs have fallen off at this point. I did a small workout today and felt fine. When I move from sitting I do have a feeling of intense pulling under my skin and it takes me several hobbling steps to loosen up.

My breasts: The bruising is 100% resolved and the needle punctures have long been closed up and are healing. My breasts feel sensitive like when you get PMS and I am wearing no underwire nursing bras that are very comfortable and supportive. I can tell my cleavage is going to be amazing when I wear a real bra. My breasts are a solid C (I was originally a saggy A) and the shape of them is amazing. My husband thinks my boobs are "perfect" and combined with the liposuction says I am a "10". He is very pleased with the changes and my sisters and close friends have already noticed a change in my shape. I look totally different with clothes. I was always petite, but now I have some curves to go with by slim shape. I am 5'4" and weight 120lbs (size 2 bottom, size 0 top) so a C looks pretty good on my frame.

Ok- next update at 6 weeks. I hope this info is helpful.

8 weeks post op. FINALLY the misery is over! My...

8 weeks post op. FINALLY the misery is over! My liposuction has taken the full 8weeks to recover, and I still don't feel like I can run without discomfort and my lower back is still numb. I really can't complain, however, because I know this is all a part of the healing process. I wanted to walk you guys through my AFT. After I stopped wearing BRAVA 3 weeks post op 10hr/ day I didn't really notice a decrease is size. The swelling went down after like a day, but the fullness remained (if you wear BRAVA then you know what I am talking about). For about a week I was so anxious about losing size, but that has not happened. I never had any cysts or obvious loss of fat (thanks Dr. Hartog!) so I really can't comment on that. I can tell you that I obsessed on fat loss and was literally worried almost every day that the boobs would go away. At about 5 or 6 weeks I finally decided to "let it go" and be content with whatever happens. Stressing about your boobs for 2+ months is exhausting! My scars at 8 weeks look like big freckles and a few are slightly raised. It is still winter so at least I don't have to worry about sun exposure yet. After like 4 weeks I felt like I could wear an underwire bra and a low cut shirt and no one would know I had anything done (no bruising, no obvious scars, etc). One thing to mention is that my nipples went back to "normal" and at 8 weeks all the dark pigmentation from wearing the BRAVA has exfoliated off and my nipples are pink again (instead of a darker pink). I have zero sensitivity or pain. I started sleeping on my stomach at about 6 weeks. I was comfortable having "simple" sex at about 2 weeks. I didn't feel comfortable with any boob touching for about 6 weeks (PMS boobs do not want to be handled!). That is all I can think to tell you. Let me know if you have any postop questions. I'm gonna post pictures at the 3 month mark.

Over 12 months after AFT and liposuction

I am updating my review of the AFT and liposuction 13months after the procedure. I am 100% happy with my results. I am a solid 32C (was a sad and saggy 32A before procedure) and have great cleavage due to the way Dr. Hartog placed the fat towards the "cleavage" area of my breasts. It took me at least 12 months for the sensation loss and tingling of my back to resolve. I still have mild asymmetry (was present before the procedure, one breast saggier than the other) that is only noticeable when I stare at my chest. I have no regrets about anything. If you have the stamina and patience for this procedure then go for it! I think in 50 plus years we will look back at breast implants and be shocked that anyone would put foreign material in their body. I will try to post a 1 year post op photo when I get a chance.
Orlando Plastic Surgeon

Internet research. The only other Plastic Surgeon I would consider in Florida was Dr. Khouri, but he is over 4 hours away. Dr. Hartog trained under Dr. Khouri and is a part of his clinical trial.

5 out of 5 stars Overall rating
5 out of 5 stars Doctor's bedside manner
5 out of 5 stars Answered my questions
5 out of 5 stars After care follow-up
5 out of 5 stars Time spent with me
5 out of 5 stars Phone or email responsiveness
5 out of 5 stars Staff professionalism & courtesy
5 out of 5 stars Payment process
5 out of 5 stars Wait times
Was this review helpful? 8 others found this helpful

Comments (60)

Sort by

The small scars in your upper breast pole area and your cleavage look conspicuously like the scars left after the doctor places the Refine medical device. Dr. Hartog invented it. It's a permanent, BARBED, mesh implant. I think I have one in me too, though I never consented to it's placement. And it's causing me HORRIFIC pain (Dr. Khouri --the butcher of my breasts, also gave me a RAFT-- a reverse tummy tuck, where he took my upper abdominal skin (of which I did not have much excess) and advanced it upwards to create a new breast. (I also did not consent to this--just look what he did to me--see my review). Anyway, I was wondering if you're had lots of pain starting at around 3 weeks post op, and also if you had the Refine permanent (implant) suture placed in your breasts. It really does look like you have those things in you (based on the placement of your scars)...I'm sorry if I sound angry but I just found out I have these things in me which Dr. Hartog invented.
  • Reply
Flat2fake2free'n'fab When you say you did not consent to this you are saying you did not sign any consent forms before having your surgery with Dr. Khouri? I had to sign a stack of them including one explaining the procedures about to be done to me. I find this very odd that you did not sign anything before having surgery.
  • Reply
There are absolutely no devices or mesh placed in my breasts. I am a doctor and feel confident to say that I would be able to palpate or discover any foreign material in my breasts. I also had an MRI performed after the procedure and no foreign material was noted. I have absolutely zero pain or complications. I hope that answers your question.
  • Reply
Hi, I had the procedure 2 weeks ago in the UK. Can I wear Brava for 3 months? how many hours a day is best? is 10 hrs the maximum time daily? Are there any food/drinks to help maximise results? Thanks
  • Reply
HI. Lovely results. About what percentage of the fat do you think you lost overall?
  • Reply
I did not appear to loose any fat from the transfer. Absolutely no complications. Successful increase 2 cup sizes.
  • Reply
Thanks you for the update!!! Very happy it all worked so well for you! Post some pics when you get a chance. Were you concerned about the lipo? I am about the same BMI as you tho i am 5'9" and 140lbs. Also, how in the world did you handle three little kids and Brava, not to mention recovery? I know how hard it is to have kids crawling all over you when your body and breasts are so sensitive and all the kids want to do is sit on you lap and put (whack) their heads against your chest.
  • Reply
I wasn't worried about the liposuction, although is retrospect I really should have been. I had my kids crawling all over me day 4 and beyond. It was basically horrible, but I think when you are a mom you can handle anything. My arms and breasts were actually the LEAST sore. My back, legs, and abdomen killed me. I am not sure how I managed, I guess you can deal with anything if you don't have a choice. The BRAVA was crazy, but you can hold a child on your hip with BRAVA on.... not much fun. I hope that helps.
  • Reply
Hi. Wondering how you are doing now a year out from having the fat transfer. I am trying to learn as much as possible to understand if it is an option for me.
  • Reply
I posted a 12 month post op update. I am so happy with the procedure, I would not have done anything different. Good luck on your quest.
  • Reply
which size of tegaderm should i GET?
  • Reply
Depends on your issues. I just bought the big size and cut to the shape I needed. Best wishes.
  • Reply
Hi Jakho, Any updates?  Are you still retaining?  Still happy? Amelia
  • Reply
Hey Amelia, Yes I am so happy. Looking back, the process was a huge commitment. However, I am only 32 and want to enjoy my body and lifestyle. Even though it was really hard to wear the BRAVA, I can now look forward to my 30s without thinking about my boobs all the time. Best Wishes J
  • Reply
Jakho when did you start cycling? how long before surgery. I am having a heck of a time getting answers/feedback from Dr. Hartog's office about extra cycling. I can't get a black bulb and the medela pump isn't available to me in Boston. I am going to rig something up and cycle myself but I am wondering if you could share the guidelines. I so appreciate your time
  • Reply
You should be cycling after 1 weeks of BRAVA wear (once your skin gets used to the domes). The black bulb should have come with your BRAVA domes and is not something extra the doctor provides. The extra equipment would have come with your BRAVA domes package. The guidelines I used are described in my posts and so there is no need for me to rewrite them at this time. It sounds to me like you may not be using the BRAVA under the guidelines of a doctor, as this stuff is very basic to the procedure and handouts are provided by the doctor when you get the domes. I don't mean to sound snippy, but this procedure is best used by individuals who are informed and overseen by their PS and staff. Your outcome may be poor if you do this without the proper guidance and compliance. Regimens for cycling may be different if you had implants, had a lump removed, are asymmetrical, or have other issues with the breast tissue. Good luck.
  • Reply
Thabks for your response i just wanted to make sure i didnt miss anyrhing thst you didnt post. Actually, I'm scheduled with your surgeon Dr. Hartog on may 29th. Brava has been a nightmare due to the recent recall and closure of the study. They stopped selling it through dr's offices and disallowed the bulb. The FDA is reconsidering and will be opening the study again shortly but I am in a bad window. I know you had a great experience with Hartog and his office but I am finding their lack of support frustrating. They have not made a bulb or the medela machine available to ma and seen annoyed at my attempts to find some on my own. That is why I am trying to figure out cycling on my own. Thank you very much for your time, and your response . Jen
  • Reply
That does sound super frustrating! My sympathies, I now look totally *itchy! I hope everything turns out ok. Good luck. J
  • Reply
Thank you for this kind response.
  • Reply
Hi. Did you only wait 1 day (24 hours) to put the Brava back on after your surgery? I noticed you wrote this but some docs are saying that Khouri's protocol is to wait 72 hours to put the Brava back on after surgery. How is everything now? You look great!
  • Reply
I wore BRAVA 24hrs after surgery and for 3 consecutive days (only removing to shower). I am 4+ months out and every day I am glad I had the procedure. I still have soreness on my upper butt when I run, but that is all. My scars continue to shrink and lighten. I'll update and post pictures at 6months.
  • Reply
Thanks Jakho!  Thats exactly what I did, waited 24 hours to put on and only wore Brava for 3 days straight after surgery as I got really sick after that & could not wear Brava any longer.  How come you only wore it for 3 days post surgery & not longer?  Or, did you wear it longer post surgery but at night only?  Yes, I am 1 month out today and I am so glad I did the surgery as well.  My results are awesome!  How many pants sizes did you go down?  I went from a size 4 to a size 0 in 1 month!  It is crazy good! LOL  Can't wait to see your results at 6 mths.  I tried to run a little today but my hips were sore so I stopped.  Is 1 month too soon to run?  When did you start running?
  • Reply
I did 3 consecutive days and the 10-12hrs a day for 3 more weeks. My size didn't change as much as the muffin top was gone and no more saddle bags. I was unable to run for several months. The elliptical and bike were fine for me after 1 month, but high impact running is still "uncomfortable". I have a mud run in August and Tough Mudder in November so I have to start running. My upper butt area is sore after I run but I am working through it. I hope this helps. I am holding steady at 34C and size 2/0. It only gets better!
  • Reply
Thanks JaKho.  Wow, I have to wait months before I can run comfortably..that is stinky!  I am mostly a walker but I love to put in little running sprints for the high/low combo.  Poo!  I am glad you are holding steady at 34C & size 2 or 0, that is what I want to hold steady at since I am that now.  Okay, so I missed those 3 weeks that you did after the 3 days but I seem to be okay.  I am thinking positive! LOL
  • Reply
I think with this procedure you can only do your best and then let it go. I am glad that I don't think about my boobs anymore and can focus on other more important things than my body. It is draining to worry. I think after 3 months you can feel settled with the results and not worry. The swelling from the liposuction took 8 weeks to really go down.
  • Reply