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.


Hooray! I love reviews about fat transfer in the breast augmentation community. We get too few of them and a lot of ladies are interested. Thanks for your posts so far and please, please keep us updated. Looking forward to reading more of your story!

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Good luck! I was going to do an AFT, but decided on implants for now. Hope to do the fat grafting eventually. Looking forward to seeing your results!
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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


I really liked reading your post. The Brava sounds really intense and confusing. I will be doing the Brava after the 1st of the year. My plastic surgeon also studied under Dr Khouri. I'm a little different than you, as I had implants for alot of years. My implants were removed on July 6th. I have assymetrical breast and my ps suggested leaving my breasts heal from the explant for at least 6 month and then he suggested doing Brava. So that gave me 6 months to save the money for the fat transfer. Was the MRI a mandatory test before doing Brava and did your insurance pay for it, or does all the testing come out of pocket also? I have so many question and can't wait to see your results. I didn't realize you had to expand to a size larger than you hope to end up. I haven't really gone over the procedure in depth with my ps. He just said when my 6 months of healing was up to make a appointment and we'll get started. I will defiently keep a watch on your review. I'll now know what I have to look forward to. Lots of luck.
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All costs are out of pocket for me. The MRI was not covered by insurance, but was at a reduced cost because of the study I am in and the association with my PS. I hope my blogging helps you prepare for the BRAVA. Breast Nexus is another place where you can read some other people's experience with BRAVA. Good luck! I'll be updating my post every week and then monthly after the AFT.

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.


Hello JaKho. Thanks for providing such detail on the Brava. I'm having a BL and have thought I might do this if my breast look too small to me after sx. Good luck & I will definitely be following your journey :)
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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 :)


Lots of luck tomorrow. You are going to look awsome.
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Thanks so much. I am worried because I have sinus congestion today. So frustrating! My lungs are clear and no cough, so I should be fine to go to surgery tomorrow. The thought of postponing surgery is intolerable. I sent my mom out to buy a nettipot and I am going to flush the heck out of my sinus and clear that gunk out. Hopefully I will be clear tomorrow. Thanks for your well wishes!

Great feedback on the Brava! Thank you so much. My thoughts will be with you on surgery day.

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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.

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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.


Congratulations on your great outcome, JaKho! Thanks so much for the great review on BRAVA! I'm so ready to schedule my surgery but I have to travel for it so I have to make the time - hard at the beginning of a new year but it will happen! Thanks so much for your detailed review!! It makes it so much more realistic and I can be so much more prepared! Congratulations again! You look amazing!!
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Glad to hear u r doing well. Your body tolerates a lot more beating from the lipo than mine did:). Can't wait to hear about your end results
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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.


Just looked at your pics and noticed you have no deep red marks and blisters from the domes. Was it because you used the aloe life gel. My skin is horriable from the domes, after having them off all day it lookes like I just took them off. Spoke to Darlene today and she told me to stop using the skin cleanser and use J&J baby shampoo to wash with and then use the aloe life gel instead of the wipes. Looked for it after you mentioned it and wasn't able to find it. Finally broke down and ordered it off line today. It can't get here soon enough. Also wanted to ask how many CC did your ps put into each breast?
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Thank you so much for sharing your insightful review of the procedure. I really appreciate it. There is not a whole lot out there yet re: AFT. I have been researching ps's (I live in Boston but am willing to travel) forever and am wondering how you chose yours. I am very impressed with what I read about Hartog and am DELIGHTED to hear how positive your experience has been! Does anybody out there have any experience with the following? Dr. Khouri, FL. Dr. Placik, Chicago, Dr. Sattler, Seattle. Dr Diana, TX. Dr. Del Vechio, Boston. Dr. Tanillo, Boston. Dr. Coleman, NY (Very $$$$). Thank you so muych for any and all comments I feel I am floundering a bit here and woukld welcome any and all comments, concerns or suggestions.
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Thank you, you have been a wealth of information for me. I was wondering if you lost tackieness on you domes. I have having a heck of a time getting my domes to suction. There are only a few spots on them that are tacky the rest is prefectly smooth. Any thoughts would be helpful. Haven't been able to get ahold of brava .
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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.


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.
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which size of tegaderm should i GET?
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Hi Jakho, Any updates?  Are you still retaining?  Still happy? Amelia
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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.


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.
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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.
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.
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
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