Breast Augmentation Through Fat Transfer - Palo Alto, CA

I wasn't comfortable with implants, but wanted...

I wasn't comfortable with implants, but wanted larger, fuller breasts. I had breastfed three children, and simply wanted restoration. I was willing to adhere to the complete Brava regimen, both pre- and post-surgery, and it made better sense to me to use my own fat than carry around a foreign object for the rest of my life.

This procedure is not for those who want instant gratification, and Dr. Greenberg was very involved throughout the weeks-long process.  I'm still just a few days out from surgery, so I honestly don't know how much I'll ultimately retain (I'm using the Brava system, so retention should be high barring unforeseen complications), but am confident that Dr. Greenberg's skill and training have insured the best long-term result.

Palo Alto Plastic Surgeon

I had breast augmentation with fat transfer done by Dr. Greenberg and couldn't be more thrilled with the initial result. As other reviews have indicated, Dr. Greenberg is very conservative in what she's willing to do (she won't perform a procedure on you unless she feels you will get a good result), and she's also very straightforward. You know the risks going in, and she doesn't sugar coat anything. I frankly appreciated her candor, and can honestly say I would recommend her to anyone - she's just that good.

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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I am thinking about going to Dr Greenberg for a consultation for the same thing. Are you still glad you had the procedure done? Was the liposuction very painful? What kind of anethesia did she use? Do you have a recent pictures you could share showing that you have kept your size? Sorry so many questions! :)
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Sorry for the delayed response. Yes, still glad I had the procedure done. I've had no significant decrease in volume, so the pics above are reasonably representative. Yes, the liposuction was painful, but the pain resolved within a week or so. Not sure re: anesthesia specifics (I was completely out for the procedure). Dr. G is fantastic - you'll learn all you need to know at your consult. Good luck!
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Not sure re: radiation-damaged breasts, but check out Del Vecchio in Boston.
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Thanks momof3CA. I plan to arrange a consultation with Dr. Del Vacchio of The Boston Breast Center, Newbury St., Boston. I could consult with him this winter, but I'll need to delay any surgery to early Spring. I will keep you informed and document progress if we proceed. jeddy031
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Can anyone give me a name(s) of a PS in the Providence, RI and/or Boston, MA area who does liposuctioned fat transfer to a breast that was reduced in size by radiation?
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Please, for those not accostomed to the lingo, what is BRAVA/the BRAVA system?
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Brava is a suction pump bra device that you wear pre surgery and a little post surgery to stretch the skin and make the breasts and the blood vessels ready to receive the fat transfer and keep the most fat. It works well but is annoying to wear. Amelia
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Hi Momof3CA.. I'm Mumof3 in Australia.. & really keen for this procedure for the same reasons as you. Will be travelling to the US for it, & have found this forum so helpful in terms of info & options.. Inc your review. I'd love to know pls - are you still happy with the results? Any other comments you have would be really helpful! All the best, Lyssa :)
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Hi Lyssa... I'm in Australia too. Soooo frustrating that you can't really get this done here! Let us know how you get on. I had this procedure done in the US last year and was very pleased.
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Hi Melbs, Can you tell me who did your surgery? I thought that I read that you went to someone in Ohio, but I can't find who it was. Thanks so much!
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Hi, yes I had it done by Dr Lu-Jean Feng in Cleveland. I was happy - she did a miracle, but in the end it wasn't enough. I got implants again :( I had a lot of issues from my previous implants, and although the fat transfer fixed most of it, I just couldn't live with the rest of it. If I had enough fat to go for a second round of fat transfer this may have done the job, but I didn't. Also, just be aware that liposuction deformities are always a risk from this surgery. I know someone else who went to the same surgeon as me and wasn't as lucky with her lipo results.
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Sorry it took so long to respond. Yes, still happy - there have been no significant changes in volume. My only regret is not having a tummy tuck done simultaneously! Guess there's always something.
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Love pink, If you could visit Boston, I suggest you research Dr. Daniel Del Vecchio of The Boston Breast Center, 38 Newbury St., Boston. Consultations are at his Newbury St. office, and breast augmentation through fat transfer is done under local anesthetic at Harvard's Massachusetts General Hospital which is nearby. Dr. Dan does not give fat transfers to a breast that has been radiated because there is no longitudinal data proving that the transfer does not increase recurrance of breast cancer in radiated breasts. I consulted with him on April 2nd, after much research, and found him and his staff to be the utmost professionals. Dr. D is a grad of Harvard Medical School, and he is on staff at MGH where he teaches medical residents the augmentation with fat transfer method. He gives lectures world-wide, and as of April 1, 2014, he had no Massachusetts Medical Board actions nor sanctions against him. As of the same date, he had no medical malpractice lawsuit claims against him in the state of MA (where he received his original M.D., before specialization) in the past, nor currently in MA (where he has practiced since his M.D.). The info you are reading is according to my research efforts which were very thorough. I don't think I could have found anyone better. I hope to schedule a bi-lateral lift to be done by him sometime over the summer. My right breast was radiated, so I bow to his expertise and will not have a fat transfer. My right breast "looks" smaller and higher than the left. The volume of tissue lost on the right side, however, was so minimal that a micro-mini lift on the right and a (larger) mini lift on the left will suffice for me to achieve the symmetry I hope and expect. I live one hour south of Dr. Dan's office and surgical hospital via Amtrak train and a short subway ride. I would be happy to open my safe, pretty home to you and a guest at no cost whatsoever for the duration of your stay(s) should you want to consider Dr. Dan for your surgical needs. I live with my husband of 27 years (I'm 58), our 17 year-old son (soon to apply to Harvard, Boston Univ., and the Univ. of Pennsylvania, etc), and our two cats. After surgery, you would need some recovery time at my home, or, if you choose, at a hotel nearby where your guest can attend to you privately. If you want to have surgery in Boston, please contact me on this website via the private (not public) venue. Whatever you choose, I wish you the best of results and future happiness. We are all sisters, are we not? Joyce
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Hi jeddy031, You are just so very very sweet! Thank you so very much for all of your information. I am a new member and must say that I am so happy to have found this group. I agree with you, that in many ways, members of the group, are like sisters. Not only by sharing there knowledge, but also helping each other thru the good and the bad times. I so admire the women that have shared there stories about there journey with fat transfers, to me they are just so very brave. I am just trying to learn what I can and decide if this would be the right decision for me. Thank you for reaching out to me and sharing some of your story. I look forward to getting to know you better along with some of the other members. I really appreciate the information about Dr. Del Vecchio, and the offer OMG, to stay at your home. Again, you are just too sweet Joyce!
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Forgot to ask..how long did you use Brava for pre-exp and post-exp and how many hours per day on avg? Did you use the black bulb/pump to accelerate results? Do you have any lumps, etc..? Have you had a mammogram since the procedure and how did that go? Do you think 400 cc per breast sounds high?
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I expanded for 6 weeks prior (just because of available surgery dates - most do for 3ish weeks), and wore them for 3 weeks post. 10ish hours on average. Yes, I used the hand pump, and many surgeons who are getting good results (1+ cup size increase) now recommend it (pre-expansion isn't sufficient otherwise, and adequate pre-expansion seems to be the key for fat retention). I don't have any lumps. I have never had a mammogram, though I'm confident in recent studies that have come out indicating that AFT does not impede proper interpretation of mammograms. Please see Dr. Greenberg's blog - she has a lot of fantastic information re: AFT. 400 cc's per breast is high, but there are surgeons who are transferring that much (Del Vecchio, etc.). The only way your surgeon is going to get that much in is if you have adequate expansion. Remember to use an experienced surgeon trained in AFT! This surgery is still in its early stages - getting it done the right way is essential to getting a good result.
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Thank you! How soon after you had the fat transfer did you start wearing Brava again? Did you use an extra large dome after? Would you mind sharing if your breasts have changed since & posting an updated photo? The surgeon I am using did a friends who turned out very nice. This doc does not use Brava alot so I am kinda figuring that out on my own. I am getting the pump this week. How often did you cycle with the pump?
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72 hours, but I think the protocol may have changed slightly since I had mine done. I used the same domes - though I wished for larger ones. I don't have any updated photos - the ones above were taken in Dr. Greenberg's office. If your surgeon "does not use Brava a lot," I'd honestly find another surgeon. It is so essential to find a trained surgeon for this procedure - there are stories all over RealSelf of people getting AFT done to their breasts w/out pre-expanding, and then having zero retention. ZERO. Do not do that to yourself. The surgery - like any other - is expensive, and painful, and you don't want all of that to be for naught. Nor do you want the calcifications and cysts that can come from 1) improper grafting technique or 2) not using Brava. Even if you try to manage the Brava process on your own, you may not expand enough - it takes a trained surgeon's eye & experience to know when you've reached the proper expansion point. Plus, to be frank, Brava is a total pain. If I hadn't had the knowledge & support of my surgeon (and the Brava support staff on Kouri's team), I wouldn't have made it through a week, let alone surgery. Apparently, some women whose breasts already have a high degree of skin laxity can retain some fat w/out pre-expanding. If you're one of these women, maybe you'll squeak by. Otherwise, and I cannot stress this enough, find someone who has proven results following Kouri's protocol.
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Thanks so much! I wonder why you waited 72 hours (3 days) to put Brava on afterwards? I totally agree w/everything that you are saying. But, I am going w/this doc b/c I met a girl from this forum who had her do the fat transfer. We spent hours together & she let me see her results. She is one year post op & went from a B to a D. She looks awesome & has no cysts. She is guiding me on the Brava & then others I ask questions to. Since she had good results & the doc is in MD where I live, I decided to go for it. My surgery is 4/11 (which will be 6 wks of pre-expansion) and I already paid in full so we are going with it, LOL! I am feeling good that this will work out based on what I've seen. She started using Brava the night of surgery but another girl on here said her doc told her not to use for a few days as the suction can suction out the fat through the nipple so I am not sure what to believe. As, I think you know that this is such an emerging procedure, that there are alot of different thought processes from alot of docs. I am not sure that any of them know for sure. I appreciate all of your help. Feel free to check my updates after surgery on 4/11 as I plan to update often and through out the years to establish long term data for women interested in this. Bet your weather is nicer there!
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The day after surgery is WAY too soon. If your doctor stitches the incisions then you won't need to worry about leakage, but most don't close them. Even after 72 hours, expect some mild fluid drainage (yellowish in color). If this happens, wear the domes upside down so the fluid doesn't ruin your Smartbox. After surgery, NEVER use increased pressure. No hand pump, Smartbox only. My doc currently recommends resuming Brava 72 hours post surgery (before that you'll be too swollen to fit them over your breasts, anyway), and continuing for 3 weeks. You can continue longer if you want, but few make it that far.
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do they feel much softer than they did before?
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They're absolutely soft - exactly like a natural breast. I must say that the only difference I've noticed is in the weight. I was always fairly small-chested (I was an A cup before having children), so it has been interesting to adjust to the heaviness of fuller breasts.
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Are they softer or the same as before though? My natural breasts are fairly firm. I'm wondering if they'll feel like *unusually* soft natural breasts.
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Softer. I also had fairly firm pre-op breasts, and they definitely feel less firm than before. I don't have any comparisons between my "enhanced" breasts and other same-size natural breasts, though (haven't tested it out, LOL!), so I can't say if they're "unusually soft." My guess is that they feel very similar.
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Hi there, Is everything still the same, size, etc? Can you submit an updated photo when you have time? Did you like your experience with Dr. Greenburg? I actually did a phone interview with her & thought she was very nice & honest/ straight forward. But, I just decided to go w/a doctor here in Maryland so I do not have to travel who also seems nice.
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