momof3CA

Breast Augmentation Through Fat Transfer - Palo Alto, CA

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.

You'll need your doctor to check current protocol. Definitely no sooner than 72 hours out (you'll be too swollen to get them on, otherwise).

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.

My experience w/Greenberg has been excellent. I'm roughly the same size, though my size fluctuates some with weight gain, etc (like any natural breast would). Just make sure your Maryland doctor has been properly trained, and that you can interview some of their patients to verify results. Also, absolutely follow the protocols set out by Kouri & team. Greenberg has a number of patients under her belt at this point, and seems to have fine-tuned her technique to maximize retention (any good surgeon would) - it takes a while for surgeons to get this technique down. There are some doctors near you who are also getting excellent results (Del Vecchio, for one), if you find your current surgeon doesn't meet your needs. Best of luck!

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.