Fat Injection and Brava System for Mild Tubular Breasts?

Question

Recently, I just found out that I have mild tubular breast and I did a lot of research. However, I do not want to place the implants. I have heard about the fat injection combined with Brava System. I wonder if it is ideal for my case. I don't want to have a lot of cups increase but just better shape and one cup increase.

Farbod Esmailian, MD · Answer

Short answer: NO.  The brava system is in my mine a novelty item.  Also fat injections as most surgeons would attest to is really not a good idea into the breast.  We worry about long term breast cancer screening.
Also, the anatomical issues you have are not corrected by the brava system and fat injection.  The tuberous breast is tight, constricted lower pole and at time short on skin.  There are fibrous bands that need to be released to allow the breast tissue redrape.  This procedure is complicated and you need to see someone who has experience in breast asymmetry and tuberous breast.
Good luck.

Otto Joseph Placik, MD · Answer

Unfortunately the Brava system is very similar to a breast pump. If you have ever seen a breast placed in a breast pump, the areola can become distorted. One of the conditions of tuberous breasts or constricted breasts is a herniation or "mushrooming" of the nippple and areola. Correction of the constricted breast often requires surgically relaxing the tight breast tissue which is not likely to happen with the fat injection/Brava technique

Robert Whitfield, MD · Answer

Please find an experienced Board Certified Plastic Surgeon
and member of the Aesthetic Society using the Smart Beauty Guide.  These Plastic Surgeons can guide you on all
aspects of facial surgery, breast augmentation and body procedures including
tummy tucks or mommy makeovers!

Fat grafting is a valuable tool in breast surgery.  This technique has gained more popularity
over the past 7 years.  There are many
techniques used to harvest the fat, process the fat and then re-inject the fat.
Conventional suction lipectomy is performed with a small diameter cannula,
processed by separating the liquid and fibrous tissue from the fat, and then
placed into syringes for re-injection or through a closed system.

Darryl J. Blinski, MD · Answer

Great question but a bad idea. As the other doctor posters have stated, you have more anatomic issues than can be solved with the Brava pump. It would truly be a waste of your time (months of wearing a very uncomfortable constricting device) and $$$$$. 
Be careful out there, if a doctor suggested this type of treatment than go get 3 more opinions from boarded plastic surgeons.
Good luck and regards!

Peter A. Aldea, MD · Answer

Implicit in what you are proposing is the false premise that small tuberous breasts can be corrected with fat grafting and suction by the Brava system. That is not the case.
First - Tuberous breasts are also more accurately called CONSTRICTED breasts and have been described as a Snoopy Dog (snout) Deformity. The base of the breast is held in by soft tissue fibers similar to how twine ropes are used to hold the branches of Christmas trees on sale on street corners. These fibers cause the breast to have the shape of a TUBER (or a root). To give them the shape they need to cover an implant (or anything else), the fibers (string) need to be cut - suction with Brava is NOT going to do it. (This is nicely done via a periareolar incision just before breast implant placement).
Second - Although the Brava system has been out there for almost 10 years. It has very few fans because it is cumbersome, the results are not stable and they often relapse in NORMAL shaped breasts.
Third. Fat grafting to the breast is increasingly done YET it remains VERY controversial. The female breast has a 1 in 11 chance of breast cancer. Placing fat grafts which are likely to die and leave calcified scar tissue in a cancer prone tissue which is usually surveyed with mammogram would make it hard on all but the most experienced mammography radiologists from telling dead fat calcium from calcium associated with breast cancer. This may translate to a lot of needless. preventable worrying in the future and and equal number of preventable breast biopsies.
I would do more research.
Peter A Aldea, MD

Richard P. Rand, MD, FACS (retired) · Answer

IF you have a tuberous breast, it will not be corrected by the Brava system and fat injections. The anatomy of the tuberous breast is the most difficult of all starting points in breast cosmetic surgery and requires release of lower pole constriction, tissue expansion with an implant, and a periareolar mastopexy. None of these maneuvers are offered by the Brava and fat injections.

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