Is Brava Necessary for Fat Transfer in Some One Who Lost a Large Amount of Weight?

I am a 27 yr old, 5'10 female who weighs 154 lbs, at my heaviest i weighed 231lbs and lost 77lbs in total 8 years ago and remained at my current weight. I would like to do a lipo and fat transfer to breasts. My doctor said that I do not need the BRAVA system to expand my breast tissue since it has already been expanded due to the weight gain and loss. I am a 34B he said i could go up to a full C and stay that have a high chance of staying that way without the BRAVA system. Is that true ?

Doctor Answers 8

Is BRAVA necessary for successful fat transfer to breast? #breastimplants

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

This is an area that I am beginning to research and offer. If you go to Roger Khouri's website he is a man who does a lot of fat transfer in the breast. I would consider him an authority in this area. He is in Miami and has some wonderful photos on his website. I do not believe he always uses the BRAVA so be careful if your surgeon does not know much about that kind of device. You may not need this device. Fat transfer for breast augmentation is evolving now. It is cutting edge and we are beginning to see better results as we learn more about fat harvest and preparation. I would advise looking at his website very much before you proceed.

Scottsdale Plastic Surgeon
5.0 out of 5 stars 54 reviews

Fat vs fiction- truths about breast augmentation w fat

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Here are the facts – there are two published papers in the American literature on fat grafting for breast augmentation that both use quantitative volumetric imaging to measure results.  Long-term volume maintenance was 60 to 70%. Both of these studies ---one performed by myself and one performed by my colleague and friend Roger Khouri both use brava. There is no published study in United States that shows quantitative results when fat grafting to the breast is done for breast augmentation without brava.

Fact number two, in an animal study that we published this September in the Journal plastic surgery, using expansion over soft tissue shows a doubling of blood vessel density and enough regulation in cell activity.


Brava is more than just creating space. These are facts and truths.   Until there is scientific clinical data that shows Brava is not necessary, I prefer to use Brava on all my breast augmentation patients. In hundreds of patients, i have never had to redo a single case for un-retained volume . Simply stated ,  I use it because it works and it is reliable.   I would also encourage anyone seeking breast augmentation with fat to seek a surgeon who is highly experienced in this procedure. I have attached a link from our original first paper on the topic. Best regards, Daniel a Del vecchio M.D.

Is BRAVA necessary for fat transfer breast augmentation?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

The BRAVA may not be necessary to expand the breast tissue if you already have enough laxity.  There are many surgeons who can do the transfer without the device.   Whether you need the BRAVA can only be determined by good examination.  One important question to ask your surgeon is if he ever uses the BRAVA at all.   If he or she never use it, and they are telling you that you don't need it, then you should consider seeing someone who is does.  Then you are more likely to get a more balanced recommendation.

Adam Hamawy, MD
Princeton Plastic Surgeon
4.8 out of 5 stars 57 reviews

Is BRAVA Necessary for Successful Fat Transfer to the Breast?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

The method of doing breast enlargement through fat transfer is an evolving science. We do not know at this point in time what the optimal processes are to achieve the most consistent effective results for successfual fat transfer procedures. It is true that some of the very best results have been demonstrated by surgeons who use the BRAVA system, and they would likely advocate for it's use even in your situation.

After a significant weight losss your breast is likely quite deflated with loose skin (Most people in your situation usually need a breast lift). With a lax skin envelope it would be easy to add fat to fill up the loose tissues. But that is not the whole story. Not only does one need enough space to place the fat, but there must be a good blood supply in the recipient tissues for the fat to survive. Failure of the transfered fat to survive will not get you the augmentation you desire, and could potentially result in some negative results like oil cysts or fat necrosis. One thing that the BRAVA system does, is that it stimulates your body to produce an increased, highly vascular tissue stroma which seems to be particularly well suited as a recipient site for transfered fat, potentially resulting in greater fat survival. So the BRAVA system may allow for a greater percentage "take" of the fat graft, and thus produce a better overall result, or allow you to get there in fewer stages. But I would not say that this benefit is proven. I would ask your surgeon if they can show you a number of good results in fat transfer without using BRAVA.

Fat transfer to breasts and Brava system

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Those surgeons that perform primary breast augmentation with fat injection ( and I am not currently one of them) sometimes use BRAVA mainly with the thought that it enhances the blood supply and space for the fat cells to survive. Not all use it.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Is Brava Necessary for Fat Transfer in Some One Who Lost a Large Amount of Weight?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

If you lost weight, your breast may be stretched, and the skin with laxity, that is good for to transfer fat without complications, the quantity must be small to be sure.  

Maria Cristina Picon, MD
Argentina Plastic Surgeon

BRAVA breast expansion before fat transfer

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

I would tend to agree.  Clearly if one loses that much weight the breasts are likely to shrink as well and very likely to have very loose skin.  BRAVA is designed to expand the breast skin/tissue and therefore theoretically allow the surgeon to better supplement the breast with fat injections. You probably don't need that. 

You should be aware first and foremost that fat injections into the healthy breast in a 27 year old woman is something that in my opinion should be done in a study protocol.  At least as of 2012.  This may soon change, but personally and professionally I am not recommending fat transfer into healthy breasts (I believe it is a different circumstance altogether in breast cancer reconstruction), especially in young women.  Mine is not the only opinion so please talk to your surgeon about this. 

BRAVA Necessary for Fat Transfer Survival

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

  That question is a good one and should be evaluated.  Facial fat grafting and the Brazilian buttlift are two common fat grafting procedures that do not use BRAVA and are highly effective. 

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.