Can Fat Injections to the Breasts Survive Without Brava?

I had 2 sets of implants removed in 20 years. I had a consultation re: injections to the breasts as a replacement. Is brava necessary in this case? I have been told there is enough stretch and my breasts are concave? I was also asked to put on weight as I do not have enough fat? The procedure this doctor is offering is Vaser (3rd generation ultra sound)

Doctor Answers 6

Fat transfer to breasts and brava

I have done fat transfer to the breasts with and without brava and really cannot tell if brava is useful.  There are no well done studies showing that brava helps.  In your case, brava is probably not helpful.  It is very helpful to put on weight if you can, when you go to lose the weight after the fat should preferentially stay in the breasts.  I cannot give you any information on Vaser as I have no experience with it.

Highland Park Facial Plastic Surgeon
4.4 out of 5 stars 41 reviews

Fat transfer to breasts

If your skin is not tight, you may not need BRAVA. Gaining weight prior to fat transfer may give more volume of fat to transfer. But, if you then loose weight, you may lose some of the volume of fat. If you can maintain the gained weight, you will do better with your fat transfers. I have not had any experience with VASER, but have used external and first generation internal ultrasound for liposuction. Typically, these types of ultrasound are not used for the fat being transferred.

Connie Hiers, MD
San Antonio Plastic Surgeon
4.6 out of 5 stars 13 reviews

Fat Transfer without Brava

Thank you for your question. If your fat transfer is being used to camouflage wrinkling and palpability from your implants, then you should do well with fat transfer without the Brava Bra.  If you are removing the implants and hoping to restore volume with fat, I would not recommend doing it without the Brava Bra.  The large volume of fat transferred to augment a breast needs a good blood supply and space in order to survive.  Transfer into a tight space can lead to fat necrosis and calcifications on your  mammogram that may need to be biopsied.  Discuss this matter further with your surgeon.

Robert F. Centeno, MD, FACS
Columbus Plastic Surgeon
4.9 out of 5 stars 77 reviews

Less of it will survive

The fact that you have some space already is good, but is it good enough? Only a consultation can tell you that. The BRAVA device not only creates the space necessary but also creates new blood vessels that are vital to keep the fat alive.

Gaining weight for a fat transfer procedure is not recommended, it is the worst advice that can be given. While it might sound counterintuitive, we ask the patient not to gain weight prior to the procedure. We prefer to harvest and graft the smaller fat cells, not the plumped up oil bags that develop with weight gain. If at all possible, we ask the patient to try to lose weight prior to grafting so that when she regains her normal weight, the transferred fat cells plump back up again and the grafted site grows.

You probably have enough fat to harvest. We have rarely turned down any patient for being too skinny.

Roger Khouri, MD
Miami Plastic Surgeon
4.2 out of 5 stars 29 reviews

Can Fat Injections to the Breasts Survive Without Brava

Without even a posted photo very hard to advise. The inventor of the BRAVA does not use the Vaser, he uses regular liposuction to obtain the fat for grafting. Thus you should seek more in person consults. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

Can Fat Injections to the Breasts Survive Without Brava

Yes  fat can survive, but those that use BRAVA have pretty good data showing a higher percentage of take. In a patient with limited donor material, that may be important enough to make the inconvenience worthwhile. 

The problem with gaining weight, is that if you lose the weight, you will lose the improvement, so unless you want permanent weight gain, it is not a great sounding idea. It may be that implants or no breast surgery are better options.,

All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.6 out of 5 stars 45 reviews

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.