Thoughts on the EveBra? (Brava)

Question

I have tight skin and wondering if it’s worth getting something like the Evebra. I’ve heard that BFT relies on the tightness of the tissue matrix and this can have a negative effect if you’re going to have BFT. Is there anything I can do to loosen tight skin?

Mats Hagstrom, MD (license on probation) · Answer

I think most plastic surgeons agree that vacuum augmentation devices do not contribute in any significant way to the outcome of breast fat transferred.
The tend to be uncomfortable and expensive and offer no benefit.
There are only two variables that determine the outcome of this procedure.
The first is the patient’s candidacy for the procedure in the first place and the second is the skill and experience of the provider.
Breast fat transfer can consistently increase breast size by 1/2 cup one done by experience providers.
Capsize tends to be subjective and some patients will report up to one cup increase in breast size as a long-term final outcome.
Typically breast size increase can be up to 100% if done by an experience provider on a patient who is an ideal candidate.
 Breast transfer can consistently increase breast size but does very little to change breast shape.
It’s very important to have a clear understanding if the problem is size or shape.
For example, women who want fullness in the upper half of their breast should not have a breast fat transfer, but rather consider implant augmentation.
The ideal candidate for breast fat transfer, has nice looking breast that need to be slightly larger.
Even in the hands of the most talented providers, the results are generally slightly subtle, especially in comparison to implant augmentation.
One important thing to consider when contemplating having this procedure is how before and after pictures should be judged.
Early fat transfer results can look very impressive, but do not in any way represent long-term final results.
Both providers and patients may be tempted to take early after pictures to show off impressive results.
Unfortunately, these results do not last And representative after pictures should always be taken at least 3 to 6 months from the date of the procedure.
Anytime you are reviewing before and after pictures always confirmed the timeframe of when after pictures were taken.
Never assumed that after pictures were taken as final representations. Always confirm.
The second most important point to recognize when considering this procedure is that fat transfer is always to operations done in conjunction.
Fat harvesting involves having liposuction.
Patience should be assessed for their candidacy for both liposuction and fat transfer.
Likewise, patients should vet providers regarding skill in both Liposuction and fat transfer.
I have unfortunately seen far too many people being disfigured from providers harvesting fat, who had minimal liposuction skill.
Delivering consistent quality, liposuction and fat transfer results is more difficult than most people realize.
The number of plastic surgeon who truly mastered this procedure is relatively small.
There is significant difference among different providers regardless of board certification, number of reviews or years of practice.
There isn’t much patience can do regarding the Round candidacy other than have a clear understanding of if they are a good candidate or not.
Candidacy is generally not black or white, but rather a spectrum.
A patient who is an excellent candidate for a surgical procedure can potentially have an excellent outcome in the hands of an excellent provider.
They can also have poor outcomes if the procedure is not done well.
Individuals were not good candidates for plastic surgery procedures do not have the potential of having good outcomes, regardless of who does the procedure.
Patients considering breast fat transfer should be assessed for both fat, transfer and liposuction since this is always a combined procedure.
To find the right provider, I suggest patients schedule multiple in person, consultations with plastic surgeons, who have a proven track record of both Liposuction and fat transfer.
I generally recommend people avoid virtual consultations whenever possible.
There’s no correct number of consultations needed to find the right provider.
Sometimes it’s simply a matter of luck.
 Considering how much variation there is in skill for this procedure I suggest patients consider having five or six consultations before selecting a provider.
The process is time-consuming, but considering that the results are permanent and you’ll be reminded of the outcome every day for the rest of your life, I think the time spent interviewing plastic surgeons is worth the effort.
Poorly done the liposuction and to some degree fat transfer can leave people permanently disfigured.
There are a lot of variables to take in the consideration.
To increase the chance of high-quality outcomes, and the process being successful, as suggest focusing your efforts on the variables that count the most.
In the end, that is always going to be provider selection.
Best,
Mats Hagstrom, MD

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