Fat transfer to breasts - Brava or no Brava?

Question

I am considering fat transfer to breasts (lipo from arms, back bra roll and hips). I was not instructed to use Brava..does Brava make a difference? I have a bit of sagging not much, but I do have room in there for more fat. Please help me understand the benefits of Brava.

Edward J. Bednar, MD · Answer

I have used Brava only in instances of severe constrictions.  We have not found great benefit of Brava regarding overall and long term retention.

Jaime S. Schwartz, MD, FACS · Answer

I appreciate your question

I perform a natural breast augmentation with fat. This can be removed from any unwanted areas including the breast itself as part of my lipo-lift procedure. I perform the fat grafting in multiple planes including under the muscle to give the best, most natural enhancement. Fat grafting is a great solution for someone who wants to bring their breast size up a cup or so and use natural tissue vs an implant. However, it can also be combined with an implant or used as a secondary procedure to fill in areas that are flat or thin. It should not affect nipple sensation, mammograms, cancer risk or breast feeding. It can be a little lump or hard at first but tends to soften over time. If you gain or lose weight, the transferred fat can do the same.

The best way to assess and give true advice would be an in-person exam.  Please see a board-certified plastic surgeon that specializes in aesthetic breast plastic surgery.

Best of luck!

Dr. Schwartz

Board Certified Plastic Surgeon

#RealSelf100Surgeon

#RealSelfCORESurgeon

George Marosan, MD · Answer

Thank you for your question. Fat transfer to the breasts can be achieved successfully with or without BRAVA external expander. One can achieve about one cup size increase without BRAVA and a little more with BRAVA. The BRAVA expander is advantageous in tight, very glandular or fibrous breasts in which "space" has to be created and increased vascularity to allow for better graft survival. This is true for post mastectomy reconstruction with or without previous radiation treatment, in tight tuberous breasts or underdeveloped breasts. As far as I am aware, BRAVA is not used in most parts of the world. See a board certified plastic surgeon who has experience in fat grafting to the breasts with or without BRAVA. Good luck.

Luis A. Cenedese, MD, FACS · Answer

The Brava device may be of benefit in certain women who have tight breast tissues limiting the amount of fat which may be transferred.  The benefit of a small amount of augmentation should be weighed against the inconvenience of wearing the device with its associated cost.  The funds invested for purchase of the device may be better allocated towards a second fat grafting to give more volume.Please consult in person with an experienced Board Certified Plastic Surgeon prior to making treatment decisions.

Tracy E. McCall, MD · Answer

The original article used the Brava system. To my knowledge, there is no information showing that it is better. I don't use Brava, but am not doing big fat transfers to the breast.

Fat transfer to breasts - Brava or no Brava?

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