Bilateral Breast Reconstruction with BRAVA and AFT (Fat Transfer)

Total breast reconstruction (post-mastectomy) using fat grafting and BRAVA is a very uncommon reconstruction choice. As such, it is difficult to find surgeons experienced in the procedure. Dr. Bucky is one of just a handful of surgeons who regularly use BRAVA and have done reconstruction with fat grafting only. My natural breasts were an A cup, which I was happy with and would like to reconstruct to that size. Given my modest size goals, overall good health, type of mastectomy, and willingness to commit to using the BRAVA, I am a good candidate for this type of reconstruction. My one limitation is fat availability. I am naturally slim, so I do not have convenient pockets of unwanted fat to take and move to the breast. I had already altered my diet to put on about 5 extra pounds, but Dr. Bucky suggested I try to gain an additional 5 pounds before my surgery. Dr. Bucky thinks I will be able to achieve an A cup in 2 fat transfer procedures.

At the time of my first fat transfer surgery I will be 8 months out from bilateral skin and nipple-sparing mastectomy. My mastectomy incisions are in the mammary fold and, thanks to an experienced physical therapist, I healed with very little scarring, so I have freely-moving skin. Dr. Bucky told me that scarring that adheres the skin to the pec/chest wall can impede expansion with the BRAVA, so keep that in mind if you are considering this procedure. I had read about the various approaches taken with the BRAVA in terms of how often it is worn before and after fat transfer and the pressure inside the dome. I will receive my detailed instruction at my pre-op appointment, but he did tell me that he has patients wear the BRAVA for 3 weeks prior to surgery and not at all post-surgery. You have to cycle the pressure every hour or so for about 6 hours a day, so you can't just put it on and go to bed.

The BRAVA device is no longer manufactured or available to buy through physicians, so I had to purchase through ebay. I payed a bit more, but the BRAVA kit I ordered is complete, new, and the correct size. I expect that I will be able to recoup some of the expense when I sell the BRAVA after I am finished.

I will post photos immediately before I begin wearing the BRAVA and throughout the BRAVA/surgery/healing process.

I met with Kim, the nurse from Dr. Bucky's practice who is guiding me, last week. She took my before photos and showed me how to use the BRAVA. She, too, is a breast cancer survivor and used the BRAVA as a part of her reconstruction. She has also helped many patients through the process since then. She is straight-forward, but kind, and emphasized that I can call her anytime. I'm only on my third day of wearing the BRAVA and I've already called her once because I was concerned that my breasts were turning purple in the domes. Turns out, that's normal. She had already called me once just to check in. The BRAVA is time consuming (6 hours a day, every day) and uncomfortable (not painful, but definitely uncomfortable). I can see why people would not want to do it. My breasts are covered in little red dots (broken capillaries) and slightly red from the increased blood flow. I was assured that this is all normal and would heal once I stopped using the domes. On the plus side, my breasts are already visibly more full. I didn't think I would see results so quickly. I have a long BRAVA road ahead of me, but I'm encouraged.