Does My Second Fat Injection Breast Augmentation Need A Brava Device First?
Q: Dr. Eppley, I had fat injection breast augmentation done six months that had a lot of problems afterward. There was drainage from under the left breast for three weeks after the procedure. I was put on antibiotics to treat it but was told the rubbing of my bra on it was the cause. Then a month later my right breast developed a large painful lump that turned out to be an abscess which required more antibiotics and needle drainage. I am now left with one breast bigger than the other and one of them is lumpy. The doctor now wants to do the procedure again but this time using the Brava device. Will this make a difference and make it more likely that the fat grafts will take? My doctor is an ObGyn who specializes in cosmetic surgery but my first experience has now made me nervous.
A: Unlike breast implants, the use of fat injections for breast augmentation is not an assured outcome. As you know and have experienced, the take of injected fat is subject to a wide variety of factors not all of which is completely understood. The take of injected fat is highly dependent on the harvesting, method of preparation and the injection technique. While the injection of fat seems like, just like the liposuction of fat, successful results ultimately depend on surgeon experience and attention to technique details.
The concept of using the Brava device is a good initial approach for small breasts with a tight skin envelope. Whether that would have been advised for your first fat grafting surgery is now irrelevant but should probably be considered for any second stage. But it is important to remember that the Brava device is an adjunctive procedure to prepare the recipient breast bed, it is not the magical solution or a substitute for adhering to sound fat graft harvest, preparation and injection principles.
Dr. Barry Eppley