- When Adrienne Reed was diagnosed with breast cancer in 2010, she didn’t have much choice but to go ahead with the traditional double mastectomy and chemotherapy. When it came to reconstructing her breasts, though, the 39-year-old Seattle piano instructor went a different route.
- “What I gleaned from my research was that all implants require changing — like tires — and general anesthesia and probably three surgeries would be required,” she says. “I was looking for something more natural and less traumatic.”
- Reed found it with a technique known as Brava/AFT (autologous fat transfer), a unique method for both breast augmentation and reconstruction featured in the May issue of Plastic and Reconstructive Surgery, the official journal of the American Society for Plastic Surgeons (ASPS).
- The six-year study, which focused on breast augmentation only, presented results of Brava/AFT on 81 patients. According to its conclusion, the method “led to significantly larger breast augmentations, with more fat graft placement, higher graft survival rates and minimal graft necrosis or complications.”
- This is big news in the world of breasts for a couple of different reasons. First, breast enlargement via fat transfer or fat grafting was essentially banned by the ASPS 25 years ago.
- “It was beyond controversial,” says Dr. Roger Khouri, a Miami plastic surgeon and lead author of the study. “In 1987, they issued a very strong statement that said fat grafting was not recommended for anybody” due to minimal results, unpredictable results and the inability of radiologists to distinguish fat nodules from cancer.
- Since then, however, the new research suggests Khouri and others have ironed out the bugs, creating a new way to augment breasts.
- More than that, they’ve created a third option for women who’ve undergone mastectomy, particularly women like Reed, who want breasts, but prefer not to go through another major surgery and/or deal with implants.
- In a nutshell, cancer survivors are now able to “grow” new girls.
- Reconstruction zone
- A far cry from your average “boob job,” the most common type of breast reconstruction involves tissue expanders which are surgically placed behind the patient’s chest wall, then slowly filled with saline over a period of weeks. Once the skin and muscle are adequately stretched, the devices are surgically swapped for either saline or silicone implants.
- Not all women are candidates for this method, though, which is where “flaps” come in. In these procedures, skin, muscle, fat and sometimes blood vessels are nipped from one part of the body and tucked into the breast area, creating a fleshy pocket. That pocket is then filled with the patient’s own tissue or fitted with an implant. Tram flaps and DIEP flaps harvest from the stomach; lat flaps from the back and “free flaps” from areas like the inner thigh or buttocks.
- In Brava/AFT, however, the patient’s fat is harvested with liposuction as opposed to a scalpel, then injected into the breast area. But not before the area’s been prepped with an external tissue expander known as the Brava, a suction-pump bra that looks like something you might find in Madonna’s costume closet.
- “It’s definitely a cumbersome device and patients have to be willing to commit to it,” says Dr. Frank Isik, a Seattle plastic surgeon who’s currently doing a clinical trial on Brava/AFT. “Some patients look at it and say, ‘This is not for me.'”
- Others, like Reed, eagerly embrace a reconstruction method that requires far less surgery and involves far less recovery time, despite the burden of wearing a “Brunhilda bra” 12 hours a day for six or more weeks.
- “The first time I put it on, I was too embarrassed to go out,” says Reed of the device that she wore — usually to bed — before and after each of her three AFT procedures. “I’m 5’2″ and it’s like a size EEE bra. But that’s not what it’s about. I kept my eye on the prize.”
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