The Brava External Tissue Expander: Is Breast Enlargement without Surgery a Reality?

Schlenz, Ingrid; Kaider, Alexandra

doi:10.1097/01.prs.0000267637.43207.19

Cited by 32 publications

(12 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…71 It uses cyclical forces, which have a greater effect than continuous forces. 16 Daily BRAVA-use induces temporary edema and angiogenesis and sustained increases in subcutaneous tissue thickness and compliance.…”

Section: Resultsmentioning

confidence: 99%

Diffusion and Perfusion

Khouri¹,

Khouri²,

Lujan-Hernandez

et al. 2014

Plastic and Reconstructive Surgery Global Open

138

View full text Add to dashboard Cite

Background:Fat grafting is now widely used in plastic surgery. Long-term graft retention can be unpredictable. Fat grafts must obtain oxygen via diffusion until neovascularization occurs, so oxygen delivery may be the overarching variable in graft retention.Methods:We studied the peer-reviewed literature to determine which aspects of a fat graft and the microenvironment surrounding a fat graft affect oxygen delivery and created 3 models relating distinct variables to oxygen delivery and graft retention.Results:Our models confirm that thin microribbons of fat maximize oxygen transport when injected into a large, compliant, well-vascularized recipient site. The “Microribbon Model” predicts that, in a typical human, fat injections larger than 0.16 cm in radius will have a region of central necrosis. Our “Fluid Accommodation Model” predicts that once grafted tissues approach a critical interstitial fluid pressure of 9 mm Hg, any additional fluid will drastically increase interstitial fluid pressure and reduce capillary perfusion and oxygen delivery. Our “External Volume Expansion Effect Model” predicts the effect of vascular changes induced by preoperative external volume expansion that allow for greater volumes of fat to be successfully grafted.Conclusions:These models confirm that initial fat grafting survival is limited by oxygen diffusion. Preoperative expansion increases oxygen diffusion capacity allowing for additional graft retention. These models provide a scientific framework for testing the current fat grafting theories.

show abstract

Section: Resultsmentioning

confidence: 99%

Diffusion and Perfusion

Khouri¹,

Khouri²,

Lujan-Hernandez

et al. 2014

Plastic and Reconstructive Surgery Global Open

138

View full text Add to dashboard Cite

show abstract

“…[20][21][22][23][24][25][26] A gain of approximately 20 percent of the total meshed area can be accomplished at each stage. This two-dimensional increase translates to a larger three-dimensional volume expansion.…”

Section: Figmentioning

confidence: 99%

Percutaneous Aponeurotomy and Lipofilling

Smit

Cardoso

Pallua

et al. 2013

Plastic and Reconstructive Surgery

120

View full text Add to dashboard Cite

show abstract

“…However, after the enthusiasm generated by this first investigations, following researches outlined the limitations of the procedure: only small breast-size enlargement (1 cup) possible, high patient compliance required, patient social life restriction and drop out rates around 25%, 50% of the volume increase only due to swelling at 10 weeks with the suggestion to wear the device for 16–20 weeks. 12 , 22 , 35 – 38 …”

Section: Discussionmentioning

confidence: 99%

The Impact of Recipient Site External Expansion in Fat Grafting Surgical Outcomes

Oranges

Striebel

Tremp

et al. 2018

Plastic and Reconstructive Surgery - Global Open

View full text Add to dashboard Cite

Background:The fat grafting process includes the 4 phases of tissue harvesting, processing, recipient-site preparation, and reinjection. Among them, the preparation of the recipient site has never been exhaustively reviewed. We aim to provide a comprehensive overview of the methods to prepare the recipient site through external expansion with the resulting outcomes.Methods:PubMed/Medline database was searched for studies on fat grafting recipient site preparation by applying the following algorithm: ((fat grafting) OR (lipofilling) OR (lipograft) AND (recipient site)). A priori criteria were used to review the resulting articles and identify those dealing with external expansion.Results:Fourteen studies published from 2008 through 2016 met inclusion criteria (4 case reports, 6 retrospective, and 4 prospective studies), representing 1,274 treated patients. Two devices for preexpansion were used with different protocols: BRAVA system and Kiwi VAC-6000M with a PalmPump. The 13 studies that applied the BRAVA system reported large fat volume transplantation to the breast (average > 200 cc). The most common complications were localized edema (14.2%), temporary bruising, and superficial skin blisters (11.3%), while the most serious was pneumothorax (0.5%). The majority of the studies reported enhancement of fat graft survival, which ranged between 53% and 82% at 6 months to 1 year follow-up, and high satisfaction of patients and surgeon.Conclusions:External expansion and fat grafting is a promising technique for breast reconstruction and augmentation. However, due to the overall low level of evidence of the available studies, further research is needed to validate the procedure.

show abstract

The Brava External Tissue Expander: Is Breast Enlargement without Surgery a Reality?

Abstract: Long-term breast enlargement without surgery is possible with an external tissue expander. The more it is used, the more the breasts grow. To avoid disappointments and drop-outs, women have to be well informed about the time and lifestyle commitment.

Cited by 32 publications

References 14 publications

Diffusion and Perfusion

Diffusion and Perfusion

Percutaneous Aponeurotomy and Lipofilling

The Impact of Recipient Site External Expansion in Fat Grafting Surgical Outcomes

Contact Info

Product

Resources

About