BRAVA. What is it? Fat grafting to the breast or nonsurgical breast augmentation?

Posted on August 22, 2011

Brava. 

What is this thing?  BRAVA  is not new.  It has been out for over a decade.  Its original claim was to increase the size of your breasts without surgery.  Woo hoo! Sign us up!  If it works, why did this not catch on like wildfire?  It does work.  But it just doesn’t increase the size much.  The size ranged from 35-250cc of lasting increase in size.  It is cumbersome, takes a while, and requires dedication. 

How does it work?  It works by using gentle tension to cause growth.  Basically you put suction cups on your breasts (which are made to give a specific pressure) and you wear the cups nightly for months to cause the size to increase. 

It was a good idea, but even with good compliance women usually only got about a 150cc improvement.  A lot of work for a small gain.

So what is causing a resurgence in BRAVA interest?   Fat grafting.  Transferring fat to the breast was the third rail of plastic surgery for a long time due to issues with calcifications and cancer surveillance or issues with losing the transferred breast fat volume and fat loss. We thought it just didn’t work. 

But our techniques and understanding of fat grafting have evolved.  We do more microfat grafting.  We treat the fat differently.  We have researched the ideal size of fat globules to survive, how to harvest them, how to process them.  In our new era of fat grafting surgery, BRAVA  is interesting.   BRAVAexpands the tissue to increase the area we can graft to, and it also increases the vascularity of the area. 

In simple terms, when you move fat from one area of the body to another, it is a free graft.  It is like moving a new plant.  You need a fertile bed and water so your new plant can grow.  BRAVA helps with creating fertile space and improving the blood flow.

I spent time with Dr. Khouri in Miami a few weeks ago.  I saw BRAVA and its effects.  Particularly for the breast reconstruction patients after breast cancer, I could see those patients who had been compliant with the BRAVA and those who were not.  And those who were using BRAVA diligently had better results.