[BREAST RECONSTRUCTION WITH THE BRAVA DEVICE AND AUTOLOGOUS FAT].

To report our experience and results in BRAVA breast pretreatment for full breast reconstruction by autologous fat grafting.BRAVA (bra like vacuum-based external tissue expander) is a method developed to expand the skin envelope, thus creating more space for the fat graft for breast reconstruction.Since 2015 we began to perform a full breast reconstruction by BRAVA and autologous fat grafting. This is a multiprocedure breast reconstruction that includes pretreatment by using the BRAVA device for 180 hours before each surgery. We will focus on the number of procedures and time duration that was needed to complete the breast reconstruction the aesthetic results and the complication rates.Between the years 2015-2019 we preformed 13 late full breast reconstructions using the BRAVA. Six women were post-radiotherapy and they completed their breast reconstruction after 5.7±1.3 rounds during 20.3± 5.3 months. Non-irradiated patients completed their breast reconstruction after 2.7±0.5 rounds during 9.4±2.6 months. We grafted an average volume of 218±16.7 ml of fat per surgery. This was in comparison to an average of 100ml fat volume grafted in surgery without pre-expansion according to the literature. We had no complications and the aesthetic results were satisficing.The addition of BRAVA expansion procedure before autologous fat grafting leads to a larger volume of fat that can be injected in every operation and reduction of procedures. The procedure is safe and with good aesthetic results.