Dr. Roger Khouri: Rebuilding What Was Lost

Dr. Roger Khouri has a point of view. Premier Guide Miami asked the questions. Here is what we learned.

Studies show that over the course of a lifetime, 1 in 8 women will be diagnosed with breast cancer. Women who survive have the option of regaining their breasts through reconstructive surgery — but traditional methods involve implants, incisions, and no natural sensation.

A new and innovative technique is changing that. Fat grafting transfers fat from various areas of the body — mainly the buttocks and abdomen — to form a silhouette of the breast. Dr. Roger Khouri, a Miami-based plastic surgeon, has perfected the technique and is impacting the lives of women all over the world, especially breast cancer patients who have lost their breasts.

Dr. Khouri's innovation, the Brava Device, is an external tissue expander worn like a brassiere that suctions the breast area and stretches the tissues, creating an adequate matrix into which fat is later injected. The procedure is performed as outpatient, often under local anesthesia, with minimal recovery time.

PGM: What is fat grafting and why should women know about this?

Dr. K: We made it possible to take fat from where you don't want it, and put it in an area where you would like more volume. Take it from here, put it there. We have shown scientifically and medically that we have the best way to make it happen, and it works.

PGM: What is your success rate?

Dr. K: We have about a 90% success rate. 90% of the fat we take survives, and that is the challenge — to get a 90% success rate with such a significant volume. We can achieve this with about 200 to 300 ccs of volume, but it takes work. You need to prepare the breast.

PGM: How do you prepare the breast?

Dr. K: This is the most important step. You have to prepare the breast with the Brava device, which applies a gentle suction over a period of time and enlarges the breast. That swelling allows us to put more fat in and have much more fat survive. We have been able to enlarge the breast significantly — the equivalent of two cup sizes in one procedure, with the benefit of liposuction on one side and breast augmentation on the other.

PGM: You have performed surgery on women who have lost their breast to cancer. Tell us about that.

Dr. K: The same procedure applies to women who have lost their breast. We can regenerate the breast — grow it back by injecting fat, stretching the tissue with the Brava device, and injecting fat inside. We give back a breast that feels normal, looks normal, and has normal sensation, without any incisions. The nerves grow back with the breast, so it gets sensation — as compared to a flap or an implant where there is no connection to the nerves.

PGM: Are doctors being receptive to the new procedure?

Dr. K: Oh yes. I have shown the procedure for the past four presidents of the American Society of Plastic Surgeons. More and more people are realizing this is the way of the future. We have decided to give a big symposium in February — over 200 plastic surgeons from all over the world are coming to Miami to watch us do the operation and see the results. I have about a dozen patients who have had the surgery done, most of them mastectomy patients who have been given back a breast with this method, without any incisions. I am very excited and very proud to be the innovator who started this procedure.

For more information on Dr. Khouri's symposium and fat grafting courses, visit www.fatgraftcourse.com. For patient information, visit www.MiamiBreastCenter.com.

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