I had fat transfer surgery with Dr Matousek a little over three weeks ago. It is too early to ascertain the fat survival rate. I did not use BRAVA before or after the surgery, as I previously had tried the system and suffered severe rib pain (and despite persisting with it for over 40 weeks, I lost ALL of the volume I thought I'd gained, which seems to be a common experience, and is why Dr Matousek does not recommend using the system without having the surgery).
Although the results of my procedure have not yet been established, what I can say about Dr Matousek is that she is very generous, kind, professional, honest, hard working, authoritative, and confident. In my consultation with her, I was impressed that she showed me a variety of before and after pictures, not just the ones with the best outcomes. As I am an interstate patient, I had the stitches removed at my GP's surgery, and the nurse remarked that Dr Matousek had done an excellent job and that the scarring would be hardly noticeable. Also, when I questioned Dr Matousek in relation to her professional opinion about something, she did not take offence and did not react defensively, which I was very impressed with.
Regarding the status of the procedure in Australia, it is completely untrue that it is "not approved" in Australia. However, because fat transfer is a relatively new procedure in Australia, and the Medicare Benefits Schedule is lagging behind, the procedure has no item number for patients with congenital deformities (such as myself) or for mastectomy patients. I have been confused by contradictory information I have received from different surgeons. Some surgeons have indicated that they will not use any item numbers at all for the surgery, because doing so would be fraudulent. Other surgeons have found some creative item numbers to use as substitutes, and I really don't know whether Medicare and the health insurers would allow it if they knew the details of the procedure.
Besides Dr Matousek, there are two other surgeons I know of who currently offer the procedure. These surgeons are Miss Ruth Bollard (breast surgeon) in Ballarat and Mr Gary Kode (plastic surgeon) in Launceston. I had consultations with both these surgeons and was also impressed with them.
A number of other surgeons I have had contact with have completed training in fat transfer, but they are unable to offer it due to their insurance not covering it. I am told the biggest medical insurer does not offer coverage for the procedure. This is another problem that is probably related to the lack of an item number, which is probably related to a systematic review conducted by Royal Australian College of Surgeons in 2010, concluding that there insufficient evidence of the efficacy of the procedure. However, one of the surgeons I spoke with told me that during discussions with RACS, the surgeon had volunteered to conduct a trial in order that the efficacy of the procedure would be demonstrated. However, RACS was not interested in such investigations. Although the evidence was insufficient, RACS seemed to have already formed its opinion. This is despite the procedure being widely accepted and available in Europe and America.
I also note that there are many international studies that have been published, with some very good results (some of them since the 2010 RACS review):
“Applicability and Safety of Autologous Fat for Reconstruction” by Claro Jr., Figueiredo et al. British Journal of Surgery 2012; 99: 768-780. “Breast Augmentation Using Preexpansion and Autologous Fat Transplantation: A Clinical Radiographic Study” by Del Veccio & Bucky. Plastic and Reconstructive Surgery 2011; June: 2441-2450. “Breast Reconstruction for Breast Asymmetry Using Recipient Site Pre-Expansion and Autologous Fat Grafting” by Del Vecchio. Annals of Plastic Surgery Vol. 62, No. 5, 2009; May: 523-527. “Fat Grafting to the Breast Revisited: Safety and Efficacy” by Coleman & Saboiero. Plastic and Reconstructive Surgery 2007; March: 775-785. “Fat Injection to the Breast Technique, Results, and Indications Based on 880 Procedures Over 10 Years” by Delay, Garson et al. Aesthetic Surgery Journal Vol. 29, No. 5, 2009; September/October: 360-376. “Got Evidence? Stem Cells, Bias and the Level of Evidence Ladder: Commentry on: ‘ASAPS / ASPS Position Statement on Stem Cells and Fat Grafting’” by Eaves III. Aesthetic Surgery Journal 31 (6); 2011: 718-722. “Patient Information Before Aesthetic Lipomodelling (Lipoaugmentation): A French Surgeon's Perspective” by Delay, Sinna et al. Aesthetic Surgery Journal Vol. 29, No. 5, 2009; September/October: 386-395. “Percutaneous Fasciotomies and Fat Grafting - Indications for Breast Surgery” by Ho Quoc, Sinna et al. Aesthetic Surgery Journal 33 (7) 2013: 995-1001. “Structural Fat Grafting: More Than A Permanent Filler” by Coleman. Plastic and Reconstructive Surgery Vol. 118, No, 3S, 2006; September: 108S-120S. “The Use of Lipofilling to Treat Congenital Hypoplastic Breast Anomalies” by Derder, Whitaker, et al. Annals of Plastic Surgery 2013. “Tuberous Breast Correction by Fat Grafting” by Delay, Sinna & Quoc. Aesthetic Surgery Journal 33 (4) 2013; 522-528. “Use of Autologous Fat Grafting for Reconstruction Postmastectomy and Breast Conserving Surgery - A Systematic Review Protocol” by Agha, Goodacre & Orgill. BMJ Open 2013
So the procedure is most definitely available in Australia, it's just not offered by many surgeons because RACS, Medicare and the medical insurers need to get with the times...
I will be needing several more surgeries to correct my deformity and will post again when I am more certain of my results and I will also provide further updates regarding my progress when I have my future procedures.