It is true that Brava is no longer available. But our extensive experience with this procedure has convinced us that we get the best results if we graft a pre-expanded recipient site. Without expansion, a cautious surgeon will only graft the small amount of fat the tissues can tolerate, resulting in minimal volume gain. Should your surgeon be more aggressive and graft more, there will be a lot of temporary swelling; but since most of that fat will not survive, the end result will be very poor.
Dr. Khouri, the inventor of Brava, still offers an external vacuum expander (EVE) to his patients. If you already have implants, your tissues are stretched. Removing your implant or replacing it with a smaller one leaves some tissue laxity that is essentially similar to the external vacuum expander effect. Therefore you might not need the external vacuum expander (EVE) if you still have implants.
If you need EVE, during your initial consultation, the Doctors at the Miami Breast Center will fit you with the expander, make sure you understand its use and can tolerate the required treatment.