ARLINGTON HEIGHTS, Ill. - Increasing breast size without surgery certainly seems ideal, however the mechanical bra system known as BRAVA, which can increase small breasted women's breast size by as much as one-cup, requires that patients follow a strict 10 week treatment protocol, reports the July issue of Plastic and Reconstructive Surgery® (PRS), the official medical journal of the American Society of Plastic Surgeons (ASPS).

The study conducted by Richard Greco, MD, of the Georgia Institute of Plastic Surgery, and the American Society of Plastic Surgeons Device and Technology Assessment (DATA) Committee found the degree of breast tissue growth varied with each patient. Each patient is required to wear the bra 12-14 hours per day for a minimum of 10 weeks. The time investment required to achieve results made compliance difficult if not impossible for many women.

The BRAVA system is an external soft-tissue expansion system comprised of two semi-rigid plastic domes that are sized for the patient. Each dome has a silicone gel border, which makes them more comfortable and allows the device to seal with the skin of the chest wall. Each dome has an outlet connected to a small, computerized vacuum device (smart box). The smart box is battery operated, records the time used, and maintains a negative pressure on the breasts through the use of pressure sensors and relief valves. The entire apparatus is contained in a fabric bra designed for ease of use and comfort.

The study initially attracted broad interest, however only eight women officially enrolled. A number of women dropped out after learning the time investment required. Several others were rejected due to breast size (chest too large or too narrow for proper fit of bra) or previous history of breast surgery.

One patient in the study experienced a tissue growth of more than one-cup after completing the 10-week cycle (The results reported in BRAVA research found average tissue growth to be 100 ml or one-cup.). Two patients increased breast size by approximately one-cup. Three patients completed their 10-week treatment and experienced only modest growth - 50-65 ml. All three of these patients opted for another BRAVA treatment cycle. Two of the initial eight patients dropped out after three weeks because they found the device inconvenient.

"Non-surgical breast enhancement can be the ideal plastic surgery procedure for a specific group of women - women who are opposed to surgery, women who will be satisfied with a relatively small enhancement, and women who do not work outside the home," said Dr. Greco. "It is not for everyone, it is not inexpensive and the results may not meet every patient's expectation."

"The greatest drawback of this technology is the stringent patient compliance," continued Dr. Greco. "If patients miss one day during the 10-week cycle, they must add one week to their treatment."

Additionally, even for a patient who is the perfect candidate psychologically, the device may not fit, as dome size is limited to a B cup or smaller.

Tissue expansion techniques have been used in medical specialties for many years, including plastic surgery. The application of tissue expansion techniques for breast enhancement is a great advance for women who do not wish to undergo surgery, noted Dr. Greco.

"I think the concept of non-surgical breast enhancement is here to stay," said Dr. Greco. "Potential patients must, however, be carefully screened and made aware of the required time commitment. It is also important to let the potential patient know that there are no provisions made by the manufacturer to deal with dissatisfied patients."

Dr. Greco's study adds to the body of research on the BRAVA breast enhancement system that to date has been limited to the technology's inventors.

ASPS, founded in 1931, is the largest plastic surgery organization in the world and the foremost authority on cosmetic and reconstructive plastic surgery. ASPS represents physicians certified by the American Board of Plastic Surgery (ABPS) or the Royal College of Physicians and Surgeons of Canada. For referrals to ABPS-certified plastic surgeons in your area and to learn more about cosmetic and reconstructive plastic surgery, call the ASPS at (888) 4-PLASTIC (888-475-2784) or visit www.plasticsurgery.org.