Brava can be tough. I have had some patients with no issues and some with a fair amount. If you are going to have an issue, it tends to be a contact dermatitis looking thing: the skin gets red, irritated, and may break down. Another major contributor is the skin being too dry, so you need to keep it lubricated. Keeping the skin clean and preventing infection are paramount.
One of my patients recently was very kind to share her tips on what worked for her. She compiled this from message boards, talking with Brava coaches, info from me(but I am always learning and every patient is different!) and good old fashioned trial and error. This is not medical advice. This is what one patient found worked for her. I am lucky to be in the Bay Area- my patients are incredibly educated, diligent, and resourceful. I wanted to share her insights.
DOMES
- Follow Brava standard protocol.
- Wash with Johnson and Johnson baby wash. She found the Brava cleanser too harsh.
- Really rinse domes well after washing as “the dome cleanser is especially brutal if every trace isn’t rinsed away.” (**This is something the Brava coaches emphasize as well.)
SKIN
- Wipe the breast area which will be under the Brava rim with No Sting Skin Prep (Use at least 1 wipe per breast. expect to purchase an extra box or two of wipes beyond what was provided with the system. She thinks this step is essential to prevent skin breakdown.)
- LET SKIN THOROUGHLY DRY before applying domes. (**This is something the Brava coaches emphasize as well.) If you put the domes onto moist or wet skin, it will cause the skin to breakdown, just like running with wet feet and no socks would do.
- When you remove the Brava, liberally apply aquaphor to the entire breast concentrating on the area under the silicone rim. Reapply ointment throughout the day.
- If irritated: Rub aquaphor ointment onto irritated areas and cover with op site flexi fix(she liked op site better than Tegaderm because she found it easier to apply)
- If irritated: She would leave the Op Site on for two to three days until it started to come off on its own. She would shower over it, etc. You don’t want to be ripping off the Op site and causing more irritation.
- If itching is an issue she used a topical Benadryl itch relief spray.
Some things she tried but didn’t work for her: paper tape (adhesive is too strong), Band aids or blister patches (adhesive too strong, and the Brava can make a “welt” reaction), Hydrocortisone (I have seen this work for some patients- again every patient is different), trying to cover the actual dome adhesive with Tegaderm (instead of putting on your skin- the dome doesn’t suction well if you do that.)