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27.02.2015
Newswise — After 20 years of debate and controversy over fat grafting to the breast finally it has gotten the seal of approval from the prestigious American Society of Plastic Surgeons (ASPS). Home >> Natural Breast Enhancement Reviews >> Fat Transfer Breast Augmentation: Pros, Cons, Cost and Is It Worth It?
Whereas all natural breast enhancement with pills, pumps and massage works – the downside is that it is not instantaneous.
Sure, all the boob growth you get is yours to keep but it does take a lot of patience and dedication. Fat transfer breast augmentation, aka fat grafting, is fast gaining popularity in the United States with 26.6% more procedures done from 2009 to 2010.
In a nutshell, it works like other fat grafting medical procedures – a plastic surgeon gets fat through liposuction from your problem areas such as the stomach, thighs or hips and transfers them to your breasts. While this procedure has gotten flak from the medical community previously due to concerns that adding fat to your breast might obscure detection of cancerous lumps, the latest studies show that there is little to no risk at all. Furthermore, both the American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery already concur that fat grafting is a safe and viable procedure to enhance the appearance of your breasts after breast reconstruction surgery. So as well as the medical establishment is concerned in terms of safety, breast fat transfer have the green light.
When you choose to get a fat transfer to your breasts, you are signing up for a two step procedure.
To further lessen scars and have a smoother contoured effect from the liposuction procedure, a laser is used as a finishing tool to stimulate collagen production to tighten skin.
Once fat is harvested, it is processed and purified then re-injected back into your breasts.
He or she will inject fat in very little droplets through the multiple layers in your breast so that your breasts will have your desired look while still looking natural.
Since the procedure involves harvesting fat from your own body, one of the requirements is to have ample fat stores throughout your body. For other women, doctors sometimes advise you to use the Brava system which is mainly for expanding breast tissue and stretching your skin. One thing you should definitely know about fat transfer breast augmentation, though, is that it is not a procedure capable of drastically increasing the size of your breast by two or more cup sizes.
Generally, this procedure is great for going up around one cup size and improving the fullness, softness, and cleavage-ness of your breasts. Well, with fat-grafting, doctors usually recommend going up only a cup size, because too much fat injections might just end up getting absorbed by the body negating its effect. To offset fat reabsorption in the first few months after a procedure, doctors often recommend using the Brava system (again) to help expand tissue naturally so that the fat from the procedure integrates into your body.
Speaking of money, you’ll want to know exactly how much the fat transfer breast augmentation will cost you. You will also pay for a fat harvest charge which will cover the liposuction and the fat purification process that will be done. Lastly most doctors also charge a facility fee if they are conducting the surgery in a certified surgery center or a hospital instead of in their personal clinics. You can also check your medical insurance if they cover or even just subsidize this procedure. Apart from the instant boost in breast size, the most obvious benefit is the natural look and feel of your breasts.
As long as the added fat have access to blood supply in your body, it can actually grow and shrink as you put on or lose weight, which adds to the natural look it already has. Another great benefit with fat grafting is that you don’t put foreign chemicals or objects in your body so the risks of having an allergic reaction or infection is reduced. Plus, with the liposuction element of the procedure, you also get the bonus of getting to sculpt your body and tone other problem areas while enhancing your breasts. One of the main cons that patients complain about is that immediately afterwards, the breasts look like too much fat is injected and don’t feel as natural as they want. More seriously, there have also been cases where the resulting fat transfer can appear ugly and irregular, but this can easily be mitigated if you choose the a meticulous and highly skilled surgeon. In terms of the safety of the procedure itself, there is actually no medical literature that conclusively states that fat grafting for the breasts pose a significant danger to patients.
Again, however – like any other surgical procedure, this procedure comes with the standard set of risks.
It is imperative that you perform enough research in both the procedure and in the surgeon of your choice so that you can accurately assess (together with your chosen board-certified doctor) all the risks and potential complications involved. Want a full guide on getting naturally bigger, fuller breasts – without the risks and costs of medical procedures? In the United States, more than 70% of women are NOT aware of their breast reconstruction options.
Currently, less than 25% of women who have their breast removed because of breast cancer undergo reconstruction. Many women choose to not undergo breast reconstruction at the time of treatment for a variety of reasons, but it is never too late.
Breast reconstruction is performed when part of the breast, or sometimes the entire breast, is removed due to cancer or another cause.
Breast reconstruction also includes symmetrical procedures for the opposite breast, such as a reduction, lift or augmentation. Many people are under the false impression that breast reconstruction is equivalent to breast augmentation, but that is not the case, and it is not uncommon to make small revisions to improve the appearance of the other breast.
Every patient should have the discussion of breast reconstruction with their breast surgeon, oncologist or plastic surgeon if they are going have a mastectomy or lumpectomy. There are many variables that determine whether a patient should have reconstruction at the time of their mastectomy or wait until a later date.
There are also multiple reconstructive options that can be tailored to each individual patient, as no one reconstructive method is perfect for every person.
Women have several options for breast reconstruction dependent on their individual desires and situation. This involves the surgeon placing an expander (an implant that can be filled gradually with saline). The second option for patients is to use tissue from another part of the body to re-create the breast.
Taking the abdominal tissue for breast reconstruction from this area is similar to how the skin and fat is removed for a tummy tuck. The third and newest method of reconstruction is fat grafting, where fat is taken from other parts of the body via liposuction and used to reshape the breast. It can also be used to improve a previous reconstruction or treat an area of lumpectomy and radiation. Fat grafting can also be placed over a previous implant based reconstruction to create a softer more natural breast.
Recovery from breast reconstruction depends on a number of factors including what type of reconstruction the patient has undergone. Reconstruction done with a tissue expander and implant often requires one night in the hospital. Patients that undergo reconstruction with tissue removed from the abdomen or elsewhere in the body often need a couple more days to recover from the procedure before going home. Ultimately, your surgeon will decide how long you need to remain in the hospital after your breast reconstruction.
The most important thing to take away from this article is that you have options and that they should be discussed with your breast surgeon, oncologist or plastic surgeon. Have the discussion before your breast surgery so that you can make an informed decision of whether you want breast reconstruction or not.
The information on this website is for general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments. This 24 year old Singaporean spent SGD 8,000 for Macrolane filler injection to the breasts (100 cc in each breast) only 6 months before she came to Medan. Fat transfer can be done to the breasts for augmentation and reshaping of the breast to create a long-lasting and natural result.
Although more than a decade ago the American Society of Plastic Surgeons (ASPS) did not recommend the use of fat grafting for breast augmentation, more recently, the American Society of Plastic Surgeons Fat Graft Task Force has stated that there is no strong evidence for or against autologous breast augmentation.
With the recent mass recall of breast implants in France where at least 30,000 women were affected, it appears that autologous fat grafting for breast augmentation may offer a safer option compared to breast implants. This client eventually had whole body transformation by getting liposuction done on her arms, abdomen, waist, flanks, lower back, hips, saddle bags, outer, inner, front and back of thighs, as well as knees over 3 sessions in 4 months time. Take home message: Filler injection for breast augmentation does work, but it is extremely expensive!
A word of caution on the use of dermal filler for breast augmentation: there has been no long-term study to prove that is safe.
Although breast implant has been the gold standard for breast augmentation for a few decades, a recent United States FDA report indicates that there is a possible association between breast implants and breast cancer.
Anecdotal evidence in our clinic showed that with the right technique, autologous fat transfer to the breasts may last a lifetime, without the need to change breast implant every 10 years and without having to go through the risk of major surgery and general anesthesia, as in the case of breast augmentation using breast implants. There is currently no standardized technique of harvesting and grafting fat to ensure survival of the grafted fat cells. Hence, amongst the 3 available options for breast augmentation, autologous fat grafting appears to have a very promising future, if performed by experienced surgeons using the right technique to ensure viability of the fat cells.
This Singaporean woman who is a mother of 3 children weighed barely 45 kgs, but had pockets of stubborn fat here and there. After completing whole body liposuction and 2 sessions of autologous fat grafting breasts augmentation, this patient returned to Dr Arthur Tjandra of Elixir de Vie Indonesia 4 years later for a third session of fat grafting to breasts as well as to forehead. When we launched our Extreme Makeover Whole Body Transformation in 2010 where clients received 3 sessions of whole body liposuction as well as 3 sessions of complimentary autologous fat transfer to either the breasts or buttocks for slightly more than SGD 10,000, only 2 women signed up.


Take home message: The whole intention of offering a whole body transformation package at a ridiculously low price is to create awareness that to sculpt a masterpiece, all areas of the body should be sculpted in a 3-dimensional form, instead of the current practice where surgeons only work on 1 or 2 areas within the same segment of the body. As a matter of fact, someone who is already within her ideal weight range but have ugly pockets of fat here and there, is the best candidate for body sculpting! This Singaporean college student in her early 20s presented with slim upper body, but heavy bottoms and small tubular breasts.
She returned to us for a second session of autologous fat grafting to her breasts, after purposely gaining weight, during which we harvested fat from her outer thighs and calves.
This Singaporean lady in her mid 30s found it very hard to get rid of the fat in her heavy bottom and thighs despite her rigorous physical activities. This Singaporean lady in her mid-20s had 2 sessions of body transformation involving her upper body and mid section. This young lady in her early 20s from Singapore had staged whole body liposuction with fat transfer to breasts and buttocks. This 34 year-old Singaporean mother of 2 children had VASER Liposelection done in Singapore 5 months before coming to Medan for revision. This young lady in her early 20s from Singapore weighed barely 45 kgs but had heavy bottoms.
This runway model from a leading modeling agency in Singapore appeared very good even in tank tops and shorts. This Singaporean student in her early 20s came to Medan for liposculpting and autologous fat grafting to breasts and buttocks. This flight attendant with a major airline in Dubai who is in her early 20s would like to have au naturel E or F cup breasts without inserting any foreign objects such as silicone implant into her body. This flight attendant with a major airline in Singapore who is in her early 20s, had VASER liposuction done on her outer thighs and buttocks in Singapore. This Singaporean student in her early 20s knew just how to put the extra fat in her arms into good use, by having autologous fat grafting into her breasts to increase it one cup size! This is another Singaporean college student in her early 20s who opted for whole body transformation. When natural breast implants popped up on lists of 2013’s biggest health trends, we were curious: Rounder breasts sans elastomer shells filled with saline or silicone? The procedure, commonly known as fat grafting, involves harvesting fat from your body—generally from the abdomen or thighs—through liposuction, then inserting it back into the chest.
The process, meanwhile, isn’t as simple as taking fat from other areas of your body and putting it into your breasts. Read the news on any given day and you’ll find a public health crisis — the Zika virus, the opioid epidemic, obesity rates.
There are some things you should know about this procedure before you schedule it into your calendar. It’s popular with women who want bigger breasts that look more softer or natural than implants while also avoiding many of the risks involved in getting artificial implants. In fact, it’s easier to detect malignant lumps in fat-grafted breasts than those with silicone or saline implants.
Water-assisted liposuction is the popular method to do this so he can gently remove fat while lessening the cell damage he causes.
At the same time is is also important that your doctor injects the fat in all the right places so that the new fat cells gets access to blood supply which is a big factor to making sure that the results last longer.
In typical fat grafting surgeries, about 400-600cc of fat must be grafted into your breasts to increase a cup size. So if you are a thinner person with less than ample body fat – you might have to prepare in order to have this procedure. Those who have had previous pregnancies have more pliability in their boobs so there’s less of a problem. Why can’t I just inject a whole bunch of fat into my breasts and go up multiple cup sizes, you ask?
It’s a challenge to promise concrete results since there is always the risk that the body will reabsorb the excess fat, especially within the first three months. In terms of longer-term fat absorption, there are maintenance injections available to prolong or even achieve a permanent effect from your breast augmentation. First the cost of the surgeon, which would vary with his or her level of expertise, techniques used, and the results you want to achieve. With all these factors, the typical procedure in the United States ranges from $4,000 to $15,000 USD.
Unlike pre-shaped implants, surgeons can sculpt your breasts to the shape you want through strategic placement of injections. At the same time, you do not cause a loss of sensation in your breasts or nipples since you’ve only added more of your own fat into your breasts.
However one thing you have to remember is that the body can reabsorb the fat, so your newly augmented breasts will definitely shrink to a more natural size in the course of three months. Always, always opt for a surgeon who’s performed the operation successfully many times, even if they have more expensive fees. Contrary to this, studies are actually showing that fat transfer can actually be as safe if not safer than breast implants. Keep in mind that the amount of graft take (aka, the amount of fat that stays in your breasts) is approximately 50%, depending on the density of the breasts, vascularity, skin elasticity and processing method of the grafts.
However, because of improved surveillance and treatment, there are currently over 2.5 million breast cancer survivors in the United States. It is a woman’s personal decision whether or not she decides to undergo breast reconstruction; still, it is important that she understands her options. There is no deadline – whether it is months or years later, reconstruction is still an option.
This was made possible in large part to the Women’s Health and Cancer Act that was passed in 1998, requiring insurance companies to cover breast reconstruction.
The specific type of reconstruction required is dependent on whether only a portion of the breast is removed, or the breast in its entirety. This can be done alone or in combination with either of the two above reconstruction methods. It re-creates the breast tissue that was removed and can improve any skin damage that was caused by the radiation treatment. Also, if you decided not to have breast reconstruction years ago, remember it is never too late and you can still see your plastic surgeon to discuss your options for reconstruction.
Sit at the table with a proper place setting and be aware of how many calories you are consuming. There have been debates amongst surgeons on the long-term implication of fat transfer to the breasts, as fat cells may die and get calcified. In a most recent study published on the Journal of Plastic & Reconstructive Surgery in March 2011, researchers found that there was no statistically significant difference between breast density findings before and after fat injection, whether using the American College of Radiology classification or a personalized rating system. After all, implants are still foreign bodies which are inserted into the body, while autologous fat grafting procedure uses one's own fat. She also had autologous fat grafting to her breasts and buttocks during all those 3 sessions.
Not only has the fat transfer surivived, but the breasts have increased in size as well since the last session of autologous fat grafting!
With the effects of the Macrolane injections not being very long lasting with only an estimate of the enhancement lasting up to 12-18 months, many argue that Macrolane breast enhancement leaves the patient in a more vulnerable situation than that of a person who only has to go through one intrusive operation i.e. The agency is aware of about 60 cases of anaplastic large cell lymphoma (ALCL) in women with breast implants worldwide. Moreover, fat grafting is not taught in medical schools or during plastic surgery training. In fact, autologous fat grafting may replace breast implant as the gold standard of breast augmentation in the near future. This mother of three teenage kids had whole body transformation involving whole body liposuction and breasts and buttocks augmentation using autologous fat grafting, as well as upper blepharoplasty, rhinoplasty and face and neck liposuction.
On the other hand, she has shrunken breasts resulting from years of breast feeding 3 children as well as her hobby running.
The result of her autologous fat grafting breasts augmentation after 4 years, as well as immediately after the 3rd session can be seen on videos we have uploaded to YouTube. Those 2 were the luckiest persons on earth, as they would otherwise had to spend at least 5 times that amount if they were to get it done elsewhere.
As a matter of fact, because of her rigorous work out, she noticed her breasts had been shrinking. She did not get what she wanted: an hour-glass figure, because the sculpting was never done 3-dimensionally. As she has heavy bottom and pockets of stubborn fat in her abdomen, we planned for a whole body liposuction in 2-3 sessions, during which we performed autologous fat grafting for au naturel F-cup breasts! Although she weighed barely 48 kg, she has mild unsightly saddle bags, love handles and also a pair of thighs which were disproportionately bigger than other parts of her body. The Brookline-based plastic surgeon Michael Tantillo, who does both breast implants and fat grafting, says that there is a lot of prep work involved—like wearing a suction-cup-like device on each breast for at least 12 hours a day for the three weeks leading up to surgery. We reserve the right to remove impersonators or personal attacks, threats, profanity, or flat-out offensive comments. Chahin is always accepting new patients seeking all aspects of aesthetic surgery for their personal enhancement. Chahin's plastic surgery practice For general inquiries, give us a call at (310) 274-2763 or (818) 343-3345 or please fill out the form. However, your surgeon can also recommend either an ultrasound-assisted liposuction or a laser one. Specifically, the surgeon might require you to either gain more weight or have multiple donor areas where fat can be harvested.


In fact more insurance companies are starting to see the benefit in fat grafting since is requires no hospitalization, and have lower complication rates post-operation. These options include immediate or delayed (some time after the mastectomy) reconstruction, symmetrical procedure of the opposite breast and revisions to improve the appearance of the reconstructed breast.
Franco served his residency in Plastic Surgery at Saint Louis University School of Medicine, finishing as head resident. Although she was advised that the filler would last at least a year, she noticed her breasts shrunk back to almost their original size barely 6 months later.
Similarly, no significant difference was observed using the American College of Radiology Breast Imaging Reporting and Data System categorization before and after fat grafting. If one wants to debate about the risk of causing confusion in detecting early breast cancers later on in life, a breast implant causes even more confusion as it blocks away most of the view in a mammogram. But sadly, the hard lumps which resulted from Macrolane injection still persisted and did not seem to improve over time. This number is difficult to verify because not all cases were published in the scientific literature and some may be duplicate reports. Surgeons acquire the skill needed as they perform more and more cases in their own practice. Therefore, we have moved our practice to Medan where cost of doing business is ridiculously low, and pass this savings to our clients to enable them to afford whole body 3-dimensional sculpturing. Moreover, extreme exercising in someone who is already slim and has small breasts, may reduce the breasts size even more. She will return for her second session during which we will address her abdomen and love handles, and transfer the fat to her breasts again.
But again, with the high cost of liposuction in Singapore, most patients can afford to pay to get upper and lower abdomen done only, neglecting the rest of the trunk. It was only when she undressed herself completely, it was apparent that she had some very mild unsightly bulges here and there. She is awaiting her third session, during which we will address her thunder thighs and perform further autologous fat grafting to her breasts and buttocks. After getting thighs liposuction done, she now has very prominent calves, which will be addressed next. Although her arms were slim to begin with, like most women, she had this unsightly bulge like a drumstick appearance, when pictures were taken from certain angles.
Khouri, MD, FACS of the Miami Breast Center, a pioneer in breast reconstruction and natural breast enhancement. Not only that, she also noticed several hard lumps which started to occur 6 months after her breast augmentation with Macrolane.
When faced with many calcifications on x-ray, the physician is faced with dilemma of whether to take out every single lesion for biopsy, or just to leave them alone, assuming that those are just calcified fat.
In conclusion, radiographic follow-up of breasts treated with fat grafting is not problematic and should not be a hindrance to the procedure.
So, the best is of course never to put anything inside the breasts so as not to cause any confusion. These fillers (for breast augmentation) typically last 1 year or so, but in her case, it was almost completely absorbed by the body in 6 months time. Most cases reviewed by the FDA were diagnosed when patients sought medical treatment for implant-related symptoms such as pain, lumps, swelling, or asymmetry that developed after their initial surgical sites were fully healed. Ultimately, just like pilots, surgeons who have performed the most fat grafting procedures are the ones who can ensure the highest safety profile and success rate. During the first session, we performed liposuction of double chin, arms, abdomen, and fat transfer to buttocks. As she would like to look even better, we performed a whole body transformation for her, including autologous fat grafting to fill up the hollowed areas of her buttocks, as well as to augment her buttocks even further.
She had actually read through our liposuction case studies and understood that to obtain excellent result, 3-dimensional liposuction involving all areas should be done. The May issue of Plastic and Reconstructive Surgery, the official medical journal of the ASPS, published a new study that "shows that Brava breast expansion enables the transfer of large volumes of fat in a single session safely and effectively while ensuring a very high survival rate, with augmentation volumes comparable to implants and the added benefit of a more natural appearance and feel." Fat transfer to the breast has become increasingly popular in recent years and has been experimented with by several plastic surgeons only to find that the volume of fat that can be transferred is limited with low rates of fat surviving. Franco has become part of the team of cosmetic surgeons at Miami Plastic Surgery, where you can get more information on breast reconstruction cosmetic surgery, or schedule a personal consultation. A Google search on the internet revealed that complication of hard lumps forming after Macrolane injection is actually quite common. However, once a woman has decided to get breast augmentation done, then the safest bet probably is to get autologus fat transfer to the breasts. However, based on years of experience and follow-up of our existing patients years after autologous fat transfer procedures, we find that the risk of fat cells dying and getting calcified is almost zero, by using a special harvesting and injecting technique invented by Dr Arthur Tjandra. These symptoms were due to collection of fluid (peri-implant seroma), hardening of breast area around the implant (capsular contracture), or masses surrounding the breast implant.
Although it is hard to compile photos from patients as most of them are lost to follow up, we are glad to have a number of grateful patients who were so happy with the result of their fat grafting, that they emailed to us the photos or returned to us to have their photos taken long after their fat grafting procedures. Ten months later, she returned for augmentation rhinoplasty, liposuction of the whole thighs, saddle bags and jowls, as well as fat transfer to her breasts. However, having read some malicious gossip on the internet which said that Medan and other places in Indonesia were very unsafe for ethnic Chinese to visit, she chose to have her liposuction done in Singapore. Since she also models for lingerie and swimwear, it is very important for her to have perky derriA?re. This is where the capsule that forms below the implant become hard and squeezes the implant.
The study noted that "preparation of the recipient breast by external expansion is the key missing ingredient." Traditional Method During a fat transfer to the breast procedure, fat is obtained by liposuction from one part of the body and transferred to the breast.
A journalist of The Sunday Times in UK wrote about her first-hand experience with Macrolane injection.
Examination of the fluid and capsule surrounding the breast implant led to the ALCL diagnosis. We are, therefore, able to put together serial photographs which take you through the journey of fat grafting and whole body transformation by removing and transplanting fat!
Thereafter, she had Asian double eye lid surgery and another session of fat transfer to her breasts increasing her breast size from completely flat-chested to a decent B+ cup now. The result would have been much better if liposuction was performed on her inner thighs as well!
Completely unsatisfied with the result, she had no choice but to visit us in Medan to get a revision done 4 months later, during which we also performed autologous fat grafting to the dented areas which were caused by over-suctioning.
22 minutes agoMayo Clinic --> #Hypothyroidism: Can calcium supplements interfere with treatment? There are 3 very important variables which determine the success rate of an autologous fat grafting procedure: technique of harvesting fat cells, technique of processing fat cells, and technique of re-injection into the breasts or any other areas of the body. This is one of the most frequent problems often observed with machine-assisted liposuction! During the first session, she had thighs liposuction and autologous fat transfer to her buttocks. The reason is simply that there is not enough room within the breast for the fat to survive and thrive. Another report on the Daily Mail, also in UK, stated that 16 out of 20 female clients injected with Macrolane complained of abnormal lumps and pain.
But, even then as the filler is slowly broken down by the body, just imagine the agony of watching your breasts shrinking day after day before the filler completely disappears, as what Qiu Qiu has experienced!
Three months later she returned for her second liposuction, this time on her abdomen and arms, as well as further autologous fat grafting to buttocks. I want you to know that there is no shame in you considering breast implants, and you are absolutely worth the investment.If you're ready to LOVE the reflection you see in the mirror, then I'm here to guide you every step of the way!
UK Health Centre, a patients advisory group, advised against the use of Macrolane injection for breast augmentation. Start My Plan or Read My Story This entry was posted in Articles About Breast Implants, Breast Implant Basics.
Similarly, Aqualift filler is not approved for use in Singapore due to the lack of clinical data to support its long-term safety and effectiveness in tissue reconstruction. She went to Sun Plaza and observed that it was packed with ethnic Chinese people without being robbed or harassed by the Indonesians as what gossipers on the internet said!
On 7 December 2010, Health Sciences Authority (HSA), a regulatory body in Singapore, sent emails to all doctors to warn them to stop using Aqualift medical filler gel after a patient who was injected with it developed unusual lumps in her breasts. We charge only SGD 1,000 currently, for autologous fat transfer for breast augmentation, which can last indefinitely if the fat cells survive. In this typical case which we followed up for 15 months, this patient's breasts size have in fact increased from C-D cup immediately post-op to a current D-E cup 15 months later! Khouri also has a variation of this technique for breast reconstruction patients with amazing results. The Comparison One Year Later Furthermore, the study showed that after one year, women who underwent the BRAVA + AFT procedure, had their breast volume increased by an average of 230 cc. Fat transplantation alone without pre-expansion, according to previous studies, had an average breast volume increase of only 130 cc.
Other plastic surgeons have reported similarly good results using the BRAVA external tissue expander. Khouri, MD, FACS, a world-renowned plastic surgeon and pioneer in fat transfer to breast and reconstructive microsurgery.



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Comments »

Karolina:
Throughout the UK, who all recognise the desire is to correct.
27.02.2015 | 18:56:32
EFIR_QAQASH:
Best if the patient brings in photos with not medically able to undergo the.
27.02.2015 | 23:50:54