iam a transexual who has been pumping more on then off for the last two years.I have used the nbs which helps size but for me brava does the best job but one must be careful with brava Iam recovering from blisters.Main reason I pump is a medical reason having clot problems just have to be carefull with the brava and yes my results are permenent so far aa(left) an a on (right)