Coleman Structural Fat Grafting to the Nose0

Injection of fat grafts into the nose provides surgeons with new tools to compliment their nasal surgery.  Fat grafted to the nose by the Coleman method is surprisingly well integrated, assuming the structural a quality of the part of the nose into which it is placed.
Shape
Rhinoplasty surgeries often leave a nose with an “open roof.” The cartilage and bony parts of the nose have been separated so that it looks like a long trough through which the septum can be felt or even seen through the thin skin on the nose in this condition.  In addition, the cartilage or bone can become deformed in many ways after rhinoplasties. The skin of the nose in some patients is so thin that irregularities can be amazingly visible, so that many structures are painfully visible through the skin after nasal surgery.This woman had four nose procedures on both coasts and silicone injections to the nose. Follow-up at one year from one procedure (right) reveals a remarkably more normal appearing nose.  The upper nose flows more naturally into the lower nose, with a more distinct central light reflex and many less irregularities.  Placement into the nostril rim flattened the notching and appears to have pushed the nasal tip over to the middle from the right.

Coverage
Placing a thin layer of fat under the skin provides support for the skin and can disguise visible irregularities of the cartilage and bone.  Concentrating the fat grafts into specific areas can improve the light reflex down the middle of the nose or subtly change the proportion of one part of the nose to another part.This patient presented after at least 12 previous nasal procedures, including GorTex placement and removal, numerous cartilage grafts from her ears and one from her chest.  The markings demonstrate the areas of placement.  One year after one procedure, you can see softening of the irregular cartilages along with an apparent thickening of the skin over the entire nose.  The area between the eyebrows is slightly fuller with a lessening of the frown wrinkles.

Posted: Facial Reconstruction

Dr. Sydney Coleman presents LipoStructure to maxillofacial and craniofacial surgeons1

In Bologna, Italy, during the 19^th Congress of the European Association for Cranio-Maxillo-Facial Surgery (EACMFS) Dr. Coleman presented a special one-hour lecture. The lecture was entitled, “The Role of Structural Fat Grafting in Aesthetic and Facial Reconstructive Surgery.”

Dr. Coleman reviewed patients from his 22-year experience of treating patients using structural fat grafting in facial reconstructive problems.

The use of fat grafting was demonstrated to aid in the correction of a large number of facial deformities, including hemifacial atrophy (Parry Romberg syndrome), hemifacial microsomia, Treacher Collins syndrome, phlagiocephay, secondary cleft lip problems and cancer survivors with significant face and neck deformities from surgery and radiation.

Patient with a significant deformity 15 years after  removal of cancer from the left lower face along with muscles and other tissues followed by irradiation (left before).  One year after only two fat grafting sessions (right after), the face appears and feels normal.

© Coleman 2008

Posted: Facial Reconstruction