27
July
2010
Sydney Coleman, a plastic surgeon in New York City, continues to improve fat grafting methods
Dr. Sydney Coleman is recognized as the world’s leading expert on fat grafting. It has been through his perseverance and insight over the last 22 years that fat grafting is becoming an important part of medicine. In the last four years, Dr. Coleman has improved dramatically the method he uses for fat grafting. The advanced methods he now uses for fat grafting not only increase the predictability of fat graft survival; but also, more importantly, the new techniques maximize the reparative effect of grafted fat on the tissue around which it is placed. Using his newly developed method, fat grafted under sun damaged and aging skin repairs the overlying skin. The eyelid of the patient below demonstrates the dramatic change that grafting fat in one procedure can have on overlying wrinkles.
Before (above) and two years after one procedure to lower eyelids in a 76 year old with no other treatment to her lower eyelids
Fat grafted under skin in the lower eyelid repairs the skin to a more radiant, youthful appearance
Probably through the same mechanism of repair, grafted fat has been shown to repair the tissue damage caused by radiation from cancer treatment. Dr. Coleman has been actively participating in laboratory research at NYU Medical Center, which has enabled him to verify his new advances in grafting fat. This new way of grafting fat increases the predictability of the volume of fat grafted, but more importantly, it maximizes the effect of grafted fat on the tissues around which it is placed.
Dr. Coleman has been speaking at meetings worldwide over the last few months to relate the advances that he has made in the last five years in fat grafting. In June alone he has given lectures in Manchester, UK; Ghent, Belgium; Aachen, Germany; Iceland; and Halifax, Nova Scotia. Earlier this year, he gave a series of lectures at a maxillofacial/craniofacial meeting in Baltimore, at the Egyptian Society of Plastic Surgery meeting outside of Cairo, at an international hand meeting in Paris, at a meeting in Los Cabos in Baja California, at a symposium of the Plastic Surgery Education Foundation meeting in Snowbird, Utah, at a breast meeting in Miami, at the American Alpine Workshop in Plastic Surgery meeting in Jackson Hole, Wyoming, and at a Regenerative Surgery meeting in Rome.
And Dr. Coleman continues to travel to Pittsburg monthly to use fat grafting on soldiers with facial war injuries. This is part of an Armed Forces project at University of Pittsburgh Medical Center supervised by the US Department of Defense.
. Written by the office staff at TriBeCa Plastic Surgery
To read the Cosmetic Surgery Times article on the use of fat grafts with stem cells for rejuvenation, please click here.
For further articles about this subject
Posted: Breast LipoStructure, Facial Reconstruction, Fat Grafting Research, Home, Natural Facial Rejuvenation
19
November
2009
The Department of Defense just awarded a $1.6 million grant to help soldiers recover from devastating facial injuries using innovative surgical technologies based on the biology of fat tissue. Peter Rubin a noted scientist and plastic surgeon, will head up a surgical team that will use the fat grafting techniques developed by Sydney Coleman to reconstruct 20 American veterans.
In a news article released on Veteran’s day last week, Dr. Rubin noted that to counteract certain basic biological challenges the surgical “team will use techniques and innovative equipment developed by Dr. Sydney Coleman, a New York plastic surgeon who will be part of the research group.” The news article goes on to say, “Dr. Coleman has developed a centrifuge …that concentrates the fat…and raises the proportion of stem cells…that can help the fat tissue grow new blood vessels. Dr. Coleman has developed special surgical tools for facial reconstruction work, Dr. Rubin said, particularly tiny tubes called cannulas…that can be used to implant the fat cells beneath the facial skin.”
Dr. Sydney Coleman used three sessions of fat grafting to reconstruct the missing portion of this man's face. Similar techniques will be used to reconstruct the war casualties
“As many as 26 percent of wounded soldiers suffer some kind of facial injury, which can have a huge impact on quality of life,” said Dr. Rubin in a recent press release. “While we can reconstruct bony structures very well, it is the surrounding soft tissues that give people a recognizable face. This project will investigate how soft tissue grafting can more precisely restore facial form and improve the lives of our wounded soldiers.”
The use of fat grafting for serious facial injuries, such as those resulting from roadside bombs is facilitated in this project by using specially designed devices and instruments for harvesting fat tissue and implanting it into regions of scarred tissue.
“Fat grafting, or moving fat tissue from one part of the body to another, has been used as a cosmetic procedure for decades,” said Dr. Rubin. “We are now applying these same techniques for reconstructive surgery to accurately restore facial form after battlefield injuries.”
© Coleman 2009
More examples of reconstruction using Dr. Coleman’s specific technique can be found at www.lipostructure.com.
Further reading:
Restoration of Missing Facial Tissue Important Alternative to Traditional Surgeries
The treatment of face and neck scars with structural fat grafting
Dr. Sydney Coleman presents LipoStructure to maxillofacial and craniofacial surgeons
Fat Injection: From Filling to Regeneration
In Dr. Coleman’s book Structural Fat Grafting
In Chapters 17 & 18 of Dr. Coleman’s book Fat Injection: From Filling to Regeneration
Treatment of the aging hand with LipoStructure
NY Times shows photos of progressive improvement in skin quality with Coleman Fat Grafting
Coleman Structural Fat Grafting to the Nose
Posted: Facial Reconstruction, Home
20
July
2009
Restoration of Missing Facial Tissues Important Alternative to Traditional Surgeries
NEW YORK CITY, NY - Sydney Coleman, a Plastic Surgeon in New York City, has demonstrated that fat grafting has an important place in facial reconstructive surgery. Dr. Sydney Coleman has shown at international meetings throughout the world that fat grafting can replace many more complicated, less effective methods of reconstruction. A patient whose case was published previously in Plastic and Reconstructive Surgery returned recently 18 months after his last procedure with an exciting result.
BEFORE FAT GRAFTING Radiation and surgery cured this young man of cancer, but left him missing one quarter of his face.
This 23 year old patient was discovered to have a rhabdomyosarcoma cancer of the masseter muscle (the muscle on the side of the face used for chewing) when he was eight years old. He was successfully treated with removal of many of the muscles of his face and therapeutic radiation to the left lower face. In the areas of the radiation, his facial and skull bones did not grow normally, and he was left with a severely deficient lower left face (see above). In addition, the skin of the irradiated area was extremely fragile and beard growth abnormal. He had had no procedures done since his original cancer surgery.
BEFORE (left) and AFTER (right) Three sessions of Coleman fat grafting.
Between 2004 and 2008, three Coleman fat graft procedures were performed to arrive at the above result (which is eighteen months after the third procedure. The fat was layered through tiny incisions over the lower one-quarter of this young man’s face and over the lower part of the skull (mastoid) using special tools developed by Dr. Coleman. The layering started at the bone each time and extended out to the skin.
BEFORE (left) and AFTER (right) Tilted views reveal more of the profound loss of structure.
BEFORE (left) and AFTER (right) Oblique views further demonstrate the extent of missing bone and muscle.
One of the most important reasons for using fat grafts in such situations is that the stem cell and growth factors present in fat grafts may promote healing of the damaged tissues.
Surgeons are hesitant to operate on body areas which have been treated with radiation because they heal poorly or not at all after a surgical procedure. Recent evidence points to the healing of radiation injury and even improvement in the appearance of aging skin by fat grafting to an area. The healing most likely takes place by bringing in stem cells (or repair cells) which build new blood vessels and capillaries to the irradiated skin, muscle and bone.
In addition to treating acquired deformities from radiation therapy or accidents, Dr. Coleman has successfully treated facial deformities such as birth defects, Romberg Syndrome, Treacher Collins Syndrome, problems from childhood cancers, radiation damage, vascular tumors and cleft lip deformities with Coleman fat grafting.
© Coleman 2009
More examples of reconstruction using Dr. Coleman’s specific technique can be found at www.lipostructure.com.
Further reading:
The treatment of body scars with structural fat grafting
Fat Injection: From Filling to Regeneration
In Dr. Coleman’s book Structural Fat Grafting
In Chapters 17 & 18 of Dr. Coleman’s book Fat Injection: From Filling to Regeneration
Treatment of the aging hand with LipoStructure
NY Times shows photos of progressive improvement in skin quality with Coleman Fat Grafting
Posted: Facial Reconstruction, Home
29
October
2008
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.
© Coleman 2008
Posted: Facial Reconstruction
2
October
2008
In Bologna, Italy, during the 19th 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
