The completely renovated lipostructure.com website will be online by early February.  In anticipation, I will begin tweeting from on a regular basis at Syd Coleman @lipostructure to inform people of the potential of LipoStructure® and advances in the use of stromal vascular fraction (SVF) and adipose derived stem cells.

LipoStructure® is the particular brand of fat grafting developed by me in the late 1980’s and now used worldwide.  As fat grafting has become more popular, people have noted that the fat does more than fill; it can repair and rejuvenate the tissues into which it is placed.

Recent scientific studies have determined that fat tissue has the highest concentration of stem cells of any tissue in the body.  These “stem cells” appear to repair damage in our bodies.  I have seen improvement in skin quality and scarring in my own patients over the last two decades.

Stromal Vascular Fraction (SVF) is the name for fat tissue with the fat cells removed.  The SVF is composed of a very high concentration of stem cells.  Research is ongoing to determine the benefits of SVF in treating a variety of conditions seen in plastic surgery and many other medical specialties.

Sydney Coleman, MD

Dr. Coleman continues to travel monthly to the University of Pittsburgh Medical Center (UPMC) to operated on soldiers with facial war injuries using Coleman Fat Grafts.  The Sunday Pittsburgh Post-Gazette updated their previous report of the ongoing studies at UPMC.  The following is an excerpt from the news article:

Sculpting with fat can restore faces (excerpt of original article)

New techniques use fat cells to smooth visages of veterans devastated by injury

Sunday, March 06, 2011
By Mark Roth, Pittsburgh Post-Gazette

Robin Rombach/Post-Gazette Jeremy Feldbusch lost his sight after a piece of artillery shrapnel tore through his skull in Iraq in 2003. He underwent a new procedure that transferred fat from other parts of his body to fill in the side temple area of his head

Jeremy Feldbusch lost his sight after a piece of artillery shrapnel tore through his skull in Iraq in 2003. He underwent a new procedure that transferred fat from other parts of his body to fill in the side temple area of his head.

Jeremy Feldbusch can’t see the results of the special cosmetic surgery he recently got — but he’s pleased when people tell him what a good job the doctors did.

Mr. Feldbusch is blind because a piece of artillery shrapnel tore through his skull in Iraq in 2003. In January, UPMC surgeon J. Peter Rubin took fat from his abdomen and thighs and injected it into cavities that his war injuries had left on his face.

Dr. Rubin, recently named chief of the Division of Plastic and Reconstructive Surgery at UPMC, has received $4.5 million from the Department of Defense for his fat resculpting project, and so far has performed the surgery on 11 injured veterans.

Using techniques developed by New York plastic surgeon Sydney Coleman, who has assisted on the surgeries here, Dr. Rubin’s team removes fat cells from a patient’s body, centrifuges them to collect the most active cells, and injects theminto injury sites using tiny tubes that can be as narrow as an intravenous needle .Fat injections have been used in cosmetic surgery for years, but the problem has been that in many cases, the fat is absorbed by surrounding tissues and the work has to be done over.

Dr. Coleman’s centrifuge technique is designed to prevent that by concentrating the fat cells, which helps them to thrive and grow new blood vessels once they are injected.

In a broader sense, Dr. Rubin’s project is part of a fast-growing movement around the world to use fat stem cells to generate new tissues for all sorts of conditions, from breast reconstruction to growing new bone.

Most human tissues contain stem cells that can generate new cells of the same type to promote healing. Fat stem cells can not only grow new fat cells, but in the lab, they have been turned into bone, cartilage, skin and muscle.

In Japan, doctors have now used fat stem cell injections in hundreds of women for breast enlargements, and report that the women think the results feel and look much more natural than synthetic implants, he said.

UPMC’s Dr. Rubin is also working with fat stem cells for reconstruction in women who have had breast cancer. Because stem cells can promote tissue growth and new blood supply, there has been some concern that these injections might trigger a recurrence of the breast cancer, he said, “but our best evidence now shows if you have dormant cancer cells present, they are not likely to be reactivated by fat stem cells.”

While some of the fat that Dr. Rubin injected into Mr. Feldbusch and the other injured soldiers consists of stem cells as well, the next step of his research will be to grow additional fat stem cells in the lab and “enrich” the mixture of fat cells that are put into the injury sites.

Fat stem cells, like those now growing in Mr. Feldbusch’s face, have two complementary benefits

In some cases, they remain fat cells when they are put in the body, but can promote blood vessel growth and healing in other tissues, which has been shown in experimental work on heart disease patients. In other cases, they can morph into completely different kinds of tissue

And they have one other advantage, Dr. Gimble said: People are happy to donate them. “There is no other tissue that someone will actually pay their doctors to take out of them,” he said.

First published on March 6, 2011 at 12:00 am

Read more: http://www.post-gazette.com/pg/11065/1130053-114.stm#ixzz1Gtdir2DF

Further reading:

The first report in the Post-Gazette back in November 2010

Update on Coleman Fat Grafting to the Nose

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

“The Surgeon Who Injects Women with Fat

Well, they do ask him to… Just when we’ve got used to fillers for the face, along comes a remarkable body resculpting technique”

Dr. Sydney Coleman holding a fat grafting cannula in his operating theater surrounded by his nurse, physician's assistant, and centrifuge Photo by Mike McGregor

“It is the last place in the world you’d expect to hear someone praising fat. But, in a chic Manhattan plastic-surgery clinic populated by impossibly lean women, Dr Sydney Coleman is doing just that, while explaining a new technique with radical implications for cosmetic and reconstructive work.

LipoStructure, or lipomodelling as it’s also known, involves taking a patient’s own body fat and reinjecting it to sculpt, fill, correct and enhance other areas. We may have got used to the idea of injectable fillers for the face; now it’s body recontouring that’s the growth industry. And, for more and more surgeons, fat is the tool of choice. In the right hands, the results are extraordinary: it can fill scars and hollows, smooth creases, retouch cellulite dimples, as well as plump and sculpt breasts and bottoms.

One of the most popular procedures Dr Coleman offers is taking fat from the abdomen and reinjecting it into the breasts, which is, as one surgeon puts it, “the answer to a maiden’s prayer” – weight loss, waist definition and breast enhancement all in one procedure.

But aren’t people squeamish about using their own fat? “They love it,” Dr Coleman says, with a big smile. “The abdomen and love handles are always my first choice because that makes the woman thinner.” Fat can, of course, be taken from anywhere it’s not wanted on the body and, as Dr Coleman says, “There’s no blood and no cuts. There are just these little puncture sites.”

Coleman first started investigating fat-grafting in the late Eighties when, he explains, “I’d go to a cocktail party and women would pull me aside and complain about their thighs and abdomens after liposuction. So that was the original motivation – to help these women who were coming to me saying, ‘What am I supposed to do now?’?”

Back when liposuction was a new procedure, many surgeons would remove too much fat from thighs, leaving them hollowed and irregular, he says. “I visited people in California and Virginia and spoke to people in France who were doing fat-grafting for the correction of liposuction deformities, but they’d never had good experiences. So I looked at what they were doing and tried to do it a little differently. I tried to bring it down to more basic principles.”

The principles may be basic, but the work is also extremely precise. Coleman’s technique involves harvesting fat very gently through low-vacuum cannulas before using a centrifuge to separate the oil and water. (Traditional liposuction techniques, which involve exerting a lot of negative pressure, can harm the fat and increase the chances of it dying once it’s been grafted, meaning it forms hard lumps.) The treated fat is then reinjected, one droplet at a time, in a lattice formation. It’s a delicate and painstaking process, with no room for error.

The surgery’s “two-for-one” aspect is not its only appeal. Unlike most conventional breast augmentation surgery, there is no scarring. There are also none of the aesthetic and practical problems that come with implants, and fat-grafting affords the surgeon more control – and room for artistry. “With silicone, you’ve got a bag and you make a hole and stuff it in the hole,” says Dr Coleman. “It’s a prefabricated volume. But with fat-grafting, you have to completely visualise everything in three dimensions. You can really shape the breast and improve projection and I’m able to go anywhere – to make cleavage, to feather into the side.” Some of the most impressive before-and-after pictures he shows involve subtle but radical changes to breast shape: an obvious implant, for example, is edged with fat and instantly becomes natural-looking.

Linda Francipane, a 44-year-old hairdresser from Queens, was an early patient of Dr Coleman’s and underwent breast augmentation surgery having spent “many, many months” researching her options. This included speaking to a lot of strippers about their implants. “I’d say 40 to 50 per cent had some kind of issue with them – whether they leaked, or the look, or the feel,” she says.

She was nonetheless determined to do something about her flat chest. “You’d be out clubbing,” she says, “and all the hot girls had tremendous boobs and I really had nothing, like nothing. This was the time when everybody was getting implants and I was like a little boy. I just wanted to get in the game.”

When a friend told her about Dr Coleman’s technique, “It seemed like a fabulous alternative to putting something foreign in my body.” She went from “below an A” to a 36C and says, “The way he did them, you can’t tell. It’s terrific. It changed my life.” She says she’s still receiving compliments.

Tal, a 36-year-old from Portland, Oregon, is another of Dr Coleman’s patients. She had implants when she was 19 but was so dissatisfied, she had them removed after just nine months. “I couldn’t breathe properly. It was just a very foreign feeling,” she explains.

As soon as she heard about breast augmentation by fat-grafting, she booked a consultation with Dr Coleman. “I thought nothing could be worse than what I had, so, even if he messed up, it would still be better. I had nerve damage from the breast implants, and stretch marks, and some scarring from under the nipple where it had been cut open. The tissue gets so stretched that I was actually flatter after breast implants.”

She wanted “breasts that were heavier at the bottom – a kind of Seventies look. I wasn’t comfortable being showy – my identity is really that of a flat-chested girl. It’s hard to create a natural-looking shape; I don’t know how he does it, but it’s just perfect – exactly what I wanted. He’s an artist. I don’t know if I’d trust anyone else.”

Tal also adds, “I don’t even wear a bra,” before laughing and reflecting, “I probably should, since I made such a large investment.””

“In a nutshell, here’s how it works:  Fat is suctioned from the abdomen, love handles, or back—’anywhere there’s excess,’ says Coleman—using low-pressure liposuction, and is transferred to another area of the body through a series of precise injections with a syringe-like instrument.  There, the tiny blood vessels within the fat will connect to the tissue around it and take up residence in their new environment.  Once it settles into place, you may see more than an increase in volume.  ’The quality of the skin—its color, its texture—improves,’ says Coleman, who also notes a softening in the appearance of stretch marks and cellulite.  That’s because fat is loaded with adult stem cells—as many as one million per cubic centimeter, by recent estimates—making it ‘a dynamic, living form of repair and rejuvenation.’”

This is an excerpt from an article named “BLOW UP” in Vogue Magazine October 2010, about fat grafting for changing body contours featuring the developer of LipoStructure, Sydney Coleman, a New York City Plastic Surgeon.

Fat grafted under skin in the lower eyelid repairs the skin to a more radiant, youthful appearance

Before (above) and after (below) a thin layer of fat grafts to the lower lids. Please note the remarkable improvement in texture, color and pore size of the skin.

Please read our previous posts on October Vogue’s article

• Advances Made by Sydney Coleman
• Creating Curves with Fat Grafting

.  Written by the office staff at TriBeCa Plastic Surgery

Read about Dr. Coleman’s development of these special procedures in Cosmetic Surgery Times.

For more information please refer to earlier posts:

• Improvements in Structural Fat Grafting
• The possible role of stem cells in facial rejuvenation

• The treatment of face and neck scars with structural fat grafting
• Dr. Sydney Coleman presents LipoStructure to maxillofacial and craniofacial surgeons
• 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

CREATING CURVES WITH FAT GRAFTING

by Catherine Piercy

“For bigger jobs, fat grafting by injection—reinjecting one’s own fat into areas that have steadily deflated with time—is emerging as an exciting recontouring tool.

Once something of a fringe procedure, fat grafting was pioneered by Coleman in the mid-eighties, when the emergence of liposuction meant that large volumes of fat were suddenly available.  These days, surgeons travel from around the world to learn his trademark LipoStructure technique.  And while pharmaceutical giants are racing to develop synthetic counter-parts for big-picture recontouring—like Macrolane, the hyaluronic acid-based filler that has received mixed reviews in Europe, where it’s approved for use—plastic surgeons agree that the unique advantages of fat, which is easily recognized by the body and, once grafted, may last anywhere from several years to a lifetime, make it

a particularly appealing body-sculpting medium.”

Buttock Augmentation before (left) and one year after one fat injection session

Before (left) and eight months after correction of liposuction deformity of the hips and abdomen

…in its present incarnation, doctors agree that fat grafting offers some uncommon advantages…to address common liposuction deformities, a corrective dose of fat can restore feminine angles and lost definition to overtreated arms, abdomens, or thighs…fat grafting to the posterior can add back some significant lift.  For an extra boost, a few c.c.s in the crease where your bottom meets your thigh pushes everything out and up.”

6 years after one injection of fat into the left buttock crease, a remarkable change of the relationship between the thigh and the leg is created by LipoStructure

Please read our previous post on October Vogue’s article

.   This post brought to you by the office staff at TriBeCa Plastic Surgery

Read about Dr. Coleman’s development of these special procedures in Cosmetic Surgery Times.

For more information please refer to earlier posts:

• Improvements in Structural Fat Grafting
• The possible role of stem cells in facial rejuvenation

• The treatment of face and neck scars with structural fat grafting
• Dr. Sydney Coleman presents LipoStructure to maxillofacial and craniofacial surgeons
• 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

Blow Up

by Catherine Piercy

“If a definitive picture of twenty-first-century aesthetic medicine is beginning to emerge, its one in which the boundaries between science fiction and reality are slowly giving way.  Take, for instance, Sydney Coleman, M.D.’s TriBeCa practice.  Inside his sleek state-of-the-art facility, the Manhattan plastic surgeon holds the tools to erase, retouch and even rescale your most stubborn problem areas.   It’s like stepping into fantasy Photoshop—and the possibilities for redesigning your body are endless.

Your options include:

• the C cup you’ve never quite been able to fill out (or that has fallen with age);

• the rounder, fuller backside of your 20s;

• the ability to retouch cellulite dimples and sunken scars;

• all of the above.

What’s novel here is that his weapon of choice isn’t a scalpel, a laser or a silicone implant.  It’s a syringe.”

We will post more excerpts from the article soon, so stay tuned!

.                    Brought to you by the office staff at TriBeCa Plastic Surgery

Before (left) and after (right) Dr. Sydney Coleman placed about 200 cc of fat into each breast

2 years after one LipoStructure by Dr. Coleman to correct over-suctioning of the thighs

Read about Dr. Coleman’s development of these special procedures in Cosmetic Surgery Times.

For more information please refer to earlier posts:

• Improvements in Structural Fat Grafting
• The possible role of stem cells in facial rejuvenation

• The treatment of face and neck scars with structural fat grafting
• Dr. Sydney Coleman presents LipoStructure to maxillofacial and craniofacial surgeons
• 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

Cryolipolysis is a non-invasive technology that has been developed by Zeltiq for fat reduction.  Dr. Coleman has been using the technology in his office in TriBeCa for over two years now.

Sydney Reese Coleman is the lead author of the clinical study that examined the efficacy and safety of the exciting new technology for non-invasive reduction of fat. Please go to the CBS website link to watch the video of the news piece and to read the script.  Please note, you will need to click on the video located in the upper right hand corner of the page.

In the interview, Dr. Coleman noted that his study demonstrated that Cryolipolysis could successfully reduce a percentage of fat in a bulge. He warned that the device has not been approved specifically for fat reduction.  However, it has been cleared by the FDA for skin cooling during dermatologic treatments as well as for temporary relief of cellulite.

Dr. Coleman has been treating patients using the Zeltiq device in his office for over two years, and the fat reduction initially observed with the published paper appear to have remained.  A preview of the article authored by Dr. Coleman can be viewed as a pdf from the journal of Aesthetic Plastic Surgery. Or the article can be seen in full by accessing the Journal of Aesthetic Plastic Surgery.  For a review of the paper check out  Aesthetic Device Review.

For background on Zeltiq and Cryolipolysis, please refer to previous postings entitled Freezing Fat for Natural Body Sculpting, Zeltiq device approved by FDA for Several Uses, Noninvasive Liposuction Alternative, and Zeltiq Device Now Available in the Office of Sydney Coleman in New York City, NY. For a more scientific description, please refer to the following: RESHAPING FAT BY CRYOLIPOLYSIS,

Further Media Coverage:

Cosmetic Surgery Times:  ”Results for cryolipolysis impressive“

American Health & Beauty: Cryolipolysis: Zeltiq Freezes Your Fat Away

Please call TriBeCa Plastic Surgery at 212 571 5200 for more information.

© Coleman 2009

For FDA Status Update click here.

Internet attacks on physicians:   This problem has been going on for years, but an Associated Press story on March 4, 2009, has drawn attention to this important issue.

Docs seek gag orders to stop patients’ reviews

 This article notes that some Internet reviews or complaint sites are little more than tabloid journalism without much interest in constructively improving practices.  It goes on to say that their sniping comments can unfairly ruin a doctor’s reputation.

“Published comments on Web pages, blogs and/or mass correspondence, however well intended, could severely damage physician’s practice.”

Of particular importance is that the privacy laws and medical ethics leave doctors powerless to respond or really do anything. A physician is held to the highest standard of accountability for anything that he places on the internet (a website, blog or posting on a board).  On the other hand, the postings on sites are often completely anonymous, so that there can be no accountability for anything said on them.  For instance, RateMd’s postings are anonymous, and the site’s operators say they do not know their users’ identities. Furthermore, the operators won’t remove negative comments.

One of the main reasons that the operators do not remove even libelous comments is that they make money from such reviews attracting traffic to the sites.  A quick look at the ads on the site will clarify the economic motives of most of the sites. 

In the article, the reader is warned, “Online doctor reviews should be taken with a grain of salt, and should certainly not be a patient’s sole source of information when looking for a new physician.”

————————————————————————————-

Recently the Internet has become a battleground of attacks on physicians by anonymous persons.  Below are a few of the numerous articles that have been written on the subject. 

Battle of the blogs
Negative web logs targeting surgeons increasing
Plastic Surgery News 

This informative article reviews the story of campaign to destroy the reputation of Dr. Coleman by creating websites and posting defamatory entries on multiple medical blogs. 

————————————————————————————-

 How my doctor fared on-line by Julie Deardorff’s column Julie’s Health Club in the Chicago Tribune

March 4, 2009

Insightful article which offers advice such as the following:

“Subjective information on user reviews is a little like gossip. On Angie’s List, I read about a genetic counselor (whom I’ve actually seen) who allegedly pushed a woman to terminate a fetus. Another person wrote that her doctor was “friendly, but condescending, and ultimately not helpful,” as she tried to make a major decision about treatment for fibroids.

A patient’s experience can be biased and manipulated—how do you know whether the opinions about a physician even come from that doctor’s patient?—but Given said a bigger problem is that there’s not enough information posted yet. Ratemds.com, for, example, has ratings on 12 percent of U.S. doctors, Given said. In Canada, the site has information on nearly 60 percent of physicians. Moreover, even if the sites start to get more feedback, it’s not necessarily representative…One nasty comment left by a patient who wanted a drug that wasn’t medically necessary, for example, could damage a reputation or career.”

——————————————————————————————————–

Gagging patients from online criticism from ZDNet Healthcare http://healthcare.zdnet.com/

This article reinforces that like RateMDs allow anonymous comments that can turn one unhappy visit into an online jihad.

——————————————————————————————————–

 Doctor ratings: Is your healthcare hot or not?   

Online, patients-as-consumers are reviewing doctors. It shifts the balance of power, but raises the question of whether consumers can simply rate an M.D. like they’d review an HDTV. By Shari Roan ?May 19, 2008

Ends her article with the message, “the reviews on RateMDs.com, Vitals.com, DrScore.com and other sites are skewed by disgruntled patients and are thus unfair, pushing some doctors to near-ruin after a single post.

“These sites don’t yield enough power yet to get bad doctors to change. And in the meantime, they may hurt good doctors,” says Dr. Phyllis Hollenbeck, a Washington, D.C., family physician and author of “Sacred Trust: The Ten Rules of Life, Death and Medicine,” a new book promoting patient empowerment. “It only takes one or two scathing comments and a doctor is put in a terrible position.”

The sites, more than two dozen of them, vary in how they operate, their scope of information provided and their efforts to be fair. But the trend is toward free, anonymous, no-holds-barred forums. Some sites have grown out of existing ratings services. Five years after he started the hugely popular RateMyProfessors.com, John Swapceinski and his business partner turned to medicine, launching RateMDs in 2004.”

——————————————————————————————————–

Censorship, or Sensible Citizenship? Physicians Take steps to Stop Online Libel  Feb 24 2009

Published by Presidio Insurance under National News

More to come!

© Coleman 2008