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Safety Concerns with Fat Grafting to the Breast

The new ASPS Guiding Principles for Fat Injection to the Breast discusses the risks and complications based on a review of all published scientific information.  They conclude that complication rates for fat grafting in general is not high compared to other procedures, and serious complications are “extremely rare.”  Specific concerns about fat grafting to the breast interfering with cancer detection is not supported by any studies.

However, using some techniques for fat grafting to the breast can result in increased complications and a poor result.  Therefore, the ASPS has emphasized, “The safety, efficacy and final outcome of any given case is dependent on the technique used.”   They go on to say “studies indicate that results of fat transfer remain dependent on a surgeon’s technique and expertise.”

A patient should try to choose a physician who is an expert at fat grafting and has a long record of success.

This 55 year old woke up to find her silicone gel plant had ruptured.  She had both removed along with the surrounding scarring four months before these photographs

This 55 year old woke up to find her silicone gel plant had ruptured. She had both removed along with the surrounding scarring four months before these photographs

6 1/2 years after the last of 2 fat grafting sessions.  Her breasts now feel and look completely natural after only two sessions of fat grafting.  In addition, her body has improved from the removal of fat from her abdomen and waist.

6 1/2 years after the last of 2 fat grafting sessions. Her breasts now feel and look completely natural after only two sessions of fat grafting. In addition, her body has improved from the removal of fat from her abdomen and waist.

Patient has completely natural appearing breast 6 1/2 years after second fat grafting.

Patient has completely natural appearing breast 6 1/2 years after second fat grafting.

Subsequent posts over the next weeks will address the other findings of the American Society of Plastic Surgery’s task force on fat grafting to the breast.  Stay Tuned!

For more detailed information about fat grafting to the breast, please refer to LipoStructure.com.

For information on the consultation, procedure and pricing for Dr. Coleman’s fat grafting to the breast CLICK HERE.

Check out these links more information on fat grafting to the breasts:

Dr. Sydney Coleman demonstrates Breast Reconstruction with LipoStructure on The Doctors

Coleman lectures on fat grafting for breast reconstruction at the American College of Surgeons

Lipofilling: a role in breast reconstruction surgery??From “Behind the Medical Headlines” produced by the Royal College of Physicians of Edinburgh and Royal College of Physicians and Surgeons of Glasgow

Breast Augmentation Via Fat Grafting?From “Plastic Surgery Practice”

Breast Implant Problems Solved with Coleman Fat Grafting

Fat Grafting to the Breast Revisited: Safety and Efficacy.?Plastic & Reconstructive Surgery. 119(3):775-785, March 2007.?Coleman, Sydney R. M.D.; Saboeiro, Alesia P. M.D.

© Coleman 2009

Fat Grafting to the Breast Has New Guiding Principles

In a new statement by ASPS entitled Fat Transfer/Fat Graft and Fat Injection ASPS Guiding Principles, fat grafting to the breast has been cautiously approved by the ASPS for use in breast reconstruction, breast shaping and breast augmentation.

Before (left) and 8 years 9 months after one fat grafting procedure of 332 ml to the right and 297 ml to the left.  Patient had 10 pound weight loss between procedures

Before (left) and 8 years 9 months after one fat grafting procedure of 332 ml to the right and 297 ml to the left. Patient had 10 pound weight loss between procedures

After ten years of experience with fat grafting to the breast using his specific technique, Dr. Sydney Coleman began presenting his results at plastic surgery meetings in 2005.  Perhaps the most pivotal presentation by Dr. Coleman was in 2006 at the American Association of Plastic Surgery.  His impressive long-term results resulted in an active discussion in the Plastic Surgery world on the use of fat grafting in the breast.

The American Society of Plastic Surgery had previously directed plastic surgeons to avoid placing fat in the breast due to safety and outcome issues.  Dr. Coleman and others demonstrated that the original concerns were not based in any scientific evidence, and instead the evidence was in support of fat grafting to the breast.

As a result of Dr. Coleman’s many presentations, he was able to persuade Roxanne Guy, then president of the American Society of Plastic Surgery, to form a task force of plastic surgeons to revisit the issue of fat grafting to the breast.  The task force began meeting in September 2007.  “The task force reviewed the scientific literature, critically appraised the information available, and developed evidence based practice recommendations.  The findings of the task force were then submitted to an approved without significant change by the American Society of Plastic Surgery and the Plastic Surgery Educational Foundation executive committees.

The recommendations indicated that “Fat Grafting may be considered for breast augmentation and correction of defects associated with medical conditions and previous breast surgeries.” The society also indicated that people should proceed cautiously because “results are dependent on technique and surgical expertise” as in every other surgical procedure.

Subsequent posts over the next few days will address the other findings of the American Society of Plastic Surgery’s task force on fat grafting to the breast.  Stay Tuned!

Before (left) and seven years after (right) one fat placement of 190 ml on the right side and 245 ml on the left.  Note the filling of the "cleavage" area and the very natural appearance (and feel) of the breast

Before (left) and seven years after (right) one fat placement of 190 ml on the right side and 245 ml on the left. Note the filling of the “cleavage” area and the very natural appearance (and feel) of the breast

For more detailed information about fat grafting to the breast, please refer to LipoStructure.com.

For information on the consultation, procedure and pricing for Dr. Coleman’s fat grafting to the breast CLICK HERE.

Check out these links more information on fat grafting to the breasts:

Dr. Sydney Coleman demonstrates Breast Reconstruction with LipoStructure on The Doctors

Coleman lectures on fat grafting for breast reconstruction at the American College of Surgeons

Lipofilling: a role in breast reconstruction surgery??From “Behind the Medical Headlines” produced by the Royal College of Physicians of Edinburgh and Royal College of Physicians and Surgeons of Glasgow

Breast Augmentation Via Fat Grafting?From “Plastic Surgery Practice”

Breast Implant Problems Solved with Coleman Fat Grafting

Fat Grafting to the Breast Revisited: Safety and Efficacy.?Plastic & Reconstructive Surgery. 119(3):775-785, March 2007.?Coleman, Sydney R. M.D.; Saboeiro, Alesia P. M.D.

© Coleman 2009

Forearm Enlargement with Coleman Fat Grafting

Finally, you can increase the size of your forearms!

Undersurface of forearm before (a,c) and 20 months after (b,d) one session of Coleman fat grafting

Undersurface of forearm before (a,c) and 20 months after (b,d) one session of Coleman fat grafting

Back of forearm and hands before (above) & 20 months after (below) fat grafting.

Back of forearm and hands before (above) & 20 months after (below) one session of Coleman fat grafting.

Whether forearms are small from birth defects, have missing areas as result of scarring from an accident, or have not grown enough despite a bodybuilder’s efforts, there are alternatives for forearm enlargement.  One of the most exciting alternatives is structural fat grafting.

A 36 year old amateur bodybuilder presented frustrated because his forearms had not developed as well as the rest of his body after years of trying (see photos).

For this patient a thin layer was placed under the skin over a large portion of the forearm and back of the hand.  In addition, some of the fat was used to sculpt the appearance of the forearm by filling in areas which the patient felt were especially deficient.  A total of 201 ml of refined fat was placed in the right forearm and 192 ml on the left.  In addition 29 ml was placed over the back of each hand (30 ml is an ounce).  For safety reasons, no fat was infiltrated deeply into the muscles or around the muscles.The patient returned 20 months after the procedure, thrilled with the results, but desiring more volume still. He has obviously continued to exercise, but he feels that most of the change is from the fat grafting.  Of particular note, he is surprisingly more vascular in appearance despite the superficial placement of the fat.

For more information on fat grafting to the arms and legs, please go to the LipoStructure.com website.

copyright 2013 Coleman

The Press Reports Internet Attacks on Physicians

Recent News Articles Highlight Internet Harassment  

Internet attacks on physicians by anonymous persons:   This problem has been going on for years, but recent news articles have drawn attention to this important issue.  Below are a few of the numerous articles that have been written on the subject.


From NBC News:  
Docs seek gag orders to stop patients’ reviews.  Doctors seek gag orders to stop patients' online reviewsAlso from:  USA Today

These articles note 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.”

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

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.”

Presidio

Censorship, or Sensible Citizenship? Physicians Take steps to Stop Online Libel  Feb 24 2009
Published by Presidio Insurance under National News

 

Please refer to the recent post by Dr. Coleman “A Note on Internet Harassment”  

© Coleman 2008

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Interview with Sydney Coleman, MD Sydney Reese Coleman is the physician who first observed and announced to the scientific community the amazing regenerative ability of fat grafts and the associated stem cells.  Beginning in 1987, he has developed procedures that...

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