Zeltiq Device Now Available in the Office of Sydney Coleman in New York City, NY
Cryolipolysis Developed by Zeltiq for Cooling Fat
Zeltiq is a new technology developed to reduce body fat by cooling bulges in your body (cryolipolysis) but currently used for a variety of indications. Dr. Sydney Coleman, author of the only peer-reviewed paper on Zeltiq, has been using the Zeltiq cooling device since February 2008. Four months ago, a new advanced version of the initial machine arrived in his office.
Before (left), 2 months after (middle) & 3 months (right) after application to lower abdomen
Closeup of above pictures before (left) and two months after (right)
The Zeltiq procedure is performed under Dr. Coleman’s supervision at TriBeCa Plastic Surgery at 44 Hudson with a non-invasive applicator that delivers precisely controlled cooling through the skin surface over fat bulges. Studies have shown that this noninvasive procedure results in a noticeable, natural-looking reduction in the treated areas without the need for needles, incisions, anesthesia, pain, medication, or recovery time. In just a few months following the Zeltiq Procedure, the study demonstrated that there is a gradual reduction in the thickness of the fat layer, resulting in cosmetic improvement of fat bulges.
Less fat can be pinched in this patient at 3 months after Zeliq procedure by Dr. Coleman
Ideal candidates are men and women who are relatively fit, but have some modest-size fat bulges that are resistant to diet and exercise. Clinical studies show that, for properly selected patients, the Zeltiq Procedure is an effective way to reduce the fat layer, without the pain, risk, and recovery time of invasive procedures. The result is noticeable, natural-looking fat reduction in the treated areas. To date, the Zeltiq Procedure has been performed on hundreds of patients in clinical studies.
Harvard Medical School dermatologists at Massachusetts General Hospital in Boston, MA developed the science behind the Zeltiq Procedure, called CryolipolysisTM. Their research showed that fat cells are naturally more vulnerable to the effects of cold than other surrounding tissues, and that fat cells can be safely eliminated without harming the skin.
Dr. Coleman’s clinical study validated that cryolipolysis for fat layer reduction of love handles and back fat pads in men and women is well-tolerated and produces a visible contour change in the majority of subjects. Based on ultrasound assessment, an average fat layer reduction of 22.4% was demonstrated after only one procedure.
Zeltiq cooling device applied to abdomen of above patient
The Zeltiq device has already been cleared by the FDA for various applications related to skin cooling during dermatologic treatments and temporary treatment of cellulite. There is a pending application for non-invasive fat layer reduction.
A preview of the article authored by Dr. Coleman can be viewed as a pdf from APS. 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, and Noninvasive Liposuction Alternative.
Please call Tribeca Plastic Surgery at 212 571 5200 for more information.
© Coleman 2009
For FDA Status Update click here.
Breast Fat Grafting Explained by Sydney Coleman
Description of Dr. Sydney Coleman’s Method of Breast Fat Grafting including Consultations, Procedure, and Pricing
My office has received many inquires about the cost and the procedure of breast fat grafting procedures. I have therefore written up the following description of my consultation, some important points of my procedure and some explanations of the cost.
Planning Consultation: The most important first step for fat grafting to the breast is for you to help me design a procedure that will give you the shape and size that you desire for your breasts. I do that by first examining and photographing your body. Then I study the photographs with you. Together we design an individualized plan to change both your breasts and to enhance your body with the harvesting of fat. I draw out blueprints of your unique procedure using pencil tracings that depict your specific body and the changes you seek. I like to color code the blueprint to indicate where I plan to remove the fat, where you desire specific changes in size or shape, and where the tiny entrance sites will be placed (see below). I use the same sheet to make notations as I review your informed consent.
Color-coded blueprint aids the patient in her understanding the procedure and enables the patient to help design the procedure. (Click on the image for a larger version)
Special Considerations: The decision to use the BRAVA system should be made weeks before the procedure. Please refer to my last post for comments.
Marking: On the day of the procedure, I follow the blueprint to mark your body with a color-coded system (see below). This lets you understand from where I am removing fatty tissue and how I am placing it into your breast to improve your shape and increase your breast size.
On the day of the procedure, Dr. Coleman marks the patients with the patient actively participating in the selection of harvest areas as well as the design of her breast augmentation.
Harvesting & Refinement: The procedure for breast augmentation with fat involves first harvesting fat from the body. Some women have enough fat in one location (outer thighs or lovehandles), which makes removal much simpler. However, many women have had liposuction to their outer thighs and lovehandles, or simply do not have enough fat in one area. In those women, I consider numerous areas for harvesting (abdomen, flanks, inner thighs, knees, calves, arms, et cetera). Obviously, this is an important part of the procedure, and you and I will want to design the removal so that your body shape is enhanced and problems are avoided. Because of the amount of fat tissue that needs to be removed, I usually perform the procedure under general anesthesia. However, for much smaller procedures, I use local anesthesia with sedation.
Grading the fat for selective placement: After the fat is harvested, I refine and concentrate the fat tissue using a centrifuge to remove any non-living components (oil, water, blood, et cetera). My experience has taught me to grade the fat into different qualities, depending on density and other factors. I use the graded densities to attain different effects. This is one of the keys to successful fat grafting.
Sculpting while layering in the graded fat: I use the concentrated fat tissue to meticulously sculpt the breast. The technique I developed alters the shape and size of the breast by placing miniscule amounts in thousands of passes through three or four tiny entrance sites located in the lower fold of the breast and the areola. The sculpting requires a three dimensional vision that must happen while the fat is being placed into the breast. Many surgeons place fat then try to move it around.
Price: How is the price determined? First of all, price varies depending on the difficulty of removing fat from select parts of your body, processing and concentrating the fat. If it is going to take me one hour to harvest the fat, then I am able to charge much less than if it will take me two or three hours. Then the difficulty of the meticulous placement into the breast needs to be considered. Previous scarring from implants or surgery will make the procedure more difficult. The more fat I harvest and place, the more that I need to charge. Simple, uncomplicated augmentations start at $20,000. Treating the problems of breast implants with fat grafting is usually less depending on the amount of fat needed to be placed and the amount of scarring present. Reconstructive procedures after breast cancer or from birth defects can often be covered at least in part by insurance.
If you call my office at +1 212 571 5200 my office staff can give you a better idea of the cost if you describe your breasts and body. If you send photographs with a description of your goals, we can give you an even better estimate of the cost.
Check out these links for more information on fat grafting to the breasts:
Combining the BRAVA system with Fat Grafting to the Breast
Fat Grafting to solve problems with Breast Implants
Safety concerns with fat grafting to the breast
The American Society of Plastic Surgery’s Position of Fat Grafting to the Breast
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