BRAVA Breast Expansion Device Reclassified by FDA
FDA asks for Investigational Device Exemption for BRAVA Studies
The FDA, in a surprising move, has re-classified the BRAVA breast expansion device into a higher risk category for the ongoing BRAVA clinical trials. We want to assure our patients (those who are currently using the device, have used it in the past, or who contemplate future use) that we are not aware of any evidence of any safety issues regarding the use of the device, and there is no reason to discontinue or postpone its use.
In order to continue the studies with FDA approval, Brava submitted an IDE (Investigational Device Exemption) application to the FDA on March 28, 2013. In the meantime, any studies involving BRAVA have been temporarily curtailed until the FDA approves the exemption (probably 1-3 months).
We have recommended the use of the BRAVA device for several years, but did not enroll patients in the clinical study. We have been impressed with the ability of the device to expand the breast tissue, allowing us to place larger volumes of fat; and studies suggest that the use of the BRAVA device post-surgery enhances graft survival.
Dr. Roger Khouri, Principal Investigator in the study, has discussed this issue at length. He recently announced the following:
“Brava as a stand-alone device to enlarge the breast without surgery has a well established safety record. It has been used by tens-of-thousands of women for over the past 10 years with no significant complications whatsoever…… The American Society of Plastic Surgeons, the most important plastic surgery society condones Brava + Fat grafting. The Society just promoted it with a large teaching course with live surgery out of the Miami Breast Center operating room…… Over the past 8 years several hundred women were enrolled in this IRB study sponsored by Brava. Results show that fat grafting after Brava expansion allows us to successfully graft much more fat and achieve much better augmentation and breast reconstruction results than if Brava was not used. Most importantly, there were essentially no complications. Certainly less than the implant and flap alternatives.”
Should you have any additional concerns, please feel free to contact our office by asking questions on this blog site or one of the following:
For more information on BRAVA, please look at the following links:
Breast Augmentation with BRAVA and Coleman Fat Grafting
Patient Testifies how Coleman Fat Grafting Combined with BRAVA changed her life.
This patient purchased a new bra recently, and found she was overfilling a D cup. Two years ago (before two sessions of Coleman fat grafting to her breasts) she was a small A cup. She scheduled an appointment to let us know how “amazing” her breasts now are.
Eleven months after her second session of Coleman fat grafting to Breasts. She went from a small A cup (left) to a full D cup (right). The red lines on her inner breast are stress marks from overfilling her D cup!
In our office she told us, “People say that breasts are not important, but they are. As I woman, I wanted breasts to feel feminine. Now I am also much more confident. The results I have received from fat grafting to my breasts have changed my life. I am ecstatic looking at myself in a mirror. ”
She had tried silicone breast implants in 1994, but had them removed after nine months because she felt the implants appeared and felt unnatural.
When she came into our office today for photographs, she said, “I’m thrilled with the completely natural results of Coleman fat grafting to my breasts. And I think it is important to share with other women this amazing technology for enlarging and enhancing breasts using only one’s own fat.”
Concerning the BRAVA reverse expansion, she reported, “I used the BRAVA exactly as Dr. Coleman asked me to do before and after the two fat grafting sessions. It was not easy to use, but obviously worth the effort.”
This lady came to our office 11 months after her second Coleman fat grafting to the breast. Before (left) she was a small “A cup”. Now she overfills a “D cup” (left). She had only Coleman fat grafting combined with BRAVA.
Eleven months after her second session of Coleman fat grafting to Breasts. She went from a small A cup (left) to a full D cup (right).
Eleven months after her second session of Coleman fat grafting to Breasts. She was a small A cup (left) and is now a full D cup (right). This arms up position emphasizes the volume of the augmentation.
Eleven months after her second session of Coleman fat grafting to Breasts. She was a small A cup (left) and is now a full D cup (right).Shooting from below also emphasizes the degree of augmentation
Usually, women do not experience more than one cup size difference after one session of fat grafting, but combining fat grafting with meticulous use of BRAVA reverse expansion Coleman fat grafting to breasts has the potential to enhances the results.
For more discussion of Coleman Fat Grafting (AKA LipoStructure), please refer to the following:
Dr. Sydney Coleman of New York City combines the BRAVA system with Breast LipoStructure
Catherine Saint Louis wrote an article in the Style Section of the New York Times on fat grafting to the breasts. Please click on this the following URL to take you to the article:
http://www.nytimes.com/2009/12/03/fashion/03skin.html?_r=1&ref=fashion
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 Began Grafting Fat to the Breast 17 Years Ago
For information on the consultation, procedure and pricing for Dr. Coleman’s fat grafting to the breast CLICK HERE.
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 Demonstrates Long-Lasting Natural Breast Results
If you are interested, these posts will help you to understand tuberous breasts, and their potential correction.
© Coleman 2012
Lumpectomy Reconstruction with Coleman Fat Grafts
Fat Transfer for a more normal breast after lumpectomy reconstruction
After conservative breast therapy for cancer (lumpectomy followed by irradiation), a woman is left with a lumpectomy defect that is often difficult to reconstruct. The therapeutic irradiation is a critical component of breast cancer treatment to decrease the possibility of the cancer returning near the site of the original cancer. Unfortunately, radiation can damage the normal tissue while it is eliminating potential cancer cells. This damage from radiation significantly complicates lumpectomy reconstruction.
Lumpectomy Reconstruction with Fat as an Alternative to Implants
Placing a saline or silicone gel-filled implant into the damaged, irradiated breast remarkably increases the incidence of scarred or hard breasts (breast capsular contracture), infection and rejection of the silicone implant. Therefore, placement of an implant in these conditions often results in a poor cosmetic result.
Mechanism of Lumpectomy Reconstruction with Fat Transfer
Lumpectomy reconstruction (putting fat into a breast after lumpectomy and irradiation) not only restores the breast by adding volume and reshaping the breast, but also appears to decrease scarring and promote the growth of a blood supply and the healing of the radiation damaged breast.
Versatility of Lumpectomy Reconstruction after Lumpectomy
Fat can be grafted in either large or small volumes to address otherwise difficult problems such as asymmetry or breast size, poor breast shape, visible implant edges, or even a hard, scarred implant. Grafted fat can provide missing coverage and may also relax breast scarring. Recent scientific articles have reported on the efficacy of fat grafting for breast reconstruction and improving the shape of the breast as well as for the treatment of radiation damage.
When fat is harvested and refined with minimal trauma and placed in small volumes with each pass of the cannula, a significant portion of the transplanted fat survives and provides a structure and shape to the breast that cannot be achieved with implants alone or with other types of surgery.
Structural fat grafting using this technique appears to be as safe as and perhaps even more effective than many other methods of changing the contour of the breast. Some reconstructive surgeons are claiming that fat grafting may be among the most significant advances in breast surgery.
Patient Example of Lumpectomy Reconstruction with LipoStructure
Before (right) and 7 months after (left) one treatment of a retracted, deforming lumpectomy scar. After lumpectomy followed by therapeutic radiation, this patient was left with a hard, painful breast. Her breast was so hard, that mammography was not possible. By six weeks after filling the lump and releasing the adhesions, the patient’s pain was almost absent and her breast was soft enough to obtain a mammogram. Please note the improvement in skin quality of the area around the indentation all the way up to the nipple.
Before (above) and 7 months after (below) one treatment of a retracted, deforming lumpectomy scar.
Before (right) and 7 months after (left) one treatment of a retracted, deforming lumpectomy scar. Profile demonstrates a subtle decrease in fullness in the area above the retracted scar. Before fat grafting, the area just above the scar was hard and full. Placement of a small amount of concentrated fat into the area above the retracted scar with surgical release of the scar resulted in a soft breast without the hard protuberant area above (orange circles).
–Written by the Staff at TriBeCa Plastic Surgery
FOR MORE INFORMATION ON BREAST FAT GRAFTING, PLEASE GO TO THE LIPOSTRUCTURE WEBSITE.
Check out these links for more information on fat grafting to the breasts:
- 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.
Catherine Saint Louis wrote an article in the Style Section of the New York Times on fat grafting to the breasts on. Please click on this the following URL to take you to the article:
http://www.nytimes.com/2009/12/03/fashion/03skin.html?_r=1&ref=fashion
Ms. Saint Louis did a great deal of research and spoke to me for close to two hours over three different conversations. She also interviewed one of my patients who has an eleven year follow-up (last paragraph of the article).
© Coleman 2012
Remarkable Case of Tubular Breast Correction with Coleman Fat Grafting
Tuberous Breasts
Treated with
Coleman Fat Grafting
In past blogs we have discussed the nature of tuberous breasts and how they can be corrected using the Coleman fat grafting technique. (see our recent blog, “Sydney Coleman Explains the Tuberous Breast Deformity” available on the blog archive on our website, lipostructure.com). We have shown before and after photos documenting the long-term amazing changes that can be achieved in tubular breast correction through fat grafting. Here, we will discuss the details of the procedure for one of our patients.
The patient above was an otherwise healthy 21 year old woman with severe bilateral tuberous breast deformity. As you can see, her breasts were very small and constricted, and the nipple/areola complex was quite protuberant and pointed downward. This patient was very bothered by what she considered an ugly, embarrassing deformity, not wanting even her mother to see her undressed. She researched the condition on her own, and found a discussion of tuberous breasts on our website, lipostructure.com. She underwent two surgeries performed by Dr. Sydney Coleman to achieve her final result. In order to enlarge the skin “envelope” into which we could place fat, we had the patient wear the BRAVA expansion device for 3 weeks prior to surgery. (You can read a more detailed discussion of how the BRAVA device works in our blog archive, under “Combining the BRAVA System with Fat Grafting to the Breast.”) At the first surgery, we placed a total of 267.5cc of structural fat into the right breast, and 328.0cc into the left breast. We harvested fat from her abdomen, flanks, hips and thighs. Fat was placed into all areas of the breasts (with the exception of the area behind the nipple/areolar complex) as well as up into the underarm areas and cleavage to create a more natural shape. Tiny incisions for fat placement are hidden in the folds under the breasts and in the border of the areola (where the darker edge blends in to the surrounding lighter skin.) The patient wore the BRAVA device for about 3 weeks after the procedure to increase the survival of the transplanted fat by stimulating the development of a new blood supply in the grafts. Her breasts were much more normal in appearance, and the areolas no longer protruded. However, the lower portion of the breasts still appeared constricted and less full than normally shaped breasts. This patient desired further improvement, and elected to have a second procedure 15 months after the original surgery. She did not wear the BRAVA before or after the second procedure, as we felt there was adequate tissue expansion and room for additional fat. At the time of the second surgery, we again harvested fat from the abdomen and lovehandle/flank areas. We placed 335.0cc of structural fat into the right breast, and 317.5cc into the left breast. There was no need for additional placement of fat into the axilla or cleavage during this surgery. 7 months after her second session of Coleman fat grafting
7 months after her second session of Coleman fat grafting
- 7 months after her second session of Coleman fat grafting. Note the change in shape of the lower, constricted breast.
The patient did extremely well, as you can see from photos above 7 months after her second surgery. After tubular breast fat transfer she now feels that her breasts are totally normal and natural, and no longer feels disfigured. She is no longer held back by negative feelings about her body, and feels free to lead a normal life.
–Written by the Staff at TriBeCa Plastic Surgery
Blog posts on tuberous breasts.
What is a Tuberous Breast?
How Can We Correct a Tuberous Breast?
Twelve year follow-up of tuberous breast correction
Coming soon: more clinical pictures of patients in whom tuberous breast correction has been performed with fat grafting
FOR MORE INFORMATION ON BREAST FAT GRAFTING, PLEASE GO TO THE LIPOSTRUCTURE WEBSITE.
Check out these links for more information on fat grafting to the breasts:
Coleman Shows Longevity of Fat Grafting to the Breasts
New York Times Reports on Fat Grafting to the Breast
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
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.
Tuberous Breast Correction Using Coleman Fat Grafting
How Can We Correct a Tuberous Breast?
Correction of a tuberous breast is a difficult problem that can best be solved in a natural manner with Coleman fat grafting instead of silicone breast implants or more invasive surgery. The transplanted fat is layered under the skin with an emphasis on placing a greater volume in the lower pole (lower third of the breast). This stretches out the tight band of skin associated with tuberous breasts so that a more natural downward sloping curve is created.
The key to tuberous breast correction with transplanted fat is to change the relative proportion of the nipple/areolar area to the rest of the breast, so that there is more fullness in the surrounding areas and less fullness behind the nipple and areola. In the diagram below a tuberous breast is represented on the left, and tuberous breast corrected with fat grafts on the right. Note that the yellow pearls of transplanted fat are located under the skin up to the areola. However, no fat is located in the breast tissue or under the areola or nipple.
Side view of tuberous breasts demonstrating correction with placement of fat grafts deep to the skin but not under the areola
Front view of left breast showing placement up to areola but not under the nipple or areola in order to change the relative proportion of the breast.
No fatty tissue is placed deep to the areola or nipple, only under the surrounding skin envelope. The structural fullness from the fat placed under the skin causes expansion of the outer portion of the breast and “overwhelms” the large nipple -areolar complex. The nipple-areolar complex effectively “shrinks” as the surrounding skin enlarges. This change in relative proportion creates a more natural-appearing and shapely breast, especially with expansion of the lower pole.
Sometimes more than one procedure is required to achieve the desired effect. We often suggest the use of the BRAVA device before and after surgery to maximize the breast “envelope” or space into which fat can be grafted.
Insurance may cover part of the costs of the procedure.
–Written by the Staff at TriBeCa Plastic Surgery
Blog posts on tuberous breasts.
What is a Tuberous Breast?
Remarkable case of tubular breast correction with Coleman fat grafting
Twelve year follow-up of tuberous breast correction
FOR MORE INFORMATION ON BREAST FAT GRAFTING, PLEASE GO TO THE LIPOSTRUCTURE WEBSITE.
Check out these links for more information on fat grafting to the breasts:
Coleman Shows Longevity of Fat Grafting to the Breasts
New York Times Reports on Fat Grafting to the Breast
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
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.
Sydney Coleman Explains the Tuberous Breast Deformity
What is a Tuberous Breast?
Tuberous breasts are the result of a developmental deformity. As the breasts are growing in adolescence, the lower half does not develop normally. A normal breast has a gentle downward sloping curve in the lower portion (see left above). The skin and underlying tissues of a tuberous breast (see above, right) do not grow normally due to a constriction in the lower half of the breast. This leaves the lower breast with a “tubular” appearance because there is not enough skin or fullness below the areola (darker skin around the nipple). A tuberous breast is often complicated by an areola that is large, prominent or even “herniating” (protruding outward in an unnatural way). In many tuberous breasts, the nipple points downward or droops. Most women who present with this problem are affected in both breasts, but the condition can be present on just one side as well. Tuberous breasts vary in severity, and are actually fairly common, much more common that people realize. Often, however, they go undetected, due to ignorance of the examining physician, or embarrassment on the part of the patient.
An absence of fullness and lack of sufficient skin of the lower breast results in the aesthetically unappealing appearance in this young woman. This creates the “tuberous” appearance as described above, where the breast resembles a tube rather than a normal breast.
This is a more normal appearing tuberous breast, but note that the lower breast is decidedly deficient in skin and fullness. The areola protrudes over the lower breast skin.
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This woman just thought that she had small breasts, until she discovered on the internet that she had a correctable deformity. In some cases, insurance may cover some of the expense.
Tuberous breasts are difficult problems that are best solved with Coleman fat grafting. Next week, Dr. Coleman will explain in a Blog post his unique, successful method to naturally reconstruct this surprisingly common deformity.
–Written by the Staff at TriBeCa Plastic Surgery
Blog posts on tuberous breasts.
How Can We Correct a Tuberous Breast?
Remarkable case of tubular breast correction with Coleman fat grafting
Twelve year follow-up of tuberous breast correction
FOR MORE INFORMATION ON BREAST FAT GRAFTING, PLEASE GO TO THE LIPOSTRUCTURE WEBSITE.
Check out these links for more information on fat grafting to the breasts:
Coleman Shows Longevity of Fat Grafting to the Breasts
New York Times Reports on Fat Grafting to the Breast
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
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.
Sydney Coleman Shows Longevity of Breast Fat Grafting
Dr. Sydney Coleman Began Grafting Fat to the Breast 17 Years Ago
& Demonstrates Long-Lasting Natural Results
Dr. Sydney Coleman, known as the pioneer of fat grafting, has been placing autologous (one’s own) fat into the breasts since 1995 – much longer than any other practicing plastic surgeon. He had amazing success with using the Coleman fat grafting technique to the breast in his earliest patients. This lead him to start using fat not only to enlarge breasts or make one side match the other, but also to cover and soften implants, fill in the “dents” left from lumpectomy, correct tuberous breasts (a congenital deformity) and enhance primary reconstructions after mastectomy. He observed that fat also helped repair radiation and solar (sun) damage, and can often help to soften retracted scarring, chronic post-mastectomy pain, and restore sensitivity to the breast. Dr. Coleman published his amazing results in 2007 with his associate, Alesia Saboeiro. This sparked a revolution in plastic surgery, and scientific studies worldwide are now trying to explain these amazing results.
Below, on the left is a patient with tuberous breasts before fat grafting surgery. On the right is the same patient 14years after the last of two fat grafting procedures to her breasts. Note the dramatic enlargement of the lower part of her breasts, and the completely natural and beautiful appearance 14 years later. Even with such dramatic changes, there are no telltale signs of having had a breast procedure. Incisions for passage of the cannula to place the fat are tiny, and placed in the fold under the breast and in the border of the areola; the scars are often all but invisible.
Tuberous Breast Correction 12 years after last fat grafting
- Tuberous Brest Side View with 12 year followup
–Written by the Staff at TriBeCa Plastic Surgery
Blog posts on tuberous breasts.
What is a Tuberous Breast?
How Can We Correct a Tuberous Breast?
Remarkable case of tubular breast correction with Coleman fat grafting
FOR MORE INFORMATION ON BREAST FAT GRAFTING, PLEASE GO TO THE LIPOSTRUCTURE WEBSITE.
Check out these links for more information on fat grafting to the breasts:
New York Times Reports on Fat Grafting to the Breast
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
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.
Catherine Saint Louis wrote an article in the Style Section of the New York Times on fat grafting to the breasts on. Please click on this the following URL to take you to the article:
http://www.nytimes.com/2009/12/03/fashion/03skin.html?_r=1&ref=fashion
Ms. Saint Louis did a great deal of research and spoke to me for close to two hours over three different conversations. She also interviewed one of my patients who has an eleven year follow-up (last paragraph of the article).
© Coleman 2012
Dr. Coleman of New York featured in an Article in The Times Magazine
An excerpt of the article written by Hermione Hoby for the London Times Magazine follows:
“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.””
Vogue Magazine Talks about Coleman Fat Grafting
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
. 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:
Vogue Magazine Features Advances Made by Sydney Coleman
This is the beginning of an article in Vogue Magazine October 2010, about innovations in aesthetic surgery featuring the developer of LipoStructure, Sydney Coleman, a New York City Plastic Surgeon.
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:
