Systemization of The Fat Injection Procedure
In the 1990s Sydney R. Coleman, with his vast experience with autologous fat transfer, reemphasized the importance of the most atraumatic technique for fat harvesting and placement to preserve fragile adipocytes.
Coleman Fat Grafting Technique
⦁ Harvesting. The goal is to collect small parcels of adipose tissue or cell clusters without interfering with cell visibility. A syringe is considered a better option with respect to lipoharvesting instrumentation.
⦁ Processing. The aim is to create the purest graft possibility by removing blood, cell debris and fatty acids. Apparently, these components stimulate an inflammatory response, which may result in graft degradation. Current methods of processing include centrifugation, decanting, filtration, straining. Centrifugation is the most common procedure. Damage to adipocytes is reported by exposure to open air and cell lysis. Tissue filtration has numerous proponents, because a closed system within a sterile field used.
⦁ Placement. Choice of the appropriate type of cannula is of paramount importance. For facial fat grafting an 18- or 22-gauge blunt cannula should be used for placement. Delivery includes the deposition of small threads of fat in a retrograde way and in multiple tunnels. To enhance the contact between the graft and the surrounding tissue only minimal aliquots should be transferred avoiding bolus.
