Guido Paolini1, Matteo Amoroso2, Benedetto Longo2, Michail Sorotos2, Dimitrios Karypidis3,4, Fabio Santanelli di Pompeo2. 1. Plastic Surgery Unit, Faculty of Medicine and Psychology, Sant'Andrea Hospital, "Sapienza" University of Rome, Via di Grottarossa 1035/1039, 00189, Rome, Italy. guido.paolini@uniroma1.it. 2. Plastic Surgery Unit, Faculty of Medicine and Psychology, Sant'Andrea Hospital, "Sapienza" University of Rome, Via di Grottarossa 1035/1039, 00189, Rome, Italy. 3. Plastic Surgery Unit, "Andrea Sygros" Hospital, School of Medicine, University of Athens, Athens, Greece. 4. II Level Master on Breast Reconstruction, Faculty of Medicine and Psychology, "Sapienza" University of Rome, Rome, Italy.
Abstract
BACKGROUND: The Coleman technique is universally recognized as the gold standard for fat transfer, but although effective, it is tedious, time consuming, and costly. This report proposes a new and more efficient method of fat grafting (simplified lipostructure). METHODS: This report introduces a modification of the standard Coleman transfer and injection technique, performed by connecting a 10-ml syringe to a 1-ml syringe and to a blunt infiltrating cannula through a "three-way stopcock valve." The study retrospectively evaluated two groups of patients who had undergone either Coleman or simplified lipostructure, comparing surgical staff, operative time, volume of infiltrated fat, cosmetic outcome, and complications. Statistical analyses were conducted using the Wilcoxon rank sum test and Spearman's rank-order correlation. RESULTS: The simplified lipostructure group compared with Coleman lipostructure showed a reduced operative staff (1 vs. 2 members), a reduced operative time (66 vs. 74.2 min) (α = 0.0035), and an increased volume of infiltrated fat (167.2 vs. 138.7 ml) (p < 0.0001) while retaining comparable cosmetic results (7.45 vs. 7.25; visual analog scale 0-10), and only minor complications. CONCLUSION: The three-way stopcock valve system appears to be a smart technical solution that eases syringe refilling, improves fat transplantation times, and reduces costs. The findings show this technical modification to be easy and effective. The authors therefore recommend it to all surgeons performing fat transfer. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
BACKGROUND: The Coleman technique is universally recognized as the gold standard for fat transfer, but although effective, it is tedious, time consuming, and costly. This report proposes a new and more efficient method of fat grafting (simplified lipostructure). METHODS: This report introduces a modification of the standard Coleman transfer and injection technique, performed by connecting a 10-ml syringe to a 1-ml syringe and to a blunt infiltrating cannula through a "three-way stopcock valve." The study retrospectively evaluated two groups of patients who had undergone either Coleman or simplified lipostructure, comparing surgical staff, operative time, volume of infiltrated fat, cosmetic outcome, and complications. Statistical analyses were conducted using the Wilcoxon rank sum test and Spearman's rank-order correlation. RESULTS: The simplified lipostructure group compared with Coleman lipostructure showed a reduced operative staff (1 vs. 2 members), a reduced operative time (66 vs. 74.2 min) (α = 0.0035), and an increased volume of infiltrated fat (167.2 vs. 138.7 ml) (p < 0.0001) while retaining comparable cosmetic results (7.45 vs. 7.25; visual analog scale 0-10), and only minor complications. CONCLUSION: The three-way stopcock valve system appears to be a smart technical solution that eases syringe refilling, improves fat transplantation times, and reduces costs. The findings show this technical modification to be easy and effective. The authors therefore recommend it to all surgeons performing fat transfer. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Authors: Vincenzo Verdura; Antonio Guastafierro; Bruno Di Pace; Mario Faenza; Giovanni Francesco Nicoletti; Corrado Rubino Journal: Arch Plast Surg Date: 2022-04-06
Authors: Scott L Spear; Courtney N Coles; Braden K Leung; Matthew Gitlin; Mousam Parekh; David Macarios Journal: Plast Reconstr Surg Glob Open Date: 2016-08-08