The Viability of Fat Grafts Harvested by the Coleman Technique: A Comparative Study
Lee L.Q. Pu, MD, PhD, Sydney R. Coleman, MD*, Xiangdong Cui, MD, Robert E.H. Ferguson,
Jr., MD and Henry C. Vasconez, MD
Division of Plastic Surgery, University of Kentucky, Lexington, KY and *New York University
School of Medicine, New York, NY
Introduction
Autologous fat grafts may still be considered the ideal filler for structural fat grafting in
facial or hand rejuvenation.1-2 In order to obtain long-term survival of autotransplanted fatty
tissue, the harvested and processed fat grafts must be viable before implantation. However, the
viability of fat grafts harvested by even a well-established technique remains poorly studied and
unknown.3 This present study is designed to determine the viability of fat grafts harvested by the
Coleman technique using a syringe, cannula, and centrifuge.4
Materials and Methods
Sixteen adult white females (Ages: 23 to 57 years) were enrolled in this self-controlled,
IRB approved study. In Group 1 (N=8), fat grafts were harvested with the Coleman technique by
a single surgeon (SRC) from the abdomen of each patient according to his well described and
standardized method. In Group 2 (N=8), fat grafts were harvested with the conventional
liposuction by a single surgeon (LLQP) and were spun at 50 G for 10 minutes. The resulted
middle layer of tissue was collected. All fat graft samples were analyzed within 30 minutes after
they were harvested for the following studies: Trypan blue vital staining after collagenase
degradation for viable adipocyte counts, glycerol-3-phophatase dehydrogenase (G3PDH) assay
as an indicator of adipocyte specific intracellular enzyme activity of fatty tissue for
determination of cellular function within harvested fat grafts, and routine histology for
morphology of harvested fat grafts.5 The data obtained from this study was analyzed with a twotail unpaired Student t-test.
Results
In this study, the higher viable adipocyte counts were found in Group 1 compared with
Group 2 (4.11 ± 1.11 vs. 2.57 ± 0.56 x 106/ml, Mean ± SD, p<0.004). The level of G3PDH
activity was significantly higher in Group 1 compared with Group 2 (0.66 ± 0.09 vs. 0.34 ±
0.13u/ml, p< 0.0001). Histology essentially showed normal structure of fragmented fatty tissues
with no distinguishable difference in both groups.
Conclusions
Our results, for the first time, demonstrate that while fat grafts harvested by both methods
maintain normal histological structure, the Coleman technique yields a greater number of viable
adipocytes and sustains a more optimal level of cellular function within harvested fat grafts and
should be considered as a standard and preferred method of choice for fat graft harvesting.
Future study may be warranted to see whether fat grafts harvested by conventional liposuction
can be optimized in vitro before they can be used as fat grafts for in vivo transplantation.
2
References
1. Coleman SR. Structural fat grafts: The ideal filler? Clin. Plast. Surg. 28: 111, 2001.
2. Coleman SR. Hand rejuvenation with structural fat grafting. Plast. Reconstr. Surg. 110:
1731, 2002.
3. Smith P, et al. Autologous human fat grafting: Effect of harvesting and preparation
techniques on adipose graft survival. Plast. Reconstr. Surg. 117: 1836, 2006.
4. Coleman SR. Harvesting, refinement and transfer. In Coleman SR. Structural fat
grafting, St. Louis, MO.: Quality Medical Publishing, 2004, pp29-51.
5. Pu LLQ, et al. The viability of fatty tissues within adipose aspirates after conventional
liposuction: A comprehensive study. Ann. Plast. Surg. 54: 288, 2005.