The LipoStructure Consultation
Our consultations are designed to facilitate good communication, which we believe is the key to making successful choices. As a patient, you will spend a considerable amount of time with Dr. Coleman, as well as our office staff, preparing and planning for your procedure. The initial consultation consists of two visits.
Your consultation actually begins at home, as we ask you to bring photos of yourself (face, and/or hands) when you were younger, or before the surgery or injury about which you are concerned. These photos will be used during your visit with the doctor and will be compared to how you look now so that we have a common goal to aim for. If you desire an augmentation of your breasts and/or buttocks, photos of the size and shape you are hoping for are also helpful.
Once in our office, you will begin by filling out our patient history questionnaire. After the paperwork is completed, you will receive a very informative power point presentation by our patient care coordinator explaining the LipoStructure technique. At this time, you will also see pre- and post- operative photos of numerous procedures, including photos taken during the recovery period. After the presentation, you will meet with your doctor. Your medical and surgical history will be reviewed and a series of photographs will be taken. The photos will be placed into a computerized presentation, and your doctor will make tracings of some of the photos.
During the second half of the consultation (which may be later on the same day as your first appointment, or on another day) you will sit with the doctor to review your photos. With your input, an individualized blueprint will be made outlining the proposed procedures. The blueprints will indicate areas for fat removal (purple), fat placement (blue, green and yellow), areas to avoid (orange) and areas where the tiny incisions will be made (red) (see below).
After a plan has been made on the blueprint, the same sheet is used to explain the informed consent. The doctor will write down his discussion on the blueprint in red with you present, and you will be given a copy of the plan and informed consent that same day. This serves to help you remember the discussion.
After the plan has been made and agreed to, you will again meet with our patient care coordinator to go over the fee proposal and look at dates for surgery, if desired.
Our staff will discuss the details of what is required for pre-operative evaluation (medical clearance, bloodwork, EKG, etc.) and all the “do’s and don’ts” before surgery. We will provide you with a packet of detailed instructions, forms for your doctor to fill out and copies of your surgical proposal. We will help you plan your post-op care and recovery. If you live outside the New York metropolitan area, we will make suggestions for you about where to stay during recovery, how long we advise you to remain in the area, etc. We have nurses who work with us regularly who can be hired for overnight care should that be recommended or desired. We will also give you a tour of our CARE FACILITY, our on-site ambulatory surgical center which is state-of-the-art and certified by AAAASF. We use only board-certified anesthesiologists whom we work with on a daily basis.
On the day of your surgery, we use this blueprint of surgery to mark your body for the removal of fat and your face for the placement of the fat (see Procedure).
Our consultations are designed to facilitate good communication, which we believe is the key to making successful choices. As a patient, you will spend a considerable amount of time with Dr. Coleman and our office staff preparing and planning for your procedure. The initial consultation consists of two visits.
Initial Consultation: Immediately before your initial consultation, you will receive a very informative education. This education explains the LipoStructure technique and we will show you pre- and post- operative photos, including photos taken during the recovery stage.
Second Visit or Planning Consultation
The most important first step for fat grafting to the breast is for you to help us design a procedure that will give you the shape and size that you desire. We do that by first examining and photographing your body. Then we 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. We draw out blueprints of your unique procedure using photos and pencil tracings that depict your body and the specific changes you seek. We like to color- code the blueprint to indicate where we plan to remove the fat, where you desire specific changes in size or shape, and where the tiny incisions (or cannula entrance sites) will be placed (see below). We use the same sheets to make notations as we review your history and discuss the risks and benefits of the procedure.
The color-coded blueprint aids the patient in her understanding the procedure and enables the patient to help design the procedure.
Special Considerations: If we believe using the BRAVA system will enhance your outcome, we will discuss this during your second consultation. We generally like patients to wear the device for at least three weeks prior to the procedure.
The Day of Surgery
Marking: On the day of the procedure, we follow the blueprint we made at the time of your second consultation to mark your body with a color-coded system (see below). This allows you to understand where we are removing fatty tissue and how we are placing it into your breast to improve your shape and increase your breast size.
(Click on the image for a larger version)
On the day of the procedure, we mark 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, we consider numerous areas for harvesting (abdomen, flanks, inner thighs, knees, calves, arms, et cetera). Obviously, this is an important part of the procedure, and we 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, we usually perform the procedure under general anesthesia. However, for much smaller procedures, we use local anesthesia with sedation.
Grading the fat for selective placement: After the fat is harvested, we refine and concentrate the fat tissue using a centrifuge to remove any non-living components (oil, water, blood, et cetera). Our experience has taught us to grade the fat into different qualities, depending on density and other factors. We 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: We use the concentrated fat tissue to meticulously sculpt the breast. The technique we 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 while the fat is being placed into the breast. Many surgeons place fat then try to move it around or mold it which is can result in many problems.
(Liposuction Deformities and Buttock Augmentation)
Our consultation is designed to facilitate good communication, which we believe is the key to making successful choices. As a patient, you will spend a considerable amount of time with Dr. Coleman. The initial consultation consists of two visits. Prior to your first appointment, you have some homework to do. Your assignment is to bring with you images of your body before the liposuction or other procedures. It is preferable to bring photos taken by a medical photographer, but if you cannot, then please bring photos of yourself during a beach vacation or other circumstance. This is to aid in analyzing the shape and dimensions of the body that you desire to achieve.
When you come in for your initial consultation, you will receive a very informative education from a member of our staff. This education explains the LipoStructure technique, or the way the doctors approach the repair of liposuction deformities. You will view pre- and post- operative results, as well as discuss the post -operative course. Next, you will meet with your doctor, who will go over your cosmetic and medical history with you. You will have numerous photos taken of you at various angles and lighting, which you will go over with Dr. Coleman at your second consultation.
The second consultation is the appointment where you and the doctors develop a detailed plan for your procedure. Patients who present with liposuction deformities have often had negative experiences with aesthetic surgeons and are usually very worried about the outcome of yet another procedure. Our goal is to make sure you understand precisely where fat will be removed and placed so that you have a positive experience and outcome. You will review the photographs taken at your initial consultation to formulate a surgical plan.
Successful treatment of body surface irregularities requires a three-dimensional visualization of the problems and their potential solutions. Dr. Coleman will spend an extensive amount of time analyzing the images taken during your first consultation. Prior to reviewing the images with you, they will go over your history again as well as explain the possible complications of the surgical procedure. As you discuss your concerns and analyze your images, the doctors will map out a plan to use as a blue print for your surgery. Once the plan has been completed, the patient care coordinator will review it with you and discuss fees and possible dates for.
Almost all surgeries are performed in our state of the art AAAASF-accredited ambulatory surgery center, The Care Facility. This is located in the same building as our offices at TriBeCa Plastic Surgery. We use only board-certified anesthesiologists and our own medical staff, consisting of a scrub nurse and physician assistant. Patients recover in our fully equipped Recovery Area until they are ready to be discharged to home or a local hotel.