title: Simplified lipostructure: a technical note.
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.
  
  
  CONCLUSIONS
  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.
  
  
  METHODS
  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.affiliation: 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.
authors.forename: Guido
authors.initials: G
authors.lastname: Paolini
authors.affiliation: Plastic Surgery Unit, Faculty of Medicine and Psychology, Sant'Andrea Hospital, "Sapienza" University of Rome, Via di Grottarossa 1035/1039, 00189, Rome, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Amoroso
authors.affiliation: Plastic Surgery Unit, Faculty of Medicine and Psychology, Sant'Andrea Hospital, "Sapienza" University of Rome, Via di Grottarossa 1035/1039, 00189, Rome, Italy.
authors.forename: Benedetto
authors.initials: B
authors.lastname: Longo
authors.affiliation: Plastic Surgery Unit, Faculty of Medicine and Psychology, Sant'Andrea Hospital, "Sapienza" University of Rome, Via di Grottarossa 1035/1039, 00189, Rome, Italy.
authors.forename: Michail
authors.initials: M
authors.lastname: Sorotos
authors.affiliation: Plastic Surgery Unit, "Andrea Sygros" Hospital, School of Medicine, University of Athens, Athens, Greece.|II Level Master on Breast Reconstruction, Faculty of Medicine and Psychology, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Karypidis
authors.affiliation: Plastic Surgery Unit, Faculty of Medicine and Psychology, Sant'Andrea Hospital, "Sapienza" University of Rome, Via di Grottarossa 1035/1039, 00189, Rome, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Santanelli di Pompeo
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation*; D000328:Adult; D000368:Aged; D003357:Cosmetic Techniques / Q000295:instrumentation; D004867:Equipment Design; D006801:Humans; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000295:instrumentation / Q000379:methods*; D012189:Retrospective Studies