When I began my plastic surgery career about 40 years ago, liposuction was just emerging as a new technique—and fat grafting was not even on the radar yet. Early attempts to use a patient’s own fat to restore volume were crude by today’s standards, typically involving large cannulas and inconsistent techniques that yielded unpredictable results. But as plastic surgery evolved, so did our tools, methods, and understanding of fat as a powerful regenerative tool.
One of the pioneers in this field, Dr. Sydney Coleman, helped bring fat grafting into the mainstream. I had the good fortune to visit Dr. Coleman and learn from him directly. Interestingly, during part of his residency at the University of California, San Francisco, Dr. Coleman worked under my longtime partner, Dr. Juris Bunkis. Dr. Coleman’s careful technique of fat harvesting, processing, and reinjection set a new standard in fat grafting and helped shift the procedure from experimental to essential.
Today, we have refined fat grafting into what we call microfat and nanofat grafting—techniques that allow us to treat delicate, high-definition areas with extraordinary precision. Using ultra-fine cannulas and carefully processed fat, we can restore volume, improve skin quality, and rejuvenate areas like the lower eyelid hollows, temples, lips, and the backs of the hands.
