207The introduction of a syringe instead of a machine to aspirate the fat was
introduced by Fournier and later optimized by Coleman for the purpose of fat graft-
ing in clinical practice (Coleman 2002 , 2004 ; Fischer 1975 , 1976 ; Fischer and
Fischer 1977 ; Fournier 1988a , b ). The Coleman technique tolerates local, regional,
epidural, or general anesthesia depending on the patient’s preference and the anes-
thetic risk. With local anesthesia, lidocaine and epinephrine are used, and during an
epidural and general anesthesia, a solution of epinephrine and Ringer’s lactate help
to maintain homeostasis. After a small puncture incision, a blunt LAMIS™ infi ltra-
tion cannula is used to introduce and infi ltrate the respective wetting solution into
the donor area with an estimated ratio of 1 ml solution per cm^3 fat to be harvested.
Through the same puncture incision, a blunt tip harvesting cannula with two distal
openings in a shape reminiscent of a bucket handle is inserted. The cannula is con-
nected to a 10 ml Luer Lock syringe, which creates minimal negative pressure as the
plunger is drawn out, while the cannula is advanced and retracted through the har-
vest site (Coleman 2002 ).
A lipofi lling study by Witort and co-workers ( 2007 ) evaluated the effects of dif-
ferent harvesting techniques on adipocytes. The results indicated that the gentle
Coleman technique was less traumatic than the mechanical aspirator (680 mmHg
vacuum) which uses power-assisted aspiration (Witort et al. 2007 ). These results
were supported by Herold and co-workers ( 2011 ) who compared the fat graft viabil-
ity of adipocytes using the Coleman technique to the Shippert technique. The
Coleman technique involves manual aspiration using a syringe and centrifugation,
while the Shippert technique uses automatic liposuction (suction assistance from a
mechanical pump system) and no centrifugation of adipose tissue. It was demon-
strated using a WST-8 test (cell proliferation assay) and annexin V/IP FACS analy-
sis (apoptotic assay) that the Coleman technique was superior with signifi cantly
increased fat graft viability (Herold et al. 2011 ). An important observation however
was that ASCs in the harvested adipose tissue were more resistant to handling and
ischemia than mature adipocytes, which are more fragile cells with a shorter lifes-
pan once harvested (Tommaso et al. 2012 ).
Iyyanki and colleagues ( 2015 ) recently compared various yields of SVF cells
and ASCs from different harvesting techniques including resection, mechanical-/
suction-assisted liposuction, Coleman technique with centrifugation, and Coleman
technique without centrifugation. The study revealed that the highest yields of SVF
cells and ASCs were obtained from the resection samples and the Coleman tech-
nique with centrifugation.
A prospective, randomized, comparative study demonstrated that the maximum
negative pressures of 10, 20, and 60 ml syringes were 275, 394, and 549 mmHg,
respectively, and no signifi cant differences in ASC integrity and viability were
observed (Charles-de-Sá et al. 2015 ).
Using a wetting solution reduces the risk of excessive bleeding during liposuc-
tion procedures, and the patient will have less post-procedural bruising, although if
liposuction is performed for the purpose of harvesting ASCs, it is questioned
whether anesthetics used in the wetting solution could have an effect on the ASCs.
Tommaso and colleagues ( 2012 ) demonstrated through histological evidence and
10 Harvesting and Collection of Adipose Tissue for the Isolation...