Cell-Assisted Lipotransfer for Cosmetic Breast Augmentation: Supportive Use of Adipose-Derived Stem/Stromal Cells

Abstract

Background Lipoinjection is a promising treatment but has some problems, such as unpredictability and a low rate of graft survival due to partial necrosis. Methods To overcome the problems with lipoinjection, the authors developed a novel strategy known as cellassisted lipotransfer (CAL). In CAL, autologous adiposederived stem (stromal) cells (ASCs) are used in combination with lipoinjection. A stromal vascular fraction (SVF) containing ASCs is freshly isolated from half of the aspirated fat and recombined with the other half. This process converts relatively ASC-poor aspirated fat to ASC-rich fat. This report presents the findings for 40 patients who underwent CAL for cosmetic breast augmentation.Results Final breast volume showed augmentation by 100 to 200 ml after a mean fat amount of 270 ml was injected. Postoperative atrophy of injected fat was minimal and did not change substantially after 2 months. Cyst formation or microcalcification was detected in four patients. Almost all the patients were satisfied with the soft and naturalappearing augmentation. Conclusions The preliminary results suggest that CAL is effective and safe for soft tissue augmentation and superior to conventional lipoinjection. Additional study is necessary to evaluate the efficacy of this technique further.

Concise Review: Adipose-Derived Stromal Vascular Fraction Cells and Stem Cells: Let's Not Get Lost in Translation

“…Thus, soft tissue defects are a logical therapeutic target for SVF cells and ASCs because they are returned to their tissue of origin. While some plastic surgeons have experienced successful outcomes with fat grafting approaches, adverse events including cyst formation, fat necrosis, and microcalcifications have been observed in a percentage of breast reconstructions [50][51][52]. In addition, the immunosuppressive and tumor promoting functions of SVF cells and ASCs leads to concerns that their introduction into the breast tissue of a postmastectomy patient could enhance the recurrent growth of residual cancer cells [38].…”

Enrichment of putative stem cells from adipose tissue using dielectrophoretic field-flow fractionation

“…Examples include the application of freshly isolated SVF mixed with fibrin glue to treat skull defects (mixture estimated to contain 2−3% stem cells), 51 the use of "purified lipoaspirate" to heal irradiationinduced lesions in human breast, 52 and a cell-assisted lipotransfer (CAL) technique in which freshly isolated SVF is mixed with lipoaspirate for cosmetic breast augmentation. 53 The level of enrichment that is required to yield safe and clinically efficacious adipose derived progenitor cell fractions is yet to be determined. However, for clinical applications, it is anticipated that a freshly prepared, pro re nata source of autologous progenitor cells would be favored over heterologous, cultured or banked sources.…”

In vitro expression of cytokeratin 18, 19 and tube formation of adipose‐derived stem cells induced by the breast epithelial cell line HBL‐100

“…Likewise, Yoshimura et al . supplemented fat grafts with SVF for purely cosmetic breast augmentation and reported excellent cosmetic outcome without any major complications 4. However, consistent long‐term clinical outcome so far are not yet available.…”