Fat grafting is an exciting alternative treatment in procedures including facial rejuvenation, breast enhancement/reconstruction and buttock augmentation. The benefit of fat grafting is that it uses incisional scars and often has fewer complications than when injecting foreign material into the body. Although fat grafting has been around for over a decade, it has recently seen a boost in popularity. The latest refinements that focus on stem cells in adipose (fat) tissue are adding promise to the rising field of fat transfer.
While fat grafting and its use of stem cells are in various stages of development throughout around the world, plastic surgeons in Japan are making the most headway. Kotaro Yoshimura, M.D., associate professor of plastic surgery at the University of Tokyo, is one of the lead investigators for the use of stem cells for aesthetic applications. Dr. Yoshimura, along with his colleagues, has developed a strategy called cell-assisted lipotransfer (CAL) to overcome common issues seen in traditional fat grafting. Fat grafting can lead to unpredictable results and a low rate of fat cell survival due to partial necrosis.
In the CAL process, fat-derived stem cells are used in conjunction with lipoinjection. Fat stem cells are removed from half the aspirated fat and then recombined with the other half. Here’s how it’s done: Imagine that a cup of fat is taken from a patient by liposuction and divided into two ½-cup portions. The stem cells are removed from one half-cup portion of fat and added to the other half-cup of fat. That gives that half-cup double the stem cells it would otherwise have, thereby changing stem cell-poor fat to stem cell-rich fat. Dr. Yoshimura has found that after fat grafting, fat cells die off and are replaced by new fat generated by the stem cells. According to Dr. Yoshimura, this shows that the amount of stem cells contained in the graft is crucial in determining the final volume of the lipoinjection.
Dr. Yoshimura’s tested the CAL process on more than 450 breast augmentation and reconstruction patients since 2003, with results demonstrating CAL as safe and effective for soft tissue augmentation.
Cell-assisted lipotransfer is a basic three-step process: fat and stem cells are extracted from a donor site, the soft tissue is purified, and then the tissue is injected elsewhere into the body. The hardest part about CAL is isolating the stem cells from half of the aspirated fat. The cells can be isolated manually in a cell-processing room or automatically using Tissue Genesis Cell Isolation System technology.
According to Dr. Yoshimura, fat grafting with stem cell-rich fat may boost the efficacy and safety of the traditional methods. According to Dr. Yoshimura, the extra stem cells are also therapeutic during the healing process and can have a similar effect as bone marrow-derived stem cells.
While the findings are promising, Dr. Yoshimura stresses that the long-term safety and efficacy of CAL needs to be confirmed. For thin patients, an issue may arise in harvesting enough fat and stem cells to make the procedure a success.
To Your Health & Beauty,
Kent V. Hasen, M.D.