Apr 7
Stem Cells and Fat Transfer
Fat transfer has become more and more popular in the last decade for restoring facial volume lost to aging and even as an alternative to breast implants. And why not? Fat is plentiful, easy to harvest, and it’s your own tissue so no need to worry about a reaction. And it works (well, mostly). The problem that has hampered fat transplantation from becoming universally accepted as the ideal volume procedure is that it can be hard to predict how much of it and how well it will last. That’s because the fat is being separated from its natural blood supply, is then transferred to a new area of the body, and is expected to develop a new blood supply that will allow it to survive. Sadly, not all of the transferred fat makes it.
In an effort to improve predictability of results, surgeons have tried all kinds of things to enhance extraction, handling, processing, and reinjection of the harvested fat. Still, even, with these precautions, about half of the fat that is transferred has a meaningful long-term survival and that’s about as good as anyone can get with traditional fat transfer. Thankfully for most patients, half of the transferred fat does very well and we have almost never had to repeat the procedure. Still, it would be nice to be able to offer an even more robust and predictable enhancement. And, that is the promise of stem cells.
In the last few years, scientists have discovered that fat contains a type of stem cell known as adipose-derived regenerative cells (ADRCs). These cells have shown the ability to improve long-term fat graft retention by secreting key growth factors that enhance blood vessel formation and promote cell survival. Cytori Therapeutics, a leader in the area, has developed technology that can isolate and concentrate these stem cells into a so-called cell-enriched fat transfer procedure.
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In the latest article published in the February issue of the Annals of Plastic Surgery, the study of this technology in mice revealed after 6- and 9-month intervals that not only was the quality of transferred fat cells improved but the quantity and retention of fat cells had increased two-fold over controls. There is always a trade-off of course and, in this case, the procedure is expected to add about 90 minutes to surgical times along with increased associated costs. But, if studies in humans can match the findings in animals, this could prove to be a very valuable innovation on the horizon. The medical device technology is currently available in Asia and Europe but not yet approved for clinical use in the USA. We’ll keep you posted on the latest updates.
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