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 natural-appearing 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.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Carpaneda, C.A., Ribeiro, M.T.: Percentage of graft viability versus injected volume in adipose autotransplants. Aesth Plast Surg 18, 17–19 (1994)
Coleman, S.R.: Structural fat grafts: The ideal filler? Clin Plast Surg 28, 111–119 (2001)
Coleman, S.R., Saboeiro, A.P.: Fat grafting to the breast revisited: Safety and efficacy. Plast Reconstr Surg 119, 775–785 (2007)
Ersek, R.A., Chang, P., Salisbury, M.A.: Lipo layering of autologous fat: An improved technique with promising results. Plast Reconstr Surg 101, 820–826 (1998)
Fagrell, D., Enestrom, S., Berggren, A., Kniola, B.: Fat cylinder transplantation: An experimental comparative study of three different kinds of fat transplants. Plast Reconstr Surg 98, 90–96 (1996)
Har-Shai, Y., Lindenbaum, E.S., Gamliel-Lazarovich, A., Beach, D., Hirshowitz, B.: An integrated approach for increasing the survival of autologous fat grafts in the treatment of contour defects. Plast Reconstr Surg 104, 945–954 (1999)
Kurita M, Matsumoto D, Shigeura T, Sato K, Gonda K, Harii K, Yoshimura K: Influences of centrifugation on cells and tissues in liposuction aspirates: Optimized centrifugation for lipotransfer and cell isolation. Plast Reconstr Surg, (in press)
Masuda, T., Furue, M., Matsuda, T.: Novel strategy for soft tissue augmentation based on transplantation of fragmented omentum and preadipocytes. Tissue Eng 10, 1672–1683 (2004)
Matsumoto, D., Sato, K., Gonda, K., Takaki, Y., Shigeura, T., Sato, T., Aiba-Kojima, E., Iizuka, F., Inoue, K., Suga, H., Yoshimura, K.: Cell-assisted lipotransfer: Supportive use of human adiposederived cells for soft tissue augmentation with lipoinjection. Tissue Eng 12, 3375–3382 (2006)
Miranville, A., Heeschen, C., Sengenes, C., Curat, C.A., Busse, R., Bouloumie, A.: Improvement of postnatal neovascularization by human adipose tissue-derived stem cells. Circulation 110, 349–355 (2004)
Moseley, T.A., Zhu, M., Hedrick, M.H.: Adipose-derived stem and progenitor cells as fillers in plastic and reconstructive surgery. Plast Reconstr Surg 118(3 Suppl), 121S–128S (2006)
Planat-Benard, V., Silvestre, J.S., Cousin, B., Andre, M., Nibbelink, M., Tamarat, R., Clergue, M., Manneville, C., Saillan-Barreau, C., Duriez, M., Tedgui, A., Levy, B., Penicaud, L., Casteilla, L.: Plasticity of human adipose lineage cells toward endothelial cells: physiological and therapeutic perspectives. Circulation 109, 656–663 (2004)
Rehman, J., Traktuev, D., Li, J., Merfeld-Clauss, S., Temm-Grove, C.J., Bovenkerk, J.E., Pell, C.L., Johnstone, B.H., Considine, R.V., March, K.L.: Secretion of angiogenic and antiapoptotic factors by human adipose stromal cells. Circulation 109, 1292–1298 (2004)
Shiffman, M.A., Mirrafati, S.: Fat transfer techniques: The effect of harvest and transfer methods on adipocyte viability and review of the literature. Dermatol Surg 27, 819–826 (2001)
Spear, S.L., Wilson, H.B., Lockwood, M.D.: Fat injection to correct contour deformities in the reconstructed breast. Plast Reconstr Surg 116, 1300–1305 (2005)
Spear, S.L., Newman, M.K.: Discussion to "Fat grafting to the breast revisited: safety and efficacy.". Plast Reconstr Surg 119, 786–787 (2007)
Strawford, A., Antelo, F., Christiansen, M., Hellerstein, M.K.: Adipose tissue triglyceride turnover, de novo lipogenesis, and cell proliferation in humans measured with 2H2O. Am J Physiol Endocrinol Metab 286, E577–E588 (2004)
Ullmann, Y., Hyams, M., Ramon, Y., Peled, I.J., Leiderbaum, E.S.: Enhancing the survival of aspirated human fat injected into nude mice. Plast Reconstr Surg 101, 1940–1944 (1998)
Yoshimura K, Matsumoto D, Gonda K (2005) A clinical trial of soft tissue augmentation by lipoinjection with adipose-derived stromal cells (ASCs). Proceedings of the 3rd annual meeting of International Fat Applied Technology Society (IFATS), Charlotteville, Virginia, pp. 9–10
Yoshimura, K., Shigeura, T., Matsumoto, D., Sato, T., Takaki, Y., Aiba-Kojima, E., Sato, K., Inoue, K., Nagase, T., Koshima, I., Gonda, K.: Characterization of freshly isolated and cultured cells derived from the fatty and fluid portions of liposuction aspirates. J Cell Physiol 208, 64–76 (2006)
Zuk, P.A., Zhu, M., Ashjian, P., De Ugarte, D.A., Huang, J.I., Mizuno, H., Alfonso, Z.C., Fraser, J.K., Benhaim, P., Hedrick, M.H.: Humanadipose tissue is a source of multipotent stem cells. Mol Biol Cell 13, 4279–4295 (2002)
Zuk, P.A., Zhu, M., Mizuno, H., Huang, J., Futrell, J.W., Katz, A.J., Benhaim, P., Lorenz, H.P., Hedrick, M.H.: Multilineage cells from human adipose tissue: Implications for cell-based therapies. Tissue Eng 7, 211–228 (2001)
Author information
Authors and Affiliations
Corresponding author
Additional information
This article is being reprinted for ISAPS 50th Anniversary Special Issue.
Rights and permissions
About this article
Cite this article
Yoshimura, K., Sato, K., Aoi, N. et al. Cell-Assisted Lipotransfer for Cosmetic Breast Augmentation: Supportive Use of Adipose-Derived Stem/Stromal Cells. Aesth Plast Surg 44, 1258–1265 (2020). https://doi.org/10.1007/s00266-020-01819-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00266-020-01819-7