TITLE:
Enrichment with Adipose-Derived Stem Cells Does Not Enhance Water-Jet Fat Graft Survival in the Breast—A Prospective Comparative Study
AUTHORS:
Hilkka H. Peltoniemi, Asko Salmi, Kai Saariniemi, Hannu Kuokkanen, Christian Herold
KEYWORDS:
Fat Transplantation, Cell-Assisted Lipotransfer, Water-Jet-Assisted Liposuction
JOURNAL NAME:
Surgical Science,
Vol.7 No.11,
October
27,
2016
ABSTRACT: Objective: Although research
increasingly underlines the theoretical importance of adipose-derived stem
cells (ASC) for successful fat transplantation, we could not prove this notion
in cosmetic breast augmentation. Stem-cell-enriched breast fat transplantation
did not yield better results than grafting based on the WAL (water-jet assisted
liposuction) technique in terms of volume persistence. To overcome inter-individual
variation, intra-individual comparison was performed. Material
and Methods: Four women underwent breast augmentation utilizing
WAL fat transplantation with and without ex-vivo ASC isolation performed with the Multistation System.
All patients underwent two fat transplantations for breast augmentation. In the
first procedure, the left breast was augmented with stem-cell-enriched fat
grafts and the right with plain WAL fat grafts. In the second surgery, the
lipofilling was performed the other way round to exclude intra-individual
differences in fat cell persistence. Results: MRI
volumetry revealed a mean volume survival of 56% of the whole (watery) graft in
the breasts with WAL only and 56% in the breasts with WAL and stem cell
enrichment. While centrifugation of the WAL grafts demonstrated an average
adipose content of 68%, the average volume survival of the adipose tissue
itself was 83% in the breasts augmented with WAL only and 83% in those with WAL
with stem cell enrichment. Conclusion: Breast augmentation by
means of lipofilling using WAL alone is faster and more inexpensive, carrying a
lower risk of contamination and offering an equal take rate. We do not see any
advantage in stem-cell-enrichment in cosmetic fat transplantation to the
breast.