Is There a Difference Between Fat Transfer and Concentrated Stem Cell Fat Transfer to the Breast?
Doctor Answers 6
Understanding stem cells in fat.
For purposes of this discussion grafted fat contains two types of cells; these are the adipocytes (fat cells) themselves, and the stem and regenerative cells. The fat cells act as the main filler, however when these are transplanted by fat grafting, there is a period of time during which they have to acquire a blood supply in order to survive. The reality is that some of these cells survive, and some do not. Most of the scientific data points to the fact that it is the other group of cells, the stem and regenerative cells, that are critical to the survival of the fat as a graft. When fat is removed with liposuction for grafting, some of these stem and regenerative cells are left behind, so the fat that is grafted is actually deficient in these cells compared to normal fat. There is good data to show that if the number f these cells is restored or enriched, then the grafted fat will take better. (Yoshimura, sterodimas and others have published extensively on this) But........ this benefit is quite likely dose related. In other words in an area like the face where the amount of fat is smaller, it is easier to enrich the fat with a larger dose of these cells, which means the benefit is easier to demonstrate than for example in the breast where larger volumes of fat are grafted and relatively fewer cells are added to enrich the fat. So it really comes down to whether enriching the fat is cost effective or not. Fat grafts will take without cell enrichment, but they take better with cell enrichment. The problem is that the process adds to the cost, and the fat from which the cells are processed is discarded - so one has to have extra fat available. The stem and regenerative cells are also considered to be responsible for some of the other benefits of fat grafting that have been observed, like improvement in skin quality, improvement in radiation damaged skin etc. In general if you have adequate fat to harvest and you can afford the extra cost, then I think there is a benefit, though the benefit from a cost perspective is hard to quantify. Some studies though are starting to show a cost benefit, such as the RESTORE study in Europe for reconstruction of the breast, where it has been shown by decreasing the number of grafting procedures required, there are cost savings. Similarly Sterodimas has shown in the face that the number of graft procedures with enriched fat is less.
Yes, there is a difference and those differences may be good or bad
The survivability of fat cells is largely dependent on how gently the fat cells are harvesting and grafted. With a good technique 70% survival can be expected.
The problem with stem cell concentrated fat is that no one knows long term if this will cause any stimulation or trigger the growth of cancerous cells in the breast.
To discuss in greater detail, see two or more board certified plastic surgeons in your area.
Stem cell fat transfer for breat augmentation
Fat transfers are fraught with peril: large volume fat transfers do not survive reliably and when they don't they cause calcifications which can interfere with mammography. Stem cells increase graft reliability but we do not know what stem cells do to breast tissue vis-a-vis breast cancer.
I do not recommend fat transfers of any kind for cosmetic breast augmentation. This is not my stance for post-mastectomy breast reconstruction.....
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Stem cells or fat cells for breast enhancement
Using fat and stem cells for breast augmentation is still being explored as a possible option for augmentation. Although, I think the kinks haven't been worked out and there are no long term studies showing its safety and consistency.
The use stem cell to fortify is not proven yet
The use of fat for the breast enhancement is becoming more popular. The use of stem cell to enhance the fat survival is attractive but not necessary based on my experience. I have done more than 250 fat grafting cases and teach the fat grafting during our meeting(fatgraftforum.com). I would recommend that your make sure your surgeon is experienced and has good success with fat grafting.
Concentrated stem cells, marketing tactics and the truth behind fat transfer
In my opinion, concentrating stem cells is completely unnecessary. I commonly perform fat grafting to the face, breast and body with excellent results. The fact of the matter is that all lipoaspirate has a significant amount of stem cells. If you are gentle with technique you will get better results without concentrating stem cells. If you are rough with te3chnique and send a significant amount of cells on an apoptotic pathway then extra steps to concentrate stem cells may help but will NEVER be as good as expertly handled and minimally processed fat. I hope this helps! Remember more technology ;does not equate to better!
All the best,
Rian A. Maercks M.D.
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