Stem and Regenerative Cell Technologies

Providing the Best in Natural Breast Reconstruction to Orlando & nearby areas of Florida

One of the most exciting discoveries of the last decade is that fat is an extremely rich source of stem and regenerative cells. Worldwide there are hundreds if not thousands of research projects related to the potential uses of these cells for numerous diease processes, with recent approval of these cells in Europe for treating heart disease, and the initiation of similar trials in the US.

In the context of fat grafting there is significant evidence that these cells, known as adipose derived stem and regenerative cells, or ADRC's, play an important role in the survival of fat grafts. These cells should be seen be seen as healing and support cells. The question arises whether it is necessary to separate out these cells in order to create cell enriched fat grafts or not, as we know that fat grafts survive even without this process. When fat is removed with liposuction for grafting, some of the ADRC's are left behind, so this fat has fewer ADRC's than the normal fat in your body. Proponents of cell enriched fat grafting propose that by enriching liposuctioned fat we are simply restoring the number of stem and regenerative cells to a normal level. There are elegant studies in animals that demonstrate improved survival of cell enriched fat grafts, but unfortunately these studies do not translate easily to our patients in every day practice. During the process of separating ADRC's from fat, the actual fat cells are discarded. When larger volumes of fat are required, as in breast reconstruction and augmentation, it is difficult to harvest enough fat and separate enough ADRC's for adequate enrichment.

In studies using smaller volumes of fat, such as lumpectomy reconstruction, or facial fat grafting, the indication is that cell enrichment improves graft survival. The apparent benefit would therefore be a reduced number of procedures to achieve the desired result. In select patients, such as lumpectomy patients who have had radiation therapy, cell enrichment is presented as an option. The RESTORE study in Europe seems to indicate that cell enrichment is beneficial in these individuals, with more predictable graft take and better patient and surgeon satisfaction. Further studies are needed however that directly compare enriched and non-enriched fat grafts in the breast. In the face, where it is much easier to obtain adequately enriched grafts due to the smaller graft volumes, a recent study by Sterodimas et al, directly compares cell enriched with non-enriched fat. The results appear to show improved graft take with cell enriched fat.

At the present time the FDA has restricted the use of any fat manipulation and fat derived stem cell use. For this reason, as well as the volume limitations mentioned above, stem cell enriched fat grafting is not recommended for our patients. Nevertheless we are able to obtain excellent graft retention using gentle liposuction and fat purification procedures and the utilization of BRAVA®

To learn more about breast reconstruction and breast augmentation with fat, please contact plastic surgeon Dr. Jeffrey Hartog to schedule a consultation if you are in the Orlando, Florida area.

4355 Bear Gully Road
Winter Park, FL 32792