New study: Stem cells improve lipofilling results

In a pilot study of 10 patients just published in The Lancet, Danish researchers showed that the addition of stem cells to a fat graft improved the survival of the fat graft at 4 months, compared to a plain unenhanced fat cell graft.   This study is significant, as it represents the first randomized study of its kind for fat grafting.

Here’s what the researchers did: participants had liposuction twice – once to harvest stem cells, and once to harvest fat cells. The stem cells were then grown in the lab, using specialized cell culture methods, and mixed back into one of the two fat cell preparations in large numbers, equal to 12% of the volume grafted.  The two fat cell grafts of about 1 ounce each – one with stem cells, one without – were then placed on the back of the patient’s arm. MRI was used to measure the fat cell volume at the time of injection, and 4 months later.

They found that the stem cell enhanced grafts did much better, with 80% retention, versus the plain fat grafts, which only had 16% retention.

Pretty cool – but what does this mean? Despite the encouraging result, this preliminary study needs to be repeated with many more patients, using much larger volumes of fat, before we can decide whether it’s clinically useful. And we need an FDA-approved method to get the huge numbers of stem cells that we would need to make this work in the volumes that we use in daily practice.

For example, if we were going to perform a Brazilian buttock lift, we might typically use 400 cc of fat on each side, or more. The Danish study would suggest we would need 50 cc of concentrated stem cells per side – and without cell culture techniques, this would take the isolation of every single stem cell in 3.5 liters of fat to get this amount. – for each buttock!! That’s neither practical nor safe.  So clearly, without some new FDA-approved method, we can’t duplicate the recipe of the Danish study in our daily practice.

I found it interesting that the retention rate was only 16% for the non stem cell group. That’s really low. By contrast, other studies that studied fat grafting to the breast found a 65% retention rate in the breast, as long as the breast was prepared with pre-operative BRAVA expansion – without needing stem cells.

 

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