Fat Graft Enhanced With Adipose-Derived Stem Cells in Aesthetic Breast Augmentation: Clinical, Histological, and Instrumental Evaluation

Abstract Background Fat graft enhanced with adipose-derived stem cells (FG-e-ASCs) has been utilized in outcomes of radiotherapy after mastectomy, breast soft tissue defects, ulcers, and loss of substance. The authors present their experience utilizing FG-e-ASCs in breast augmentation. Objectives The aim of this study was to evaluate the safety and efficacy of a study group (SG) regarding utilization of FG-e-ASCs in breast augmentation for aesthetic improvement, comparing the results with a control group (CG). Methods A total of 46 patients affected by breast hypoplasia were treated with FG-e-ASCs, comparing results with those of a CG (n = 30) treated with fat graft not enhanced with adipose-derived stem cells (FG-ne-ASCs). The preoperative evaluation included a complete clinical evaluation, a photographic assessment, magnetic resonance imaging of the soft tissue, ultrasound, and mammography. Postoperative follow-up took place at 1, 3, 7, 12, 24, and 48 weeks and then annually. Results The patients treated with FG-e-ASCs showed 58% maintenance of the contour restoring and of 3-dimensional (3D) volume after 3 years compared with the patients of the CG treated with FG-ne-ASCs, who showed 29% maintenance. In 67.4% (n = 31) of breast augmentations treated with FG-e-ASCs, we observed a restoration of the breast contour and an increase of 10.3 mm in the 3D volume after 36 months, which was observed in only 20.0% (n = 6) of patients in the CG treated with FG-ne-ASCs. Volumetric persistence in the SG was higher than that in the CG (P < 0.0001 SG vs CG). Conclusions Utilization of FG-e-ASCs was safe and effective in this series of cases performed. Level of Evidence: 4

Download Full-text

Small Extracellular Vesicles From Human Adipose-derived Stem Cells: A Potential Promoter of Keeping Fat Graft Survival

10.21203/rs.3.rs-127314/v1 ◽

2020 ◽

Author(s):

Aizhen Chen ◽

Shijie Tang ◽

Jiawei He ◽

Xiangyu Li ◽

Guohao Peng ◽

...

Keyword(s):

Stem Cells ◽

Survival Rate ◽

Regenerative Medicine ◽

Extracellular Vesicles ◽

Umbilical Vein ◽

Fat Graft ◽

Control Group ◽

Adipose Derived Stem Cells ◽

Ki 67

Abstract Background: Small extracellular vesicles (sEVs) with genetic information secreted by cells play a crucial role in the cellular microenvironment. In this study, our purpose is to explore the characteristics of the small extracellular vesicles of human adipose-derived stem cells (hADSC-sEVs) and studied the role of hADSC-sEVs in improving the survival rate of grafted fat.Methods: In the present study, we used the transmission electron microscopy, nano-tracking analysis, nanoflow surface protein analysis, zeta potential value to identify sEVs. SEVs' trajectory was traced dynamically to verify whether hADSC-sEVs can be internalized into human umbilical vein endothelial cells (HUVECs) in vitro. The angiogenic property of hADSC-sEVs was observed by measuring the volume, weight and histological analysis of the grafted fats in nude mice modles. Results: Our research showed that the extracellular vesicles were sEVs with double-layer membrane structure and the diameter of which is within 30-150nm. hADSC-sEVs exert biological influence mainly through internalization into cells. Compared with the control group, the hADSC-sEVs group had a significantly higher survival rate of grafted fat, morphological integrity and a lower degree of inflammation and fibrosis. And immunohistochemistry showed that hADSC-sEVs significantly increased the neovascularisation and the expression of CD34, VEGFR2 and KI-67 in the graft tissue. Conclusions: As a potential nanomaterial, hADSC-sEVs has been explored in the field of cell-free application of stem cell technology. hADSC-sEVs promoted the survival of grafted fats by promoting the formation of new blood vessels, which is another promising progress in the field of regenerative medicine. We believe that hADSC-sEVs will have a broad application prospect in the field of regenerative medicine in the future.

Download Full-text

Commentary on: Fat Graft Enhanced With Adipose-Derived Stem Cells in Aesthetic Breast Augmentation: Clinical, Histological, and Instrumental Evaluation

Aesthetic Surgery Journal ◽

10.1093/asj/sjaa064 ◽

2020 ◽

Vol 40 (9) ◽

pp. 978-980

Author(s):

Alexandra Condé-Green

Keyword(s):

Stem Cells ◽

Breast Augmentation ◽

Fat Graft ◽

Adipose Derived Stem Cells ◽

Instrumental Evaluation ◽

Aesthetic Breast

Download Full-text

Comparative study on the effect of adipose-derived stem cells versus alpha-lipoic acid in autologus fat graft survival in adult female albino rat: histological and immune histochemical study

QJM ◽

10.1093/qjmed/hcaa051.001 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

S H Ibrahim ◽

S M M Omar ◽

G A Ibrahim ◽

A E Omar

Keyword(s):

Stem Cells ◽

Survival Rate ◽

Lipoic Acid ◽

Fat Graft ◽

Control Group ◽

Adipose Derived Stem Cells ◽

Alpha Lipoic Acid ◽

Inflammatory Infiltration ◽

Autologous Fat ◽

Fat Grafts

Abstract Background Autologous fat transfer is a popular option for soft tissue augmentation, but has a low survival rate. So, enriching the transplanted fat with stem cells (cell assisted lipotransfer) or oral administration of alpha-lipoic acid (ALA) before and after graft injection, were thought to increase the survival rate of the transplanted fat. Aim of Study Is to compare between cell-assisted lipotransfer (CAL) and ALA therapy in improvement of fat graft survival. Materials and Methods Thirty adult female albino rats were used and divided into three groups. Group I: the control group. Group II: CAL group received autologous fat mixed with adipose derived stem cells (ASCs). Group III: ALA group in which animals received oral ALA four days before fat transplantation and continued throughout experiment. Fat grafts were collected from the sites of injection after twenty-eight days. Histological and immune histochemical studies were performed. Statistical analysis was also done. Results Histological evaluation of the fat grafts from animals of control group revealed atrophy and death of adipocytes with formation of fat cysts. Severe inflammatory infiltration with giant cells formation and fibrosis were detected. Significant decrease of VEGF reaction was seen. In CAL group significant increase in number of intact adipocytes together with decrease in inflammation and fibrosis occurred. Moreover, significant increase in VEGF reaction was observed. In ALA group, significant decrease in number of intact adipocytes and VEGF reaction was detected compared with CAL group. Also, significant increase in inflammatory infiltration and fibrosis were detected compared to CAL group. Conclusions Both ASCs and ALA showed improvement in all histological parameters compared with control group. However, enrichment of fat with ASCs showed the best results.

Download Full-text

Engineered Fat Graft Enhanced with Adipose-Derived Stromal Vascular Fraction Cells for Regenerative Medicine: Clinical, Histological and Instrumental Evaluation in Breast Reconstruction

Journal of Clinical Medicine ◽

10.3390/jcm8040504 ◽

2019 ◽

Vol 8 (4) ◽

pp. 504 ◽

Cited By ~ 31

Author(s):

Pietro Gentile ◽

Donato Casella ◽

Enza Palma ◽

Claudio Calabrese

Keyword(s):

Breast Reconstruction ◽

Preoperative Evaluation ◽

Three Dimensional ◽

Stromal Vascular Fraction ◽

Fat Graft ◽

Control Group ◽

Study Group ◽

Fat Tissue ◽

Calvarial Defects

The areas in which Stromal Vascular Fraction cells (SVFs) have been used include radiotherapy based tissue damage after mastectomy, breast augmentation, calvarial defects, Crohn’s fistulas, and damaged skeletal muscle. Currently, the authors present their experience using regenerative cell therapy in breast reconstruction. The goal of this study was to evaluate the safety and efficacy of the use of Engineered Fat Graft Enhanced with Adipose-derived Stromal Vascular Fraction cells (EF-e-A) in breast reconstruction. 121 patients that were affected by the outcomes of breast oncoplastic surgery were treated with EF-e-A, comparing the results with the control group (n = 50) treated with not enhanced fat graft (EF-ne-A). The preoperative evaluation included a complete clinical examination, a photographic assessment, biopsy, magnetic resonance (MRI) of the soft tissue, and ultrasound (US). Postoperative follow-up took place at two, seven, 15, 21, 36 weeks, and then annually. In 72.8% (n = 88) of breast reconstruction treated with EF-e-A, we observed a restoration of the breast contour and an increase of 12.8 mm in the three-dimensional volume after 12 weeks, which was only observed in 27.3% (n = 33) of patients in the control group that was treated with EF-ne-A. Transplanted fat tissue reabsorption was analyzed with instrumental MRI and US. Volumetric persistence in the study group was higher (70.8%) than that in the control group (41.4%) (p < 0.0001 vs. control group). The use of EF-e-A was safe and effective in this series of treated cases.

Download Full-text

Fat graft – the natural choice for reconstructive, regenerative and aesthetic surgery

Advances in Cell Biology ◽

10.1515/acb-2017-0008 ◽

2017 ◽

Vol 5 (2) ◽

pp. 113-117

Author(s):

Samir Ibrahim ◽

Joanna Rybacka-Mossakowska ◽

Sławomir Michalak

Keyword(s):

Stem Cells ◽

Donor Site ◽

Aesthetic Surgery ◽

Fat Grafting ◽

Fat Graft ◽

Clinical Effects ◽

Adipose Derived Stem Cells ◽

Safe Alternative ◽

Natural Choice ◽

Reconstructive Operations

AbstractThe search for appropriate filler, which can be used for aesthetic and reconstructive operations is currently one of challenges for plastic surgery. The application of absorbable and permanent artificial fillers may cause adverse events. Thus, autologous fat grafting can be a safe alternative. Moreover, fat tissue is rich in adipose-derived stem cells (ASC), which can be successfully used for regenerative procedures. The paper reviews reports on fat grafting procedures, which indicate risks and their possible prophylactic.Adipose tissue is a much more prolific source of ASCs than bone marrow. Basically, ASC are characterized by a spectrum of markers: CD11b-CD45-CD13+CD73+CD90+, which can be widened by CD36+CD-106-CD10+CD26+CD49d+CD49e+CD3-D49f -PODXL- to improve phenotyping. It is suggested to use at least two negative markers and two positive markers during the same phenotyping analysis. Fat transfer requires appropriate approach, planning and technique to make it clinically successful.Fat grafting fulfills the expectations for ideal injectable agent, which can be used for aesthetic and reconstructive surgery. To improve the survival of fat graft, careful decisions on donor site, local anesthetic administration, liposuction method, processing and placement methods need to be made. Moreover, fat is the source of adipose-derived stem cells which can be used for regenerative procedures. A proper transformation and identification of those cells is required to improve clinical effects.

Download Full-text

A Randomized, Controlled Clinical Trial of Autologous Adipose-derived Stem Cell Transplantation to Promote Mechanical Stretch-induced Skin Regeneration

10.21203/rs.3.rs-99755/v1 ◽

2020 ◽

Author(s):

Poh-Ching Tan ◽

Pei-Chuan Chao ◽

Chen Cheng ◽

Chu-Hsin Chen ◽

Ru-Lin Huang ◽

...

Keyword(s):

Clinical Trial ◽

Stem Cells ◽

Mechanical Stretch ◽

Skin Regeneration ◽

Control Group ◽

Controlled Clinical Trial ◽

Skin Thickness ◽

Adipose Derived Stem Cells ◽

Skin Texture ◽

Mechanical Stretching

Abstract Background: The regeneration response of skin to mechanical stretching in vivo has been explored in reconstructive surgery for repairing large-scale deformities. The ability of skin to regenerate limits the reconstructive outcome. Here, we propose an approach in which autologous adipose-derived stem cells and mechanical stretching are combined to overcome this limitation and promote skin regeneration.Methods: This randomized, blinded, placebo-controlled clinical trial screened 22 participants undergoing tissue expansion with a presence of exhausted regeneration. Twenty eligible participants received intradermal injections with stromal vascular fraction (SVF) or placebo treatments. Follow-ups were conducted at 4, 8, and 12-weeks to assess efficacy and for 2-years to assess safety. The primary endpoint was the expanded skin thickness at 12 weeks. The secondary endpoints included the skin thickness at 4 and 8 weeks, the expansion index (EI) and the skin texture score at all visits. Results: The skin thickness of the SVF group was significantly higher than that of the control group at both 8 weeks (mean difference 0.78 [95% CI -1.43 to -0.11]; p = 0.018) and 12 weeks(0.65 [95% CI -1.30 to -0.01]; p = 0.046). In the SVF group, the increment of skin thickness was significant at 4 weeks (0.49 [95% CI -0.80 to -0.06]; p = 0.010) to 8 weeks (0.45 [95% CI -0.92 to 0.02]; p = 0.026) and maintained after 12 weeks, whereas that in the control group was reduced after 8 weeks (0.42 [95% CI -0.07 to 0.91]; p = 0.037). The SVF group showed higher EI increments than the control group (0.50 [95% CI -0.00 to 0.99]; p = 0.047). The skin texture scores in the SVF group were higher than those in the control group at 12 weeks. Histologically, the SVF-treated expanded skin showed more proliferating cells and blood vessels, and the volume of extracellular matrix increased. No severe adverse events occurred.Conclusions: Transplantation of autologous adipose-derived stem cells can expedite the potency of mechanical stretch-induced skin regeneration and provide clinical reconstruction with plentiful tissue. Trial registration: This trial was registered with Chinese Clinical Trial, ChiCTR2000039317 (registered 23 Oct 2020 - retrospectively registered, http://www.chictr.org.cn/showproj.aspx?proj=62738).

Download Full-text

Porous Cellulose-Collagen Scaffolds For Soft Tissue Regeneration: Influence of Cellulose Derivatives On Mechanical Properties And Compatibility With Adipose-Derived Stem Cells.

10.21203/rs.3.rs-1187939/v1 ◽

2022 ◽

Author(s):

Katarína Kacvinská ◽

Martina Trávničková ◽

Lucy Vojtová ◽

Petr Poláček ◽

Jana Dorazilová ◽

...

Keyword(s):

Mechanical Properties ◽

Tissue Engineering ◽

Stem Cells ◽

Cell Adhesion ◽

Soft Tissue ◽

Vascular Tissue ◽

Biological Properties ◽

Cellulose Derivatives ◽

Adipose Derived Stem Cells ◽

Soft Tissue Regeneration

Abstract This study deals with cellulose derivatives in relation to the collagen fibrils in composite collagen-cellulose scaffolds for soft tissue engineering. Two types of cellulose, i.e., oxidized cellulose (OC) and carboxymethyl cellulose (CMC), were blended with collagen (Col) to enhance its elasticity, stability and sorptive biological properties, e.g. hemostatic and antibacterial features. The addition of OC supported the resistivity of the Col fibrils in a dry environment, while in a moist environment OC caused a radical drop. The addition of CMC reduced the mechanical strength of the Col fibrils in both environments. The elongation of the Col fibrils was increased by both types of cellulose derivatives in both environments, which is closely related to tissue like behaviour. In these various mechanical environments, the ability of human adipose-derived stem cells (hADSCs) to adhere and proliferate was significantly greater in the Col and Col/OC scaffolds than in the Col/CMC scaffold. This is explained by deficient mechanical support and loss of stiffness due to the high swelling capacity of CMC. Although Col/OC and Col/CMC acted differently in terms of mechanical properties, both materials were observed to be cytocompatible, with varying degrees of further support for cell adhesion and proliferation. While Col/OC can serve as a scaffolding material for vascular tissue engineering and for skin tissue engineering, Col/CMC seems to be more suitable for moist wound healing, e.g. as a mucoadhesive gel for exudate removal, since there was almost no cell adhesion.

Download Full-text

Abstract 3899: SDF-1α Mediates the Therapeutic Effect of Human Adipose-Derived Stem Cells on Acute Myocardial Infarction Recruiting Bone Marrow-Derived Endothelial Progenitor Cells

Circulation ◽

10.1161/circ.118.suppl_18.s_500 ◽

2008 ◽

Vol 118 (suppl_18) ◽

Author(s):

Masaaki Ii ◽

Ayumi Yokoyama ◽

Miki Horii ◽

Hiroshi Akimaru ◽

Takayuki Asahara

Keyword(s):

Myocardial Infarction ◽

Stem Cells ◽

Cardiac Function ◽

Therapeutic Effect ◽

Heart Diseases ◽

Capillary Density ◽

Ischemic Myocardium ◽

Control Group ◽

Adipose Derived Stem Cells ◽

Ischemic Heart Diseases

Background: Recently, human multipotent adipose-derived stem cells (hMADSs) have been isolated featuring extensive expansion capacity ex vivo. However, little is known about the therapeutic efficacy of hMADS in ischemic heart diseases. We tested the hypothesis that hMADS transplantation may contribute to cardiac functional recovery following myocardial infarction (MI). Methods and Results: Nude rats were either transplanted with hMADSs (5x10 5 /rat, n=10) or PBS (control, n=9) in ischemic myocardium immediately following MI induction. The cardiac function, infarct size and capillary density in the peri-infarct area were evaluated by echocardiography and immunostaining 28 days after surgery. The cardiac function was significantly greater with increased capillary density and reduced fibrosis area in the hMADS group than that in the control group. Next, we examined tissue regeneration in the infarct heart by the transplanted hMADSs. However, remarkable differentiation of hMADSs into any cardiac cell lineages was not detected. To explore another mechanism for the favorable effect of hMADSs, we further examined mRNA expression of cytokines in hMADSs under hypoxic conditions. Although hypoxia decreased the expressions, robust VEGF, bFGF, and SDF-1α expressions were detected in hMADSs. Notably, the stem/progenitor chemokine SDF-1α expression in hMADSs was significantly greater than that in human mesenchymal stem cells that are well known to have a therapeutic effect on ischemic heart diseases. We then focused on SDF-1α /CXCR4 axis and examined the contribution of bone marrow (BM)-derived endothelial progenitor cells (EPCs), that have CXCR4 receptor for SDF-1v, to ischemic myocardium using a Tie2/LacZ BM transplantation nude mouse model. β-gal positive EPCs are frequently observed in ischemic myocardium in the hMADS group compared to the control group. Conclusion: hMADSs exhibit a therapeutic effect on cardiac function following MI with the production of VEGF, bFGF, and SDF-1α demonstrating paracrine effects rather than direct contribution to cardiac regeneration. These findings suggest that transplanted hMADSs and recruited EPCs may synergistically promote angiogenesis playing a role in ischemic myocardium.

Download Full-text