Breast Augmentation Using Fat Transplantation With Adipose-Derived Stem/Stromal Cells

Backgroud:Lipoinjection is a promising treatment for breast augmentation with natural form and without incision or immune response. But it has some problems, such as a low rate of graft survival due to partial necrosis and calcification, cystic fibrosis and pseudocyst, which greatly undermined its surgical outcomes. So, how to maintain the survival of transplanted adipose tissue is the key solution to this problem.Objective:With continuous progress on research of Adipose-Derived Stem Cells (ADSCs), breast augmentation using fat transplantation with ADSCs has been the new focus of plastic surgery field. However, there is no large sample report of it, this research is to evaluate the clinical outcomes of this new technology.Methods:One hundred patients were enrolled in this research who underwent ADSCs assisted fat transplantation for breast augmentation from November2010to December2011. Adipose tissue was suctioned subcutaneously from lower abdomen or thighs of the patient,and5mL of ADSCs was extracted from100mL of liposuction aspirates.ADSCs was mixed uniformly with graft material and injected to patients’ breast, each one for about200mL.We measured the vertical distance between root of nipple and sternal coronal plane before and after surgery, took the increasing amount to measure augmentation of breast. It was measured2weeks,1month,3months and 6months after surgery,and retention percentage was calculated taking2weeks’ measurement as reference value.Results:Each surgery was completed successfully without severe complication, and almost all the patients were satisfied with the soft and natural-appearing augmentation. Average increase of vertical distance between root of nipple and sternal coronal plane was14.3mm,and the retention percentage of1,3and6months after surgery was79.08%,66.75%and70.57%, respectively. Differences between2weeks and the other three groups, between one month and3months,6months showed significance (P<0.05). And there was no significant difference between3months and6months after surgery. Difference among different age groups shows no significance except2weeks after surgery. There is no difference in clinical outcomes between groups which received more than or less than200mL lipoinjection for unilateral breast.Conclusions:This research suggests that ADSCs assisted fat transplantation for breast augmentation is safe and effective, especially excellent in the natural appearing. Fat tissues retention in breast3months after surgery would survive and maintain the augmentation of breast for long time. Patients of all age groups may share the same benefit of this technology. Amount of lipoinjection for unilateral breast should below200mL.