Japan Makes Sizable Advances in the Use of Stem Cells During Fat Grafting

Fat grafting is an alternative used during soft tissue augmentation that has grown in popularity over the past few years. Although this technique has been around for over a decade, recent international advancements and the use of stem cells have dramatically increased the presence of fat grafting in the plastic surgery industry.

Fat grafting is beneficial in that it only leaves incisional scars and often has less complication then injecting dermal fillers and other foreign substances into the body. Although doctors around the world have been working hard to improve the final result of fat grafting, physicians in Japan have recently made the most important headway

Kotaro Yoshimura, M.D., associate professor of plastic surgery at the University of Tokyo, is leading the investigation into the use of stem cells of aesthetic applications. The doctor and his team recently developed a strategy called cell-assisted lipotransfer (CAL) to overcome some common issues with traditional fat grafting such as unpredictable results and low fat cell survival rates due to necrosis.

How CAL Works:
Stem cells found within adipose (fat) tissue are combined with traditionally lipoinjection. The fat removed after liposuction is split in half and stem cells from one half of the fat are removed and added to the other part of the fat. This process creates stem cell-enriched fat. Dr. Yoshimura and his colleagues found that after grafting fat, some of the cells die off and are replaced by new fat generated by the stem cells. The amount of stem cells contained in the graft is crucial in determining the final results following lipoinjection.

Dr. Yoshimura has tested the CAL process on more than 450 breast augmentation and restoration patients since 2003. The results demonstrated CAL as a safe and effective alternative for soft tissue augmentation.

How Stem Cells Are Isolated:
There are three basic steps executed during CAL: fat and stem cells are extracted from a donor site, the soft tissue is purified, and then the tissue is injected elsewhere into the body. The most difficult step in the process is isolating the stem cells from the rest of the fat cells. This can be done manually using a cell-processing room or automatically using Tissue Genesis technology.

According to Dr. Yoshimura, using stem cell-enriched fat during grafting may boost the safety and effectiveness of the traditional methods. The fat stem cells may even have a therapeutic effect, similar to bone marrow-derived stem cells, which can aid in the healing process following lipoinjection.

These advances in stem cell technology are certainly promising, however, Dr. Yoshimura stresses that the long term safety and efficacy of CAL still needs to be studied. Patients with a low BMI may also be poor candidates for fat grafting as issues may arise in harvesting enough fat and stem cells to make the procedure successful.