Cellest Plastic Surgery Clinic, Altzeren sk. No: 5, Levent, Istanbul, Turkey.
Aesthetic Plast Surg. 2011 Dec;35(6):965-71. doi: 10.1007/s00266-011-9716-x. Epub 2011 Apr 13.
Autologous fat transplantation is frequently used for a variety of cosmetic treatments and difficult reconstructive indications such as involutional disorders, hemifacial atrophy, sequelae of radiation therapy, or similar problems. However, the limitations of fat transplantation are well known in such difficult cases, particularly the long-term unpredictability of volume maintenance. The ideal method of preparing autologous fat grafts optimizes tissue survival and reduces the variability of outcomes. We propose that enriching traditionally prepared fat grafts with adipose-derived regenerative cells (ADRCs) represents one such method.
Using a staged approach, we performed cell-enriched fat transfer by injecting autologous ADRCs into soft tissue that was recently grafted using traditional methods of fat transfer. Over a 3-year period, data were prospectively collected from 29 patients who underwent a single session of stem cell-enriched tissue injections (SET).
Cell-enriched grafts ranged in volume from 10 to 390 cc per recipient area and were obtained by manual or automated processes. The mean follow-up period was 10 months. Postoperative atrophy of the injected tissue was minimal and subjectively did not change after 8 weeks. Of note, historically reported rates of atrophy range from 20 to 80%. All patients were satisfied with the primary result with no need for a secondary session except for the cosmetic cases.
These preliminary results suggest that SET is safe and may provide superior results compared to traditional fat grafting. By performing the procedure in a staged approach, operating room expenses are minimized, which ultimately decreases the cost of the procedure. Adipose-derived regenerative cells may mitigate early ischemia by increasing angiogenesis, decreasing apoptosis, and modulating the local inflammatory response. This technique may be of particular value to the surgeon when grafting high volumes of fat or when faced with hostile recipient area conditions, including fibrosis and post radiation.
自体脂肪移植常用于各种美容治疗和困难的重建指征，如退行性病变、半面萎缩、放射治疗后遗症或类似问题。然而，在这些困难的情况下，脂肪移植的局限性是众所周知的，特别是体积维持的长期不可预测性。理想的自体脂肪移植制备方法可以优化组织存活率并降低结果的可变性。我们提出，用脂肪来源的再生细胞（ADRC）来丰富传统制备的脂肪移植物是这样一种方法。
我们采用分阶段的方法，通过将自体 ADRC 注射到最近使用传统脂肪移植方法移植的软组织中，进行细胞富集脂肪转移。在 3 年的时间里，我们对 29 名接受干细胞富集组织注射（SET）单次治疗的患者的数据进行了前瞻性收集。
细胞富集移植物的体积为每个受区 10 至 390cc，通过手动或自动过程获得。平均随访时间为 10 个月。注射组织的术后萎缩极小，8 周后主观上没有变化。值得注意的是，历史上报告的萎缩率范围为 20%至 80%。除了美容病例外，所有患者对初次治疗结果均满意，无需再次治疗。
这些初步结果表明，SET 是安全的，与传统脂肪移植相比，可能提供更好的效果。通过分阶段进行手术，可最大限度地减少手术室费用，从而降低手术成本。脂肪来源的再生细胞可通过增加血管生成、减少细胞凋亡和调节局部炎症反应来减轻早期缺血。当移植大量脂肪或面对纤维化和放射后等恶劣的受区条件时，这种技术对外科医生可能特别有价值。
