Author(s)

Hilkka H. Peltoniemi^1*, Asko Salmi¹, Kai Saariniemi², Hannu Kuokkanen², Christian Herold³

¹Plastic Surgery Hospital KL, Helsinki, Finland.
²Department of Plastic Surgery, Tampere University Hospital, Tampere, Finland.
³Klinik für Plastische und Asthetische Chirurgie, Sana Klinikum Hameln-Pyrmont, Hameln, Germany.

Objective: Although research increasingly underlines the theoretical importance of adipose-derived stem cells (ASC) for successful fat transplantation, we could not prove this notion in cosmetic breast augmentation. Stem-cell-enriched breast fat transplantation did not yield better results than grafting based on the WAL (water-jet assisted liposuction) technique in terms of volume persistence. To overcome inter-individual variation, intra-individual comparison was performed. Material and Methods: Four women underwent breast augmentation utilizing WAL fat transplantation with and without ex-vivo ASC isolation performed with the Multistation System. All patients underwent two fat transplantations for breast augmentation. In the first procedure, the left breast was augmented with stem-cell-enriched fat grafts and the right with plain WAL fat grafts. In the second surgery, the lipofilling was performed the other way round to exclude intra-individual differences in fat cell persistence. Results: MRI volumetry revealed a mean volume survival of 56% of the whole (watery) graft in the breasts with WAL only and 56% in the breasts with WAL and stem cell enrichment. While centrifugation of the WAL grafts demonstrated an average adipose content of 68%, the average volume survival of the adipose tissue itself was 83% in the breasts augmented with WAL only and 83% in those with WAL with stem cell enrichment. Conclusion: Breast augmentation by means of lipofilling using WAL alone is faster and more inexpensive, carrying a lower risk of contamination and offering an equal take rate. We do not see any advantage in stem-cell-enrichment in cosmetic fat transplantation to the breast.

Fat Transplantation, Cell-Assisted Lipotransfer, Water-Jet-Assisted Liposuction

Peltoniemi, H. , Salmi, A. , Saariniemi, K. , Kuokkanen, H. and Herold, C. (2016) Enrichment with Adipose-Derived Stem Cells Does Not Enhance Water-Jet Fat Graft Survival in the Breast—A Prospective Comparative Study. Surgical Science, 7, 485-495. doi: 10.4236/ss.2016.711065.