Welcome to Cell – Enriched Solutions

Cell-Enriched Cosmetic Surgery harnesses the patient’s own fat and extracted fat-derived stem and regenerative cells to enhance areas on the body. This revolutionary option is currently available to patients in Europe. This cell-enriched procedure uses only natural components of the patient’s body.

Who are candidates for this procedure?

Patients need to be healthy and need to have an adequate supply of excess fat for this procedure.

What can this technique be used for?

There are many applications for cell-enriched fat grafting. In addition to breast augmentation, facial rejuvenation, others application areas include, but are not limited to:

The doctor will determine if fat can be harvested. If there is no excess fat – or not enough of it – the doctor may recommend using an alternative product, possibly in combination with cell-enriched fat to achieve the desired results.

Will the patient be able to feel the difference between grafted and non-grafted area?

The grafted areas look and feel natural just like other areas of your body.

What are traditional choices to restore volume in cosmetic surgery?

Why the addition of CELLS. What is the difference to traditional lipofilling?

Clinical experience to date has demonstrated that cell-enriched fat grafting is safe. In addition, cell-enriched fat grafting yields durable and long-lasting results for most patients. While further data needs to be collected to warrant or guarantee the results, the fat-derived stem and regenerative cells are believed to allow the transplanted graft to survive by promoting the creation and maintenance of new blood vessels. During liposuction, the fat is cut off from the blood supply that keeps it alive. Upon transplantation into the desired area, new blood vessels need to form in order for the transplanted graft to receive the oxygen and other nutrients essential for survival.

Often times, it is asked whether this procedure can influence the occurrence of breast cancer. There is no evidence linking the delivery of cell-enriched fat to the breast with the development of breast cancer, nor does the procedure impede the diagnosis of cancer in the future.

Like any surgical procedure, cell-enriched cosmetic surgery poses certain risks. Any risks generally associated with anesthesia, liposuction, or general surgery may apply. The possible side effects of re-implanting fat enriched with regenerative cells into the body are not completely known — however, it is believed that they would be generally the same as possible side effects of standard fat transfers. The possible side effects and complications are generally minor and recovery is usually fast.

Augmenting the breast with the patient’s own fat tissue first became popular in the 1980s. Professional organizations, including ASPS and ASAPS, initially cautioned its members against the technique because it was thought to be difficult to distinguish on mammograms between calcifications associated with breast cancer and calcifications associated with fat transfer. Today, with access to sophisticated radiology and modern digital mammography equipment, radiologists can determine the difference between any calcifications that may form as the result of the procedure and a tumor.

In the case of breast augmentation, by how many cup sizes can the breast be increased?

This procedure offers about a one to two-cup size enlargement and the enlargement will depend on the amount of spare fat the patient has.

ADRCs are a heterogeneous or mixed population of uncultured regenerative cells, including stem cells, endothelial progenitor cells, tissue resident macrophages, microvascular cells and smooth muscle cells that reside within adipose tissue (fat). For liposuction procedures, this tissue is generally considered to be medical waste.

What is the value of a mixed cell population?

Most experts agree a mixed population of uncultured (fresh) regenerative cell types found in adipose tissue is most effective. In contrast, the majority of stem cell research models use isolated or pure cell populations (i.e. rely on cell culture). Although cell culture can increase the number and purity of a desired cell type, this process eliminates the other useful regenerative cell populations. A mixed population of fresh cells has had positive outcomes while avoiding the difficulties commonly associated with cell culture or other cell selection methods.

What other applications for ADRCs are being investigated?

While there are no ADRC-based therapies approved for the treatment of a specific disease state today, ADRCs are currently under preclinical or clinical investigation for a variety of medical conditions and potential applications, including, but not limited to, autologous fat grafting, heart disease, renal injury, Parkinson’s disease, arthritis, spinal cord injury, corneal repair and pulmonary disease, among others.

What are the proposed mechanisms for how ADRCs work?

There are numerous mechanisms of action by which ADRCs have been shown preclinically to have significant impact on certain diseases or medical conditions. For example, preclinical studies have shown that ADRCs improve perfusion to ischemic tissue through accelerating the rate of growth of new blood vessels, modulate the inflammatory response through secretion of various cytokines and chemokines, and reduce cell death, thereby creating a microenvironment favoring healing over scarring. In addition, preclinical ADRC research has shown the cells have some capacity to differentiate into mature cell phenotypes, enabling the replacement of tissue or structures. The ability to provide benefit through a variety of mechanisms in various disease states is consistent with the emerging opinion of the broader scientific community as to how regenerative cells function.

Are ADRCs derived from embryos?

ADRCs are not derived from embryos. They are adult cells that are extracted from adult adipose (fat) tissue by a process of washing, enzymatic digestion and filtration.

How do ADRCs compare to adult stem cells from bone marrow?

ADRCs include a mixture of cells types, including mesenchymal-like adult stem cells. Adipose tissue is the richest known source of adult stem cells with properties similar to mesenchymal stem cells from bone marrow, comprising 1-2% (and as much as 5%) of the cell population. By comparison, the population of mesenchymal stem cells found in bone marrow only comprises 0.0004% of all cells.

How do ADRCs compare to cord blood stem cells?

ADRCs include a mixture of cells types, including mesenchymal-like stem cells, endothelial progenitor cells, tissue resident macrophages, microvascular cells and smooth muscle cells. These cells are believed to exhibit a number of important properties, including the release of chemicals or proteins that contribute to the formation of new blood vessels. Cord blood is mainly comprised of hematopoietic cells, including hematopoietic stem cells, which ultimately give rise to multiple types of blood cells. Hematopoietic stem cells are mainly used to treat blood diseases such as leukemia; ADRCs are potentially more versatile than hematopoietic stem cells. In addition, cord blood cells must be banked within a limited window of time following birth, whereas adipose-derived cells can be banked at any time during a donor’s lifetime. This allows adults whose cord blood cells were not banked at birth the opportunity to preserve their cells.

Do the cells grow tissue?

Research has shown that growth of breast tissue at puberty and during and following pregnancy as well as simple maintenance of breast tissue is managed by breast stem cells. These are cells that are capable of generating the different functional cell types that make up the milk-producing structures of the breast. However, the breast is not made solely of milk-producing tissue, it also includes breast adipose tissue (fat). This tissue is maintained by different cells.

Adipose tissue is unusual in that it can undergo large increases and decreases in size as an individual gains or loses weight. In other tissues increased size occurs almost exclusively by generating more cells. Adipose is different; rather than growing by making new cells adipose grows by having existing fat cells grow bigger. In essence, fat cells are like tiny balloons that inflate as they accumulate fat during weight gain and deflate as the individual loses weight. In addition, research has shown that individual fat cells are relatively long-lived with an average age of approximately 10 years. Consequently, fat cell replacement requirements are very low such that the body replaces only about 8% of all fat cells each year. Because of this the stem cells that give rise to new fat cells are generally very quiet. For example, adipose stem cells are approximately 1,000 times less active than stem cells responsible for maintaining blood cells or intestine.

However, when individual fat cells inflate the whole tissue gets bigger. When this happens the blood vessels within the adipose must also grow. Unlike fat cells, the cells that make up these vessels can’t simply inflate or stretch sufficiently to meet the need. Rather, when adipose tissue size increases regenerative cells responsible for adipose blood vessels generate longer vessels by generating new cells. In fact, it has been shown that the regenerative cells responsible for managing blood vessels in adipose tissue are different than those in other tissues in terms of their ability to rapidly increase or decrease in response to weight gain or loss.

What does this mean for fat grafting into the breast?

First, there is no evidence that the fat graft or added regenerative cells generate new milk-producing breast tissue. As noted above, breast size is the combination of the volume of milk-forming glandular tissue and the volume of adipose tissue. A fat graft adds to the adipose component without affecting, in any way, the volume of milk-forming tissue. Secondly, the special biology of adipose blood vessel cells means that they are ideally suited for growing the new blood vessels needed to ensure that the transferred fat survives. As a result, within a few months after fat grafting the transferred tissue becomes integrated within the breast and is essentially normal breast adipose.

It is well known that when women gain or lose weight there is often a corresponding increase or decrease in breast size. This is because the fat cells within breast adipose tissue inflate and deflate with weight change in much the same way as fat cells throughout the body. The same thing will happen with the grafted fat. If a women who has received a fat graft into the breast gains weight it is reasonable to expect that there will be an increase in breast size due to inflation of fat cells within the adipose that was originally present as well as those within the grafted adipose tissue. Current evidence strongly indicates that this is the only means by which a fat graft can cause a further increase in breast size after the fat graft becomes fully integrated with the rest of the breast adipose.

That is, breast reconstruction or augmentation using fat grafting works by increasing the total volume of adipose (fat) tissue within the breast. It has no effect on the volume of milk-producing (glandular) tissue. Because the transferred fat is normal adipose tissue it will respond to weight gain and loss in much the same way as adipose throughout the body, increasing and decreasing in size as individual fat cells inflate and deflate.