Over the last few years, autologous fat grafting has been at the forefront of aesthetic plastic surgery clinical practice, since it provides exceptional results for the treatment of soft-tissue contour deformities (1, 2). Similar to bone marrow, the adipose tissue is derived from the embryonic mesenchyme and contains a supportive stromal vascular fraction (SVF) that can be easily isolated (3). Typically, SVF from adipose tissue contains different types of cells, including endothelial cells, smooth muscle cells, pericytes, leukocytes and pre-adipocytes, otherwise named as adipose-derived stem cells (ASCs) (4).The potential of ASCs to differentiate into diverse cell types both in vitro and in vivo, offers outstanding opportunities for their clinical application as therapeutic agents (5). In particular, preclinical studies have revealed their capacity to differentiate toward the osteogenic, adipogenic, myogenic, and chondrogenic lineages (6, 7). Nevertheless, adipose tissue displays a significant heterogeneity in terms of stem cell yield, proliferation, and differentiation capacity not only among individuals, but even when comparing different fat depots within one individual (8). 1229This article is freely accessible online.Correspondence to: Diamantis I. Tsilimigras, MD,

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Enrichment of fat grafts with adipose-derived stem cells (ASCs) has gained popularity due to promising preliminary results. Herein, we present two patients who were treated with ASC-enriched fat grafts following mastectomy and breast reconstruction with implants. Both exhibited favorable outcomes achieving a significant improvement of breast defects and asymmetries.

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