Autologous Fat Grafting in the Breast: Critical Points and Technique Improvements

Hivernaud, Vincent; Lefourn, Bruno; Guicheux, Jérôme; Weiss, Pierre; Festy, Franck; Girard, Anne-Claire; Roche, Régis

doi:10.1007/s00266-015-0503-y

Cited by 49 publications

(25 citation statements)

References 78 publications

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“…Adipocytes are sensitive to hypoxia and as a consequence prone to apoptosis (Eto et al , ; Kato et al , ; Suga et al , ). Depending on the technique and time that is required for harvesting and lipofilling (Fisher et al , ; Pu et al , ), 40–90% of the injected lipograft volume will remain (Hivernaud et al , ), while the rest is resorbed within months after grafting. Oily cysts may remain in the grafted area as a consequence of this fat necrosis.…”

Section: Lipofilling On a Cellular Levelmentioning

confidence: 99%

The power of fat and its adipose-derived stromal cells: emerging concepts for fibrotic scar treatment

Spiekman

Dongen

Willemsen

et al. 2017

J Tissue Eng Regen Med

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Lipofilling or lipografting is a novel and promising treatment method for reduction or prevention of dermal scars after injury. Ample anecdotal evidence from case reports supports the scar‐reducing properties of adipose tissue grafts. However, only a few properly controlled and designed clinical trials have been conducted thus far on this topic. Also, the underlying mechanism by which lipofilling improves scar aspect and reduces neuropathic scar pain remains largely undiscovered. Adipose‐derived stromal or stem cells (ADSC) are often described to be responsible for this therapeutic effect of lipofilling. We review the recent literature and discuss anticipated mechanisms that govern anti‐scarring capacity of adipose tissue and its ADSC. Both clinical and animal studies clearly demonstrated that lipofilling and ADSC influence processes associated with wound healing, including extracellular matrix remodelling, angiogenesis and modulation of inflammation in dermal scars. However, randomized clinical trials, providing sufficient level of evidence for lipofilling and/or ADSC as an anti‐scarring treatment, are lacking yet warranted in the near future. © 2017 The Authors Journal of Tissue Engineering and Regenerative Medicine Published by John Wiley & Sons Ltd

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Section: Lipofilling On a Cellular Levelmentioning

confidence: 99%

The power of fat and its adipose-derived stromal cells: emerging concepts for fibrotic scar treatment

Spiekman

Dongen

Willemsen

et al. 2017

J Tissue Eng Regen Med

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“…With the overall survival rates increasing, more and more patients select breast reconstruction as a way to reduce the disabling effects of the mutilation . Autologous fat graft has been used as a filler for breast reconstruction in breast cancer patients following conservative surgery . That is partly because the ADSCs in adipose tissues (about 10 5 ADSCs per gram adipose tissue) can secrete numerous cytokines to benefit the proliferation and angiogenesis of the graft which make it a better graft than other materials .…”

Section: Introductionmentioning

confidence: 99%

Human Adipose-Derived Mesenchymal Stem Cell-Secreted CXCL1 and CXCL8 Facilitate Breast Tumor Growth By Promoting Angiogenesis

Wang¹,

Liu²,

Jiang

et al. 2017

Stem Cells

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Autologous adipose tissue or adipose tissue with additive adipose-derived mesenchymal stem cells (ADSCs) is used in the breast reconstruction of breast cancer patients who undergo mastectomy. ADSCs play an important role in the angiogenesis and adipogenesis, which make it much better than other materials. However, ADSCs may promote residual tumor cells to proliferate or metastasize, and the mechanism is still not fully understood. In this study, we demonstrated that human ADSCs (hADSCs) could facilitate tumor cells growth after co-injection with MCF7 and ZR-75-30 breast cancer cells (BCCs) by promoting angiogenesis, but hADSCs showed limited effect on the growth of MDA-MB-231 BCCs. Intriguingly, compared with ZR-75-30 tumor cells, MCF7 tumor cells were more potentially promoted by hADSCs in the aspects of angiogenesis and proliferation. Consistent with this, cytokine and angiogenesis array analyses showed that after co-injection with hADSCs, the CXCL1 and CXCL8 concentration were significantly increased in MCF7 tumor, but only moderately increased in ZR-75-30 tumor and did not increase in MDA-MB-231 tumor. Furthermore, we found that CXCL1/8 were mainly derived from hADSCs and could increase the migration and tube formation of human umbilical vein endothelial cells (HUVECs) by signaling via their receptors CXCR1 and CXCR2. A CXCR1/2-specific antagonist (SCH527123) attenuated the angiogenesis and tumor growth in vivo. Our findings suggest that CXCL1/8 secreted by hADSCs could promote breast cancer angiogenesis and therefore provide better understanding of safety concerns regarding the clinical application of hADSCs and suggestion in further novel therapeutic options. Stem Cells 2017;35:2060-2070.

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“…Current literature suggests that the efficacy of fat grafting is highly variable, with graft take ranging from 20 to 80 % [22, 31]. As a result, plastic surgeons often counsel patients that only half of the transferred fat will engraft.…”

Section: Introductionmentioning

confidence: 99%

Fat Grafting with Tissue Liquefaction Technology as an Adjunct to Breast Reconstruction

et al. 2016

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BackgroundTissue liquefaction technology (TLT) delivers warmed saline from the liposuction cannula tip at low pressure pulses to disaggregate adipocytes. This technology differs significantly from that used in other liposuction devices including water jet-assisted liposuction. Here we introduce our early experience with this technology in the setting of fat transfer for revision breast reconstruction.MethodsA retrospective chart review of 136 consecutive patients who underwent fat harvest with TLT and subsequent transfer into 237 breast reconstructions was conducted at a single institution. This two-surgeon series examined donor and recipient site complication rates over a median follow-up of 143 days [87–233].ResultsThe overall complication rate was 28.7 %, of which the majority (22.1 %) was fat necrosis at the recipient site as documented by any clinical, imaging, or pathologic evidence. The abdomen served as the donor site for half of the cases. Donor site complications were limited to widespread ecchymosis of the donor site notable in 10.4 % of cases. Twenty-five percent of patients had received postmastectomy radiotherapy prior to fat transfer. Prior to revision with fat transfer, implant-based breast reconstruction was used in 75.5 % of cases, and autologous flaps in the remainder. Fat transfer was combined with other reconstructive procedures 94.1 % of the time.ConclusionsTLT can be used to harvest adipocytes for fat transfer with donor site morbidity and recipient site complications comparable to other modalities. The efficiency and quality of harvested fat makes this technology appealing for wide spread adoption during fat transfer.Level of Evidence IVThis journal requires that the authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

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Autologous Fat Grafting in the Breast: Critical Points and Technique Improvements

Cited by 49 publications

References 78 publications

The power of fat and its adipose-derived stromal cells: emerging concepts for fibrotic scar treatment

The power of fat and its adipose-derived stromal cells: emerging concepts for fibrotic scar treatment

Human Adipose-Derived Mesenchymal Stem Cell-Secreted CXCL1 and CXCL8 Facilitate Breast Tumor Growth By Promoting Angiogenesis

Fat Grafting with Tissue Liquefaction Technology as an Adjunct to Breast Reconstruction

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