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Improving Autologous Fat Grafting in Regenerative Surgery through Stem Cell-Assisted Lipotransfer

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Abstract

Autologous fat transplantation -i.e., lipofilling- has become a promising and popular technique in aesthetic and reconstructive surgery with several application such as breast reconstruction, facial and hand rejuvenation. However, the use of this technology is still limited due to an unpredictable and low graft survival rate (which ranges from 25%-80%). A systematic literature review was performed by thoroughly searching 12 terms using the PubMed database. The objective of this study is to present the current evidence for the efficacy of adjuvant regenerative strategies and cellular factors, which have been tested to improve fat graft retention. We present the main results (fat retention rate, histological analysis for pre-clinical studies and satisfaction/ complication for clinical studies) obtained from the studies of the three main fat grafting enrichment techniques: platelet-rich plasma (PRP), the stromal vascular fraction (SVF) and adipose-derived stem cells (ADSCs) and discuss the promising role of recent angiogenic cell enrichment that could induce early vascularization of fat graft. All in all, adding stem or progenitor cells to autologous fat transplantation might become a new concept in lipofilling. New preclinical models should be used to find mechanisms able to increase fat retention, assure safety and transfer these technologies to a good manufacturing practice (GMP) compliant facility, to manufacture an advanced therapy medicinal product (ATMP).

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Acknowledgements

The central illustration/figure 1 was created with BioRender.com

Funding

This work was supported by grants from the PROMEX STIFTUNG FUR DIE FORSCHUNG foundation that we deeply thank. Benjamin Debuc received a grant from AP-HP for research project.

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Authors and Affiliations

  1. Department of Plastic Surgery, European Georges Pompidou Hospital, AP-HP, Paris, France

    Benjamin Debuc

  2. Innovative Therapies in Haemostasis, INSERM UMR-S 1140, University of Paris, F-75006, Paris, France

    Benjamin Debuc, Nicolas Gendron, Audrey Cras, Jeanne Rancic, Aurélien Philippe, Alexandre G. Lellouch & David M. Smadja

  3. Department of Hematology, European Georges Pompidou Hospital, AP-HP, 20 Rue Leblanc, F-75015, Paris, France

    Nicolas Gendron, Aurélien Philippe & David M. Smadja

  4. Department of Cell Therapy, Saint Louis Hospital, AP-HP, F-75010, Paris, France

    Audrey Cras

  5. Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    Curtis L. Cetrulo Jr. & Alexandre G. Lellouch

  6. Shriners Hospitals for Children-Boston, Boston, MA, USA

    Curtis L. Cetrulo Jr. & Alexandre G. Lellouch

  7. Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Boston, MA, USA

    Curtis L. Cetrulo Jr. & Alexandre G. Lellouch

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Contributions

BD, NG, AGL and DMS wrote the paper. AGL and DMS organized the work. All authors contributed to manuscript revision, read and approved the submitted version. Authors declare that the submitted work is original and has not been published before (neither in English nor in any other language) and that the work is not under consideration for publication elsewhere.

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Correspondence to David M. Smadja.

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Debuc, B., Gendron, N., Cras, A. et al. Improving Autologous Fat Grafting in Regenerative Surgery through Stem Cell-Assisted Lipotransfer. Stem Cell Rev and Rep 19, 1726–1754 (2023). https://doi.org/10.1007/s12015-023-10568-4

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