Aesthetic Plastic Surgery

, Volume 35, Issue 6, pp 1022–1030 | Cite as

Autologous Cell-Enriched Fat Grafting for Breast Augmentation

  • Tatsuro KamakuraEmail author
  • Kohei Ito
Original Article


Autologous fat grafting for breast augmentation has faced some historical hurdles. However, in recent years it has been gaining acceptance from the medical community. This prospective, nonrandomized open-label study of 20 Japanese women supports the use of autologous fat grafting in breast augmentation and explores enhancement of fat graft tissue with autologous adipose-derived regenerative cells (ADRCs). After adipose harvesting using syringe liposuction, the tissue is processed in the Celution 800 System®, which washes the graft and isolates ADRCs. The average cells per gram of harvested adipose tissue was 3.42 × 105, and the mean cell viability measured using an automated cell counting system before graft delivery was 85.3%. All patients demonstrated improvement in circumferential breast measurement (BRM) from their baseline state, and breast measurements were stable by 3 months after surgery. The mean BRM 9 months after surgery had increased 3.3 cm from preoperative measurements. Through 9 months, overall physician satisfaction was 69% and patient satisfaction was 75%. No serious or unexpected adverse events were reported, and the procedure was safe and well tolerated in all patients. Postoperative cyst formation was seen in two patients. These prospective results demonstrate that ADRC-enriched fat grafts processed with a closed automated system maintain high cell viability and that the procedure is safe and effective, with all patients showing improvement after a single treatment.


Adipose-derived regenerative cells Adipose tissue graft Autologous fat graft Breast augmentation Cell-enriched graft Celution Stem cells 



Editorial assistance and technical support for the Celution 800 System® were provided by Cytori Therapeutics. The authors have no other conflicts of interest and did not receive any other support, financial or otherwise, from Cytori Therapeutics.

Conflict of interest

The authors have no other conflicts of interest and did not receive any other support, financial or otherwise, from Cytori Therapeutics.


  1. 1.
    Czerny V (1895) Plastischer Ersatz der Brusthus durch ein Lipoma. Zentralbl Chir 27:72Google Scholar
  2. 2.
    Coleman S, Saboeiro A (2007) Fat grafting to the breast revisited: safety and efficacy. Plast Reconstr Surg 119:775–785PubMedCrossRefGoogle Scholar
  3. 3.
    Har-Shai Y, Lindenbaum ES, Gamliel-Lazarovich A, Beach D, Hirshowitz B (1999) An integrated approach for increasing the survival of autologous fat grafts in the treatment of contour defects. Plast Reconstr Surg 104:945–954PubMedCrossRefGoogle Scholar
  4. 4.
    Shiffman MA, Mirrafati S (2001) Fat transfer techniques: the effect of harvest and transfer methods on adipocyte viability and review of the literature. Dermatol Surg 27:819–826PubMedCrossRefGoogle Scholar
  5. 5.
    Khouri R, Del Vecchio D (2010) Breast reconstruction and augmentation using pre-expansion and autologous fat transplantation. Clin Plast Surg 36:269–280CrossRefGoogle Scholar
  6. 6.
    Toledo LS, Mauad R (2006) Fat injection: a 20-year revision. Clin Plast Surg 33:47–53, viGoogle Scholar
  7. 7.
    Butterwick KJ, Nootheti PK, Hsu JW, Goldman MP (2007) Autologous fat transfer: an in-depth look at varying concepts and techniques. Facial Plast Surg Clin North Am 15:99–111, viiiGoogle Scholar
  8. 8.
    Yoshimura K, Shigeura T, Matsumoto D, Sato T, Takaki Y, Aiba-Kojima E, Sato K, Inoue K, Nagase T, Koshima I, Gonda K (2006) Characterization of freshly isolated and cultured cells derived from the fatty and fluid portions of liposuction aspirates. J Cell Physiol 208:64–76PubMedCrossRefGoogle Scholar
  9. 9.
    Zuk PA, Zhu M, Ashjian P, De Ugarte DA, Huang JI, Mizuno H, Alfonso ZC, Fraser JK, Benhaim P, Hedrick MH (2002) Human adipose tissue is a source of multipotent stem cells. Mol Biol Cell 13:4279–4295PubMedCrossRefGoogle Scholar
  10. 10.
    Gimble JM, Kats AJ, Bunnell BA (2007) Adipose-derived stem cells for regenerative medicine. Circ Res 100:1249–1260PubMedCrossRefGoogle Scholar
  11. 11.
    Lendeckel S, Jodicke A, Christophis P, Heidinger K, Wolff J, Fraser JK, Hedrick MH, Berthold L, Howaldt HP (2004) Autologous stem cells (adipose) and fibrin glue used to treat widespread traumatic calvarial defects: case report. J Craniomaxillofac Surg 32:370–373PubMedCrossRefGoogle Scholar
  12. 12.
    Miranville A, Heeschen C, Sengenes C, Curat CA, Busse R, Bouloumie A (2004) Improvement of postnatal neovascularization by human adipose-derived stem cells. Circulation 110:349–355PubMedCrossRefGoogle Scholar
  13. 13.
    Planat-Benard V, Silvestre JS, Cousin B, Andre M, Nibbelink M, Tamarat R, Clergue M, Manneville C, Saillan-Barreau C, Duriez M, Tedgui A, Levy B, Penicaud L, Casteilla L (2004) Plasticity of human adipose lineage cells toward endothelial cells: physiological and therapeutic perspectives. Circulation 109:656–663PubMedCrossRefGoogle Scholar
  14. 14.
    Strem BM, Hicok KC, Zhu M, Wulur L, Alfonso Z, Schreiber RE, Fraser JK, Hedrick MH (2005) Multipotential differentiation of adipose tissue-derived stem cells. Keio J Med 54:132–141PubMedCrossRefGoogle Scholar
  15. 15.
    Schenke-Layland K, Strem BM, Jordan MC, Deemedio MT, Hedrick MH, Roos KP, Fraser JK, Maclellan WR (2009) Adipose tissue-derived cells improve cardiac function following myocardial infarction. J Surg Res 153:217–223PubMedCrossRefGoogle Scholar
  16. 16.
    Rehman J, Traktuev D, Li J, Merfeld-Clauss S, Temm-Grove CJ, Bovenkerk JE, Pell CL, Johnstone BH, Considine RV, March KL (2004) Secretion of angiogenic and antiapoptotic factors by human adipose stromal cells. Circulation 109:1292–1298PubMedCrossRefGoogle Scholar
  17. 17.
    Sadat S, Gehmert S, Song YH, Yen Y, Bai X, Gaiser S, Klein H, Alt E (2007) The cardioprotective effect of mesenchymal stem cells is mediated by IGF-I and VEGF. Biochem Biophys Res Commun 363:674–679PubMedCrossRefGoogle Scholar
  18. 18.
    Kitamura K, Mori M, Sugimachi K (2007) Stem cell augmented reconstruction: a new hope for reconstruction after breast conservation therapy (abstract). Breast Cancer Res Treat 106(Supp1):4071Google Scholar
  19. 19.
    Yoshimura K, Suga H, Eto H (2009) Adipose-derived stem/progenitor cells: roles in adipose tissue remodeling and potential tissue for soft tissue augmentation. Regen Med 4:265–273PubMedCrossRefGoogle Scholar
  20. 20.
    Spear SL, Wilson HB, Lockwood MD (2005) Fat injection to correct contour deformities in the reconstructed breast. Plast Reconstr Surg 116:1300–1305PubMedCrossRefGoogle Scholar
  21. 21.
    Spear SL, Newman MK (2007) Discussion to fat grafting to the breast revisited: safety and efficacy. Plast Reconstr Surg 119:786–787CrossRefGoogle Scholar
  22. 22.
    Smahel J (1989) Experimental implantation of adipose tissue fragments. Br J Plast Surg 42:207–211PubMedCrossRefGoogle Scholar
  23. 23.
    Carvajal J, Patino J (2008) Mammographic findings after breast augmentation with autologous fat injection. Aesthetic Surg J 28:153–162CrossRefGoogle Scholar
  24. 24.
    Delay E, Garson D, Tousson G (2009) Fat injection to the breast: technique, results, and indications based on 880 procedures over 10 years. Aesthetic Surg J 29:360–376CrossRefGoogle Scholar
  25. 25.
    Delay E, Sinna R, Delaporte T, Flageul G, Tourasse C, Tousson G (2009) Patient information before aesthetic lipomolding (lipoaugmentation): a French plastic surgeon’s perspective. Aesthetic Surg J 29:386–395CrossRefGoogle Scholar
  26. 26.
    Yoshimura K, Sato K, Aoi N, Kurita M, Hirohi T, Harii K (2008) Cell-assisted lipotransfer for cosmetic breast augmentation: Supportive use of adipose-derived stem/stromal cells. Aesthetic Plast Surg 32:48–55PubMedCrossRefGoogle Scholar
  27. 27.
    Rigotti G, Marchi A, Montemezzi S et al (2008) Lipoaspirate transplant to treat breast conservative treatment side effects: evaluation of the risk to develop calcifications. In: Presented at the 87th annual American association of plastic surgeons (AAPS), meeting and aesthetic symposium, 5–8 April 2008Google Scholar
  28. 28.
    Missana MC, Laurent I, Barreau L, Balleyguier C (2007) Autologous fat transfer in reconstructive breast surgery: indications, technique, and results. Eur J Surg Oncol 33:685–690PubMedCrossRefGoogle Scholar
  29. 29.
    Leiberman AJ, Styblo T, Bostwich J (1997) Mammography of the postreconstruction breast. Plast Reconstr Surg 99:698–704CrossRefGoogle Scholar
  30. 30.
    Sickles E, Herzog K (1981) Mammography of the postsurgical breast. AJR Am J Roentgenol 136:585–588PubMedGoogle Scholar
  31. 31.
    Bilgen I, Ustan E, Memis A (2001) Fat necrosis of the breast: clinical, mammographic, and sonographic features. Eur J Radiol 39:92–99PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC and International Society of Aesthetic Plastic Surgery 2011

Authors and Affiliations

  1. 1.Cosmetic Surgery SeishinTokyoJapan

Personalised recommendations