Skip to main content

Advertisement

SpringerLink
Log in

Fat Grafting Versus Adipose-Derived Stem Cell Therapy: Distinguishing Indications, Techniques, and Outcomes

  • Review
  • Published:
Aesthetic Plastic Surgery Aims and scope Submit manuscript

Abstract

With adipose-derived stem cells (ASCs) at the forefront of research and potential clinical applications, it is important that clinicians be able to distinguish them from the fat grafting currently used clinically and to understand how the two approaches relate to one another. At times, there has been confusion in clinically considering the two therapies to be the same. This report is aimed at distinguishing clearly between fat grafting and ASC therapy with regard to the indications, harvesting, processing, application techniques, outcomes, and complications. Findings have shown that autologous fat transfer, a widely used procedure for soft tissue augmentation, is beneficial for reconstructive and cosmetic procedures used to treat patients with volume loss due to disease, trauma, congenital defects, or the natural process of aging. On the other hand, ASCs have been identified as an ideal source of cells for regenerative medicine, with the potential to serve as soft tissue therapy for irradiated, scarred, or chronic wounds. Recent advances in tissue engineering suggest that the supplementation of fat grafts with ASCs isolated in the stromal vascular fraction may increase the longevity and quality of the fat graft. Research suggests that ASC supplementation may be a great clinical tool in the future, but more data should be acquired before clinical applications.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Rigotti G, Marchi A, Galie M, Baroni G, Benati D, Krampera M et al (2007) Clinical treatment of radiotherapy tissue damage by lipoaspirate transplant: a healing process mediated by adipose-derived adult stem cells. Plast Reconstr Surg 119:1409–1422 discussion 23–24

    Article  PubMed  CAS  Google Scholar 

  2. Newman N. Stem cell lift. Retrieved 14 October 2010 at www.Stem-Cell-Lift.com

  3. Giampapa V. Stem cell facelift. Plastic Surgery Center Internationale. Retrieved 14 October 2010 at http://www.youthfulneck.com/stem-cell-face-lifts.htm

  4. Kaufman MR, Bradley JP, Dickinson B, Heller JB, Wasson K, O’Hara C et al (2007) Autologous fat transfer national consensus survey: trends in techniques for harvest, preparation, and application, and perception of short- and long-term results. Plast Reconstr Surg 119:323–331

    Article  PubMed  CAS  Google Scholar 

  5. Bai X, Yan Y, Song YH, Seidensticker M, Rabinovich B, Metzele R et al (2010) Both cultured and freshly isolated adipose tissue-derived stem cells enhance cardiac function after acute myocardial infarction. Eur Heart J 31:489–501

    Article  PubMed  CAS  Google Scholar 

  6. Jack GS, Zhang R, Lee M, Xu Y, Wu BM, Rodriguez LV (2009) Urinary bladder smooth muscle engineered from adipose stem cells and a three-dimensional synthetic composite. Biomaterials 30:3259–3270

    Article  PubMed  CAS  Google Scholar 

  7. Harris LJ, Abdollahi H, Zhang P, McIlhenny S, Tulenko TN, Dimuzio PJ (2011) Differentiation of adult stem cells into smooth muscle for vascular tissue engineering. J Surg Res 168(2):306–314

    Google Scholar 

  8. Scherberich A, Muller AM, Schafer DJ, Banfi A, Martin I (2010) Adipose tissue-derived progenitors for engineering osteogenic and vasculogenic grafts. J Cell Physiol 225:348–353

    Article  PubMed  CAS  Google Scholar 

  9. Bunnell BA, Flaat M, Gagliardi C, Patel B, Ripoll C (2008) Adipose-derived stem cells: isolation, expansion, and differentiation. Methods 45:115–120

    Article  PubMed  CAS  Google Scholar 

  10. Zuk PA, Zhu M, Mizuno H, Huang J, Futrell JW, Katz AJ et al (2001) Multilineage cells from human adipose tissue: implications for cell-based therapies. Tissue Eng 7:211–228

    Article  PubMed  CAS  Google Scholar 

  11. Baer PC (2011) Adipose-derived stem cells and their potential to differentiate into the epithelial lineage. Stem Cells Dev 20(10):1805–1816

    Google Scholar 

  12. Jang S, Cho HH, Cho YB, Park JS, Jeong HS (2010) Functional neural differentiation of human adipose tissue-derived stem cells using bFGF and forskolin. BMC Cell Biol 11:25

    Article  PubMed  Google Scholar 

  13. Rubio D, Garcia-Castro J, Martín MC, de la Fuente R, Cigudosa JC, Lloyd AC, Bernad A (2005) Spontaneous human adult stem cell transformation. Cancer Res 65(8):3035–3039

    PubMed  CAS  Google Scholar 

  14. Neuber F (1893) Fat transplantation. Chir Kongr Verhandl Dsch Gesellch Chir 20:66

    Google Scholar 

  15. Bruning P (1919) Contribution a l’etude def greffes adipeuses. Bull Acad R Med Belgique 28:440

    Google Scholar 

  16. Brucker M, Sati S, Spangenberger A, Weinzweig J (2008) Long-term fate of transplanted autologous fat in a novel rabbit facial model. Plast Reconstr Surg 122:749–754

    Article  PubMed  CAS  Google Scholar 

  17. Mulliken JB (1977) Biographical sketch of Charles Conrad Miller, “featural surgeon”. Plast Reconstr Surg 59:175–184

    Article  PubMed  CAS  Google Scholar 

  18. Coleman SR (2001) Structural fat grafts: the ideal filler? Clin Plast Surg 28:111–119

    PubMed  CAS  Google Scholar 

  19. Ersek RA (1991) Transplantation of purified autologous fat: a 3-year follow-up is disappointing. Plast Reconstr Surg 87:219–227 discussion 28, 1991

    Article  PubMed  CAS  Google Scholar 

  20. Coleman SR (2006) Structural fat grafting: more than a permanent filler. Plast Reconstr Surg 118(3 Suppl):108S–120S

    Article  PubMed  CAS  Google Scholar 

  21. Moseley TA, Zhu M, Hedrick MH (2006) Adipose-derived stem and progenitor cells as fillers in plastic and reconstructive surgery. Plast Reconstr Surg 118(3 Suppl):121S–128S

    Article  PubMed  CAS  Google Scholar 

  22. Kaufman MR, Miller TA, Huang C, Roostaeian J, Wasson KL, Ashley RK et al (2007) Autologous fat transfer for facial recontouring: is there science behind the art? Plast Reconstr Surg 119:2287–2296

    Article  PubMed  CAS  Google Scholar 

  23. Garcia-Olmo D, Garcia-Arranz M, Herreros D, Pascual I, Peiro C, Rodriguez-Montes JA (2005) A phase I clinical trial of the treatment of Crohn’s fistula by adipose mesenchymal stem cell transplantation. Dis Colon Rectum 48:1416–1423

    Article  PubMed  Google Scholar 

  24. Puissant B, Barreau C, Bourin P, Clavel C, Corre J, Bousquet C et al (2005) Immunomodulatory effect of human adipose tissue-derived adult stem cells: comparison with bone marrow mesenchymal stem cells. Br J Haematol 129:118–129

    Article  PubMed  Google Scholar 

  25. Tanna N, Wan DC, Kawamoto HK, Bradley JP (2011) Craniofacial microsomia soft tissue reconstruction comparison: Inframammary extended circumflex scapular flap versus serial fat grafting. Plast Reconstr Surg 127:802–811

    Article  PubMed  CAS  Google Scholar 

  26. Illouz YG, Sterodimas A (2009) Autologous fat transplantation to the breast: a personal technique with 25 years of experience. Aesthetic Plast Surg 33:706–715

    Article  PubMed  Google Scholar 

  27. Rosing JH, Wong G, Wong MS, Sahar D, Stevenson TR, Pu LL (2011) Autologous fat grafting for primary breast augmentation: a systematic review. Aesthetic Plast Surg 35(5):882–890

    Google Scholar 

  28. Babovic S (2010) Complete breast reconstruction with autologous fat graft: a case report. J Plast Reconstr Aesthet Surg 63:e561–e563

    Article  PubMed  Google Scholar 

  29. Sarfati I, Ihrai T, Kaufman G, Nos C, Clough KB (2011) Adipose-tissue grafting to the postmastectomy irradiated chest wall: preparing the ground for implant reconstruction. J Plast Reconstr Aesthet Surg 64(9):1161–1166

    Google Scholar 

  30. Klinger M, Caviggioli F, Vinci V, Salval A, Villani F (2010) Treatment of chronic posttraumatic ulcers using autologous fat graft. Plast Reconstr Surg 126:154e–155e

    Article  PubMed  Google Scholar 

  31. U.S. Preventive Services Task Force Grade Definitions. May 2008 (updated May 2008). Retrieved 2 June 2011 at http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm

  32. Gutowski KA (2009) Current applications and safety of autologous fat grafts: a report of the ASPS fat graft task force. Plast Reconstr Surg 124:272–280

    Article  PubMed  CAS  Google Scholar 

  33. Yoshimura K, Sato K, Aoi N, Kurita M, Inoue K, Suga H et al (2008) Cell-assisted lipotransfer for facial lipoatrophy: efficacy of clinical use of adipose-derived stem cells. Dermatol Surg 34:1178–1185

    Article  PubMed  CAS  Google Scholar 

  34. 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 32:48–55; discussion 6–7

    Google Scholar 

  35. Garcia-Olmo D, Herreros D, De-La-Quintana P, Guadalajara H, Trebol J, Georgiev-Hristov T et al (2010) Adipose-derived stem cells in Crohn’s rectovaginal fistula. Case Report Med 2010:3, Article ID 961758

  36. Garcia-Olmo D, Herreros D, Pascual I, Pascual JA, Del-Valle E, Zorrilla J et al (2009) Expanded adipose-derived stem cells for the treatment of complex perianal fistula: a phase II clinical trial. Dis Colon Rectum 52:79–86

    Article  PubMed  Google Scholar 

  37. Garcia-Olmo D, Herreros D, Pascual M, Pascual I, De-La-Quintana P, Trebol J et al (2009) Treatment of enterocutaneous fistula in Crohn’s disease with adipose-derived stem cells: a comparison of protocols with and without cell expansion. Int J Colorectal Dis 24:27–30

    Article  PubMed  Google Scholar 

  38. Hwangbo S, Kim J, Her S, Cho H, Lee J (2010) Therapeutic potential of human adipose stem cells in a rat myocardial infarction model. Yonsei Med J 51:69–76

    Article  PubMed  Google Scholar 

  39. Strem BM, Hedrick MH (2005) The growing importance of fat in regenerative medicine. Trends Biotechnol 23:64–66

    Article  PubMed  CAS  Google Scholar 

  40. Valina C, Pinkernell K, Song YH, Bai X, Sadat S, Campeau RJ et al (2007) Intracoronary administration of autologous adipose tissue-derived stem cells improves left ventricular function, perfusion, and remodelling after acute myocardial infarction. Eur Heart J 28:2667–2677

    Article  PubMed  Google Scholar 

  41. Fu BC, Gao JH, Lu F, Li J (2010) Experimental study of the effect of adipose stromal vascular fraction cells on the survival rate of fat transplantation. Zhonghua Zheng Xing Wai Ke Za Zhi 26:289–294

    PubMed  Google Scholar 

  42. Jeong JH, Lee JH, Jin ES, Min JK, Jeon SR, Choi KH (2010) Regeneration of intervertebral discs in a rat disc degeneration model by implanted adipose-tissue-derived stromal cells. Acta Neurochir Wien 152:1771–1777

    Article  PubMed  Google Scholar 

  43. Tiryaki T, Findikli N, Tiryaki D (2011) Staged stem cell-enriched tissue (SET) injections for soft tissue augmentation in hostile recipient areas: a preliminary report. Aesthetic Plast Surg. [Epub ahead of print]

  44. Gimble JM, Guilak F, Bunnell BA (2010) Clinical and preclinical translation of cell-based therapies using adipose tissue-derived cells. Stem Cell Res Ther 1:19

    Article  PubMed  Google Scholar 

  45. Ryu HH, Lim JH, Byeon YE, Park JR, Seo MS, Lee YW et al (2009) Functional recovery and neural differentiation after transplantation of allogenic adipose-derived stem cells in a canine model of acute spinal cord injury. J Vet Sci 10:273–284

    Article  PubMed  Google Scholar 

  46. Prantl L, Muehlberg F, Navone NM, Song YH, Vykoukal J, Logothetis CJ et al (2010) Adipose tissue-derived stem cells promote prostate tumor growth. Prostate 70:1709–1715

    Article  PubMed  CAS  Google Scholar 

  47. Zimmerlin L, Donnenberg AD, Rubin JP, Basse P, Landreneau RJ, Donnenberg VS (2010) Regenerative therapy and cancer: in vitro and in vivo studies of the interaction between adipose-derived stem cells and breast cancer cells from clinical isolates. Tissue Eng Part A 17(1–2):93–106

    Google Scholar 

  48. Medicine CfEB. Oxford Centre for Evidence-Based Medicine: Levels of Evidence. March 2009 (updated 15 April 2011). Retrieved 2 June 2011 at http://www.cebm.net/index.aspx?o=1025

  49. Faustini M, Bucco M, Chlapanidas T, Lucconi G, Marazzi M, Tosca MC et al (2010) Nonexpanded mesenchymal stem cells for regenerative medicine: Yield in stromal vascular fraction from adipose tissues. Tissue Eng Part C Methods 16:1515–1521

    Article  PubMed  Google Scholar 

  50. Kurita M, Matsumoto D, Shigeura T, Sato K, Gonda K, Harii K et al (2008) Influences of centrifugation on cells and tissues in liposuction aspirates: optimized centrifugation for lipotransfer and cell isolation. Plast Reconstr Surg 121:1033–1041 discussion 42–43

    Article  PubMed  CAS  Google Scholar 

  51. Bucky LP, Percec I (2008) The science of autologous fat grafting: views on current and future approaches to neoadipogenesis. Aesthet Surg J 28:313–321 quiz 22–24, 2008

    Article  PubMed  Google Scholar 

  52. Keck M, Zeyda M, Gollinger K, Burjak S, Kamolz LP, Frey M et al (2010) Local anesthetics have a major impact on viability of preadipocytes and their differentiation into adipocytes. Plast Reconstr Surg 126:1500–1505

    Article  PubMed  CAS  Google Scholar 

  53. Sterodimas A, de Faria J, Nicaretta B, Papadopoulos O, Papalambros E, Illouz YG (2010) Cell-assisted lipotransfer. Aesthet Surg J 30:78–81

    Article  PubMed  Google Scholar 

  54. Yoo JU, Barthel TS, Nishimura K, Solchaga L, Caplan AI, Goldberg VM et al (1998) The chondrogenic potential of human bone-marrow-derived mesenchymal progenitor cells. J Bone Joint Surg Am Vol 80:1745–1757

    CAS  Google Scholar 

  55. Pu LL, Coleman SR, Cui X, Ferguson RE Jr, Vasconez HC (2008) Autologous fat grafts harvested and refined by the Coleman technique: a comparative study. Plast Reconstr Surg 122:932–937

    Article  PubMed  CAS  Google Scholar 

  56. Gonda K, Shigeura T, Sato T, Matsumoto D, Suga H, Inoue K et al (2008) Preserved proliferative capacity and multipotency of human adipose-derived stem cells after long-term cryopreservation. Plast Reconstr Surg 121:401–410

    Article  PubMed  CAS  Google Scholar 

  57. Gabbay JS, Heller JB, Mitchell SA, Zuk PA, Spoon DB, Wasson KL et al (2006) Osteogenic potentiation of human adipose-derived stem cells in a 3-dimensional matrix. Ann Plast Surg 57:89–93

    Article  PubMed  CAS  Google Scholar 

  58. Peer L (1950) Loss of weight and volume in human fat grafts. Plast Reconstr Surg 5:217–230

    Article  Google Scholar 

  59. Kim SS, Kawamoto HK, Kohan E, Bradley JP (2010) Reconstruction of the irradiated orbit with autogenous fat grafting for improved ocular implant. Plast Reconstr Surg 126:213–220

    Article  PubMed  CAS  Google Scholar 

  60. Zhu M, Kohan E, Bradley J, Hedrick M, Benhaim P, Zuk P (2009) The effect of age on osteogenic, adipogenic, and proliferative potential of female adipose-derived stem cells. J Tissue Eng Regen Med 3:290–301

    Article  PubMed  CAS  Google Scholar 

  61. ClinicalTrials.gov: 2011 (updated 2011) Clinical trials. Retrieved 4 January 2011 at www.clinicaltrials.gov

  62. Cervelli V, De Angelis B, Lucarini L, Spallone D, Balzani A, Palla L et al (2010) Tissue regeneration in loss of substance on the lower limbs through use of platelet-rich plasma, stem cells from adipose tissue, and hyaluronic acid. Adv Skin Wound Care 23:262–272

    Article  PubMed  Google Scholar 

  63. Matsumoto D, Sato K, Gonda K, Takaki Y, Shigeura T, Sato T et al (2006) Cell-assisted lipotransfer: supportive use of human adipose-derived cells for soft tissue augmentation with lipoinjection. Tissue Eng 12:3375–3382

    Article  PubMed  CAS  Google Scholar 

  64. Abbott LC (1927) The operative lengthening of the tibia and fibula. J Bone Joint Surg 9:128

    Google Scholar 

  65. Cytori Therapeutics: 2011 (updated 2011) Cytori-sponsored clinical trials. Retrieved 4 January 2011 at www.cytori.com/Innovations/ClinicalTrials.aspx

  66. Zhu M, Zhou Z, Chen Y, Schreiber R, Ransom JT, Fraser JK et al (2010) Supplementation of fat grafts with adipose-derived regenerative cells improves long-term graft retention. Ann Plast Surg 64:222–228

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgment

All sources of funds supporting the completion of this report are under the auspices of the University of California–Los Angeles.

Author information

Authors and Affiliations

  1. Division of Plastic and Reconstructive Surgery, David Geffen School of Medicine at University of California Los Angeles, 200 Medical Plaza, Suite 465, Los Angeles, CA, 90095-6960, USA

    Christina J. Tabit, Ginger C. Slack, Kenneth Fan, Derrick C. Wan & James P. Bradley

  2. Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, 900 Blake, Wilbur Drive, Palo Alto, CA, 94304, USA

    Derrick C. Wan

Authors
  1. Christina J. Tabit
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ginger C. Slack
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kenneth Fan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Derrick C. Wan
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. James P. Bradley
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to James P. Bradley.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Tabit, C.J., Slack, G.C., Fan, K. et al. Fat Grafting Versus Adipose-Derived Stem Cell Therapy: Distinguishing Indications, Techniques, and Outcomes. Aesth Plast Surg 36, 704–713 (2012). https://doi.org/10.1007/s00266-011-9835-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00266-011-9835-4

Keywords

Search

Navigation