August 2012 Plastic and Reconstructive Surgery Journal has an interesting article in the experimental section. (This means it is still being tested in the lab, and isn’t ready for prime time yet.) The article is a little scientific sounding, “Endogenous Stem Cell Therapy Enhances Fat Graft Survival.” To distill it into English:
- We know there is variable fat cell survival when it is moved. Rates can be anywhere from 30% surviving to 80% surviving. That is a big difference. How can we make fat transfer more reliable and predictable?
- We know when fat is moved it needs to be a healthy fat cell, and it needs to develop a new blood supply.
How can we improve the fat healthiness and improve the new blood supply?
- The authors analyze fat after centrifuge (Most of us try to centrifuge the fat when doing fat transfer. The thought is it helps concentrate the fat and remove any oil/ unhealthy fat cells).
- They found after centifuge, 10% of the sample is “high density fat.”
- This high density fat has more progenitor cells in it, and these cells are thought to promote new blood supply.
- The high density fat has better survival.
BUT, the high density fat is only 10% of the sample after centrifuge. The other 90% they call “low density fat.” This low density fat has a much lower rate of survival. Knowing we can’t throw out 90% of every fat sample to just get the really good high density fat, is there something we can add to help the low density fat survive? In this study they use “stem cell mobilizer” which they refer to as AMD3100. This was injected daily for 14 days into the abdomen of the mice.
Findings?
- The low density fat with the AMD3100 had survival rates close to the high density fat.
So what does this mean? This is an experimental study in mice. Again, this is not ready for prime time. What it does indicate is there is variability to the quality of fat harvested in its ability to live when moved to a new part of the body. You may be able to help the “lower” quality fat have better survival by adding factors to it which stimulate new blood vessels to the area. Better blood supply= better fat survival.
I am a fan of fat transfer and fat grafting. I am doing it in the cheek, face, breast, and buttock area with increasing frequency. A better understanding will help us tailor better how much to transfer, and if we have excess fat, which fat is the “best” to use.
I applaud the plastic surgeons in the lab- I think fat and stem cells are an exciting new fronteir. The more we know, the better we will be.