Fat grafting and transfer is the new age of plastic surgery. I love it- the concept of replacing “like with like,” using your own body tissue instead of foreign fillers and objects, moving fat from an area where you don’t want it (like the love handle) to a place where you do (face, buttock, breast). But it is a new fronteir. We know it works, but we don’t know exactly how. We desire predictability and understanding.
Journal time: this month November 2012 issue of Plastic & Reconstructive Surgery Journal had an article on
“instrinsic Dynamics of teh Fat Graft: In Vitro Interactions between the Main Cell Actors.” It is a study out of Belgium. What did it look at?
- Fat was harvested from healthy female patients
- It was studied In Vitro (which means outside of the body in a lab)
- They were trying to figure out the “exact nature and fate of the different cells in the transplanted fat graft.”
- Findings:
- mature “adult” fat cells signal the stem cells to proliferate and differentiate
- stem cells injected alone into tissue do not produce soft tissue fill
- fat is a dynamic “organ”
- cultures with added adipose stem cells grew better
- the main actors- adipose graft, the adipose derived stem cells, and the mature fat cells- interact. They have 2 of the 3 needed requirements for tissue engineering: stem cells and growth factors. What they need is a matrix or scaffold. (which we think we are giving when we inject fat into a site in the body.)
- the fate of these cells when injected in fat transfer surgery is still largely unknown (this means we don’t know exactly what happens in the body when we move fat. Do the mature cells live? get a new blood supply? Do they die and leave progenitor cells? Do they signal stem cells to transform into new fat cells?)
So?
This study is yet another view into the world of fat transfer. What cells are involved, what stem cells are there in fat removed from the women in their study, and what growth factors are needed. The more we know, the better we can get to answering how to improve our techniques. How can we get the mature fat cells to signal stem cells to proliferate? Get them to proliferate into new fat cells? Improve the amount of fat survival?
I will keep updating as we figure out more…