Wednesday, May 11, 2011

Update: Stem Cells and Fat Grafting

Here are a few new items on stem cells and fat grafting I’ve come across recently. 

First are a couple of nice posts by fellow plastic surgeon/blogger Dr. Thomas Fiala, the Orlando plastic surgery blog who is attending The Aesthetic Meeting 2011 in Boston this week.

Live from Boston: Fat grafting controversies !!  (May 6, 2011)

……It's pretty clear that fat grafting works, and can be done safely. There seem to be two major methods that work……

One bit of consensus: if the breast was not pre-expanded, you can't expect to get more than 100 cc of fat to survive.

ASAPS 2011: Best of Hot Topics (May 9, 2011)

Here are my choices for the "Hot Topics" presented at the Boston ASAPS meeting:

1. "Stem Cell Facelift" - Dr. Peter Rubin reviewed the literature on the so-called Stem Cell facelift. It turns out that there really is no consistent technique for this method. Many advertised "stem cell facelifts" are simply regular facelifts with regular fat grafting and don't involve any extra stem-cell work at all. Furthermore, to date, there is NO DATA that this technique is superior to facelift with standard fat grafting. Summary: as of today, the stem cell facelift can either be considered unproven and under development, or if you are a little more cynical, it might just be "marketing hype".

The review by Rubin was highlighted in a press release:   ASAPS and ASPS Issue Joint Position Statement on Stem Cells and Fat Grafting on Monday, May 9, 2011.

….. Based on the current state of knowledge, the task force made the following recommendations to ASAPS/ASPS members and their patients:

  •     Terms such as "stem cell therapy" or “stem cell procedure” should be reserved to describe those treatments or techniques where the collection, concentration, manipulation, and therapeutic action of the stem cells is the primary goal, rather than a passive result, of the treatment. For example, standard fat grafting procedures that do transfer some stem cells naturally present within the tissue should be described as fat grafting procedures, not stem cell procedures.
  •     The marketing and promotion of stem cell procedures in aesthetic surgery is not adequately supported by clinical evidence at this time.
  •     While stem cell therapies have the potential to be beneficial for a variety of medical applications, a substantial body of clinical data to assess plastic surgery applications still needs to be collected. Until further evidence is available, stem cell therapies in aesthetic and reconstructive surgery should be conducted within clinical studies under Institutional Review Board approval, including compliance with all guidelines for human medical studies.  ………….

And the last item comes from the PRSonally Speaking Blog:  Articles of Interest Sneak Peak: Breast fat grafting with platelet-rich plasma: a comparative clinical study and current state of art.  It highlights the abstract of an article which will be published in the PRS journal in June 2011.

The role of Platelet-Rich Plasma (PRP) in enhancing fat grafts take is attracting the scientific community. However, there is a lack of clinical series on the matter.

The aim of this paper is to report Authors' experience in breast fat graft with and without PRP and to investigate the state-of-art on adipose tissue PRP enrichment……

Conclusion: In Authors' retrospective analysis no effect of PRP was seen in enhancing fat graft take when compared to Coleman fat graft. Further research and prospective clinical studies are strongly needed to understand the role of PRP, if any, in fat grafting.

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