Is the Resorption of Grafted Fat Reduced in Cell-Assisted Lipotransfer for Breast Augmentation?

Cell-assisted lipotransfer (CAL) is a cotransplantation of adipose tissue and stromal vascular fraction (SVF) including adipose-derived stem cells. But although CAL can get satisfactory outcomes in breast augmentation, the resorption of the grafted fat is still unclear. A total of 12 patients received breast augmentation using CAL. All of them completed 6 months of follow-up. In 1 mini-CAL case, 500-mL liposuction fluid was used to harvest the SVF cells. In 11 full-CAL cases, 250-mL aspirated fat was needed apart from 500-mL liposuction fluid. The percentage of adipose-derived stem cells in SVF cells was detected using flow cytometry and their multilineage potential ability was assessed with in vitro induction. The volumes of breasts and pectoral muscle were measured, and radiological image change was analyzed using magnetic resonance imaging before the operation and 3 and 6 months after the operation. Additionally, the subjective evaluation on the cosmetic outcomes was determined by surgeons and patients. Adipose-derived stem cells in SVF cells accounted for 40.27% and 3.34% in full-CAL cases and mini-CAL cases, respectively. Postoperative atrophy occurred within the first 3 months. At the 6 months postoperatively, breast volume is augmented, ranging from 60.71 to 197 mL, with a mean value of 125.35 (45.49) mL. The ultimate resorption of grafted fat at the 6 months postoperatively is 51.84% (16.74%). Newly formed cysts and nodules were detected in 2 cases. No calcification was found in all magnetic resonance images. Only 1 patient was unsatisfied with the cosmetic outcome. Our preliminary study displayed a satisfactory augmented volume with little complications using CAL for breast augmentation. But the resorption at the 6 months postoperatively [51.84% (16.74%)] showed no significant advantage over non-CAL technique (40%-60% reported), which suggested that SVF cells harvested from 250-mL aspirated fat and 500-mL liposuction fluid were insufficient to average 250-mL grafted fat for each breast in this study. More SVF cells are needed to achieve lower resorption.