Fat Grafting & the use of Stem Cells
With Stem Cells being used in the media and by other surgeons like an every day word, we want to clarify our standings on its use
What is Fat Transfer?
Fat transfer, also known as fat grafting or autologous fat transfer, is the process of using the patient's own fat to increase the volume of fat in another area of their body. The fat is harvested or extracted with a liposuction cannula. They are prepared for reintroduction into the body and injected into the new part of the body where the additional bulk is used for medical or cosmetic purposes. The most common donor areas, where fat is taken from, are the stomach, thighs, and waist.
The procedure is minimally invasive making it very appealing. Another advantage of fat transfer is that the body does not reject it because it is the patient's own fat. However, there is a rate of absorption, a percentage of the transferred fat, that does not survive. Therefore, it is extremely important to select a surgeon that uses a proven technique with the highest fat survival rate.
Dr. Khouri's Fat Transfer Procedure
Many women have turned to the Miami Breast Center looking for natural and permanent results. Dr. Khouri is a pioneer in the use of autologous fat to reconstruct and augment breasts. He is able to rebuild an entire breast using only the patient's fat and the external tissue expander BRAVA. The BRAVA bra is worn a few weeks prior to surgery and stretches the tissue, both externally and internally, creating a matrix into which the transferred fat will be injected. This matrix is essential for fat placement and survival.
Dr. Khouri uses a very fine needle-like cannula, that he developed, to gently perform liposuction. The fat naturally contains stem cells, which are harvested in the process along with the fat and preserved in the transfer. However, nothing artificial is added nor biologically manipulated within the harvested fat.
Studies have shown that breasts rebuilt with this fat transfer process, pre-expanded with BRAVA, result in high fat survival and last forever. They look and feel natural and retain near-normal sensation. Compared to implants that on average need to be replaced every 10 years and can leave a woman with non-sensate breasts and nipples, Dr. Khouri offers a great alternative.
Stem Cells in Fat Transfer- Is there supporting clinical evidence or is it a misleading marketing tactic?
Growing concerns have emerged over the clinical practices and marketing claims made by the plastic surgery community promoting stem cell use in fat transfers. The term "stem cells" is hyped by the media and used by some surgeons like an everyday word. A small group of unethical practitioners are deliberately misleading and exploiting the public with false claims. Therefore, a task force was convened to address the false advertising claims that are not substantiated by scientific evidence.
The task force was made up of two of the world's largest organizations of board-certified plastic surgeons, the American Society for Aesthetic Plastic Surgery (ASAPS) and the American Society of Plastic Surgeons (ASPS). They issued a joint position statement during The Aesthetic Meeting 2011, the annual meeting of ASAPS.
Dr. Roger Khouri himself sat on the task force and participated in the joint position statement. Here are a few of the recommendations made by the task force:
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.
Dr. Khouri is a strong proponent of truth in advertising and very clearly states that his technique is a fat grafting procedure and not a stem cell procedure. Our technique of fat harvesting, preparation, and grafting preserves the native stem cells in the fat graft because we use very fine needle-like cannulas to gently liposuction the patient's fat. The harvested fat is naturally rich in stem cells. Nothing artificial is added nor biologically manipulated within the harvested fat.
The marketing and promotion of stem cell procedures in aesthetic surgery is not adequately supported by clinical evidence at this time.
Despite there being great promise for the future, there is NO scientific evidence that stem cells have ANY proven useful medical application to date. Dr. Khouri's has published his clinical studies that demonstrate the efficacy of his fat transfer to the breast procedure. The most recent study published by the Journal of Plastic and Reconstructive Surgery in May 2012 highlights the success of Dr. Khouri's procedure. The six-year study concluded that his procedure, with the use of BRAVA "leads to significantly larger breast augmentations, with more fat graft placement, higher graft survival rates, and minimal graft necrosis or complications, demonstrating high safety and efficacy for the procedure."
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.
The respected medical establishments have refrained from offering unproven therapies and do not market themselves as providing "Stem Cell Therapy" or "Stem Cell Procedures" simply because there is not enough clinical data. Cosmetic procedures advertising the use of fat-derived stem cells lack the scientific evidence to support it. To read the entire ASPS and ASAPS Joint Position Statement on Stem Cells and Fat Grafting click here.
Know The FACTS
If a surgeon makes a claim about the efficacy of a stem cell procedure ask them for the published study. If it's not available don't be misled. Beware of unethical practitioners who "manipulate" stem cells and claim better results. Ask to see the scientific proof showing the stem cells are a direct cause of the final results.
Dr. Khouri's technique has been recognized around the world. Last year he received the European Award for Best Reconstruction Procedure. He shares his expertise at seminars and conferences around the world. Plastic surgeons from different countries flock to his annual Fat Graft Course where he teaches his revolutionary fat grafting technique. He mentors surgeons one-on-one and trains them to successfully and permanently rebuild an entire breast using a woman's own fat. His revolutionary fat grafting technique is not a false claim, it is a proven clinical wonder.