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Breast Reconstruction with Enhanced Stromal Vascular Fraction Fat Grafting: What Is the Best Method?

Gentile P, Scioli MG, Orlandi A, Cervelli V - Plast Reconstr Surg Glob Open (2015)

Bottom Line: In enhanced SVF-treated patients treated with cells obtained by Celution system, we observed a 63% ± 6.2% maintenance of contour restoring after 1 year, compared with 39% ± 4.4% of control group.SVF cell counting indicated that Celution and Fatstem were the most efficient systems to obtain SVF cells.Celution and Fatstem were the 2 best automatic systems to obtain SVF and to improve maintenance of fat volume and prevent the reabsorption.

View Article: PubMed Central - PubMed

Affiliation: Department of Plastic and Reconstructive Surgery, Tor Vergata University of Rome, Rome, Italy; and Anatomic Pathology, Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy.

ABSTRACT

Background: Actually, there are 2 main methods to obtain stromal vascular fraction (SVF): enzymatic digestion and mechanical filtration; however, the available systems report heterogeneous and sometimes not univocal results. The aim of this study is to evaluate different procedures for SVF isolation and compare their clinical efficacy in the treatment of soft-tissue defects in plastic and reconstructive surgery. The authors evaluated Celution and Medikhan, enzymatic systems, and Fatstem and Mystem system, mechanical separation systems.

Methods: Fifty patients affected by breast soft-tissue defects were treated in the Plastic and Reconstructive Surgery Department of Tor Vergata University of Rome. Four groups of 10 patients were managed with enhanced SVF fat grafts using cells obtained by Celution (Cytori Therapeutics, Inc., San Diego, Calif.), Medikhan (Medi-Khan Inc., West Hollywood, Calif.), Fatstem (Fatstem CORIOS Soc. Coop, San Giuliano Milanese, Italy), and Mystem (Mystem evo Bi-Medica, Treviolo, Italy) systems. A control group of 10 patients was treated with only centrifuged fat according to Coleman's technique.

Results: In enhanced SVF-treated patients treated with cells obtained by Celution system, we observed a 63% ± 6.2% maintenance of contour restoring after 1 year, compared with 39% ± 4.4% of control group. In patients treated with SVF obtained by Medikhan system, we observed a 39% ± 3.5% maintenance, whereas enhanced SVF with Fatstem and Mystem systems gave a 52% ± 4.6% and 43% ± 3.8% maintenance of contour restoring, respectively. SVF cell counting indicated that Celution and Fatstem were the most efficient systems to obtain SVF cells.

Conclusions: Celution and Fatstem were the 2 best automatic systems to obtain SVF and to improve maintenance of fat volume and prevent the reabsorption.

No MeSH data available.


Related in: MedlinePlus

Mystem procedure. A, Mystem kit. B, Fat (80 ml) was added to Mystem and it was contained in the bag. C, After filtration and washed cycles, the residual fluid and oil was removed. D, 10 ml of the e-SVF suspension was extracted from the system (see Supplemental Fig. 1, Supplemental Digital Content 1, which shows a patient affected by breast hypoplasia treated with e-SVF fat graft obtained by Fatstem, http://links.lww.com/PRSGO/A99).
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Figure 4: Mystem procedure. A, Mystem kit. B, Fat (80 ml) was added to Mystem and it was contained in the bag. C, After filtration and washed cycles, the residual fluid and oil was removed. D, 10 ml of the e-SVF suspension was extracted from the system (see Supplemental Fig. 1, Supplemental Digital Content 1, which shows a patient affected by breast hypoplasia treated with e-SVF fat graft obtained by Fatstem, http://links.lww.com/PRSGO/A99).

Mentions: Ten patients affected by breast soft-tissue defects (2 patient affected by unilateral breast hypoplasia, 6 patients affected by outcomes of radiotherapy in breast cancer reconstruction, and 2 patients after prosthesis removal) were treated with SVF-enhanced autologous fat grafts obtained by Mystem (Fig. 4) for breast reconstruction. Fat (80 ml) was subjected to automatic wash and filtration cycles (Fig. 4B) based on the direct passage through 0.2-μm filter, after which 10 ml of the residual fluid was extracted from the system (Fig. 4C). The e-SVF suspension (20-ml average) was extracted from the filter (Fig. 4D). Subsequently, the e-SVF suspension was added and mixed with the centrifuged fat graft. This system does not include a centrifuge, and so the authors centrifuged and purified fat grafting using the Coleman procedure. Then, using specific microcannulas for implantation, the SVF-enhanced fat graft was transferred into 10-ml syringes and aseptically reinjected into the soft-tissue defect.


Breast Reconstruction with Enhanced Stromal Vascular Fraction Fat Grafting: What Is the Best Method?

Gentile P, Scioli MG, Orlandi A, Cervelli V - Plast Reconstr Surg Glob Open (2015)

Mystem procedure. A, Mystem kit. B, Fat (80 ml) was added to Mystem and it was contained in the bag. C, After filtration and washed cycles, the residual fluid and oil was removed. D, 10 ml of the e-SVF suspension was extracted from the system (see Supplemental Fig. 1, Supplemental Digital Content 1, which shows a patient affected by breast hypoplasia treated with e-SVF fat graft obtained by Fatstem, http://links.lww.com/PRSGO/A99).
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Related In: Results  -  Collection

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getmorefigures.php?uid=PMC4494476&req=5

Figure 4: Mystem procedure. A, Mystem kit. B, Fat (80 ml) was added to Mystem and it was contained in the bag. C, After filtration and washed cycles, the residual fluid and oil was removed. D, 10 ml of the e-SVF suspension was extracted from the system (see Supplemental Fig. 1, Supplemental Digital Content 1, which shows a patient affected by breast hypoplasia treated with e-SVF fat graft obtained by Fatstem, http://links.lww.com/PRSGO/A99).
Mentions: Ten patients affected by breast soft-tissue defects (2 patient affected by unilateral breast hypoplasia, 6 patients affected by outcomes of radiotherapy in breast cancer reconstruction, and 2 patients after prosthesis removal) were treated with SVF-enhanced autologous fat grafts obtained by Mystem (Fig. 4) for breast reconstruction. Fat (80 ml) was subjected to automatic wash and filtration cycles (Fig. 4B) based on the direct passage through 0.2-μm filter, after which 10 ml of the residual fluid was extracted from the system (Fig. 4C). The e-SVF suspension (20-ml average) was extracted from the filter (Fig. 4D). Subsequently, the e-SVF suspension was added and mixed with the centrifuged fat graft. This system does not include a centrifuge, and so the authors centrifuged and purified fat grafting using the Coleman procedure. Then, using specific microcannulas for implantation, the SVF-enhanced fat graft was transferred into 10-ml syringes and aseptically reinjected into the soft-tissue defect.

Bottom Line: In enhanced SVF-treated patients treated with cells obtained by Celution system, we observed a 63% ± 6.2% maintenance of contour restoring after 1 year, compared with 39% ± 4.4% of control group.SVF cell counting indicated that Celution and Fatstem were the most efficient systems to obtain SVF cells.Celution and Fatstem were the 2 best automatic systems to obtain SVF and to improve maintenance of fat volume and prevent the reabsorption.

View Article: PubMed Central - PubMed

Affiliation: Department of Plastic and Reconstructive Surgery, Tor Vergata University of Rome, Rome, Italy; and Anatomic Pathology, Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy.

ABSTRACT

Background: Actually, there are 2 main methods to obtain stromal vascular fraction (SVF): enzymatic digestion and mechanical filtration; however, the available systems report heterogeneous and sometimes not univocal results. The aim of this study is to evaluate different procedures for SVF isolation and compare their clinical efficacy in the treatment of soft-tissue defects in plastic and reconstructive surgery. The authors evaluated Celution and Medikhan, enzymatic systems, and Fatstem and Mystem system, mechanical separation systems.

Methods: Fifty patients affected by breast soft-tissue defects were treated in the Plastic and Reconstructive Surgery Department of Tor Vergata University of Rome. Four groups of 10 patients were managed with enhanced SVF fat grafts using cells obtained by Celution (Cytori Therapeutics, Inc., San Diego, Calif.), Medikhan (Medi-Khan Inc., West Hollywood, Calif.), Fatstem (Fatstem CORIOS Soc. Coop, San Giuliano Milanese, Italy), and Mystem (Mystem evo Bi-Medica, Treviolo, Italy) systems. A control group of 10 patients was treated with only centrifuged fat according to Coleman's technique.

Results: In enhanced SVF-treated patients treated with cells obtained by Celution system, we observed a 63% ± 6.2% maintenance of contour restoring after 1 year, compared with 39% ± 4.4% of control group. In patients treated with SVF obtained by Medikhan system, we observed a 39% ± 3.5% maintenance, whereas enhanced SVF with Fatstem and Mystem systems gave a 52% ± 4.6% and 43% ± 3.8% maintenance of contour restoring, respectively. SVF cell counting indicated that Celution and Fatstem were the most efficient systems to obtain SVF cells.

Conclusions: Celution and Fatstem were the 2 best automatic systems to obtain SVF and to improve maintenance of fat volume and prevent the reabsorption.

No MeSH data available.


Related in: MedlinePlus