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CosmeticSurg Blog

Dr. Rodriguez discusses Plastic Surgery, Medicine, and Stem Cell Research

Fat Stem Cell injections to the breast- Risky?

Fat processing in centrifuge

Fat processing in centrifuge

I recently heard a news video clip about fat derived stem cell injections to the breast. There were a lot of unsubstantiated claims made, and I thought I would try to clarify some issues regarding Breast Augmentation with fat derived stem cells.

There are two types of fat injection that are being confused in this debate. The first is injection of fat itself for breast augmentation. We will call this fat injection. The second is injection of fat which is supplemented with an ultra concentrated volume of fat. This ultra concentrate sample of fat has a high concentration of stem cells. We will call this stem cell enhanced fat injection.

 Fat injection for breast augmentation: The American Society of Plastic Surgeons has put out a position paper regarding fat transfer. This link will download the pdf file for you:  asps-fat-transfer-graft-guiding-principles. In it the issue of breast cancer detection is addressed. To quote the ASPS text: 

“Concern regarding the interference of autologous fat grafts with breast cancer detection is not validated by the limited number of studies available on the topic.” 

In other words, at this point there is no evidence that fat injection interferes with breast cancer detection.” As far as complications, lumps, or irregularities the position paper states:

“Studies indicate that results of fat transfer remain dependent on a surgeon’s technique and expertise”.

In other words, when an experienced surgeon uses the correct technique, the results are good. In more than four years of injecting massive volumes of fat to the buttocks, I have yet to encounter any significant complications. I use techniques described by Sidney Coleman which have stood the test of time.

Fat injections for breast augmentation have been done carefully, systematically, and succesfully in other countries as well as in the US. As long as proper technique is used, I don’t see why results would be any different than fat injection to the buttocks, which already has an established track record.

Stem cell enhanced fat cell injection: There are no new types of cells injected in a stem cell enhanced fat cell injection. The stem cells come from the same place the rest of the fat cells come from, your own fat tissue. There are normally occurring stem cells mixed with other fat cells as within the blood vessels and connective tissue of the fat.

All that we are doing is concentrating those cells so they are injected in closer proximity to each other. This likely allows for greater interaction between the stem cells themselves and the surrounding tissues, so there is stimulation for the stem cells to differentiate and create new healthy tissues.

This is not theory, it has been shown to work in breast cancer patients who have had lumpectomies followed by irradiation of tissues. I have seen the positive results in my own lumpectomy patients. These are very difficult cases which up to now were treated with complicated tissue transfers  that depended on taking large pieces of tissue from other parts of the body. Clinical studies in Italy, France, and the United states have shown the efficacy of stem cell enhanced fat transfers in helping these patients. 

There is a theory that stem cells themselves pose a risk to the breast by somehow turning themselves into breast cancer cells. In order to do that the stem cells would have to differentiate first into breast duct cells. The breast duct cells develop as outgrowths from the areola after a long and complex series of signals highly dependent on specific surrounding tissues. That a stem cell injected into breast would follow this highly specific series of steps is unlikely, at best. Rather, stem cells injected into connective tissue, as they are in the breast, will follow local tissue signals and differentiate ito new connective tissue. This has been demonstrated clinically.

Stem cells injected into the breast are no more likely to turn cancerous than anywhere else in the body.

There is a lot of misinformation and confusion regarding stem cell therapy, as this is a new and exciting field. The FDA is even thinking of classifying stem cell therapy as “drug therapy”. This would be a tremendous mistake as it would bring progress in this extremely promising field to a screeching halt.

Adult stem cells are purified from your own fat. They are not a “drug”. I know that I will be discussing this more.
 
Ricardo L Rodriguez, MD
Board-Certified Plastic Surgeon
© Cosmeticsurg.net

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35 Comments

  • avatar Dr. Ricardo L Rodriguez wrote
    March 11, 2012 at 6:54 pm

    Ava:
    First of all, nobody should be doing stem cell therapy to the breast in the US unless its part of an IRB approved study. If the physician is doing it outside of a study the FDA would like to know about it. As part of a study your surgery should be free. We had consulted this directly with the FDA and have documentation from the FDA that this is the case.
    As far as fat grafting for lumpectomy defects, there have been thousands done in the US without reactivation of Cancer. Fat has the highest proportion of stem cells in the body. By processing the fat right, you can create what is called a high density fat graft. I has lower proportions of large mature cells and a higher proportion of small cells, a lot of whom are stem cells. Check out our posts on fat tissue processing and long lasting results with fat grafting.

  • avatar Ava wrote
    March 11, 2012 at 3:01 am

    Dear Doctor Rodriquez:

    I have gone to two plastic surgeons for a possible stem cell fat transfer for a repair of a large lumpectomy divot. The first one says I am a good candidate and would like to proceed. He said I should have a good result.

    The Second surgeon although he does stem cell treatment for facial rejuvenation as well as a lot of regular fat transfers says Stem Cell Treatment for Lumpectomy repairs is dangerous because you do not know if the stem cells could fuel cancer regrowth. He refused to do it due to the fact he could be possibly sued if my cancer would return. I will be 5 years cancer free in October. He wants me to do the regular fat transfer to fix the divot. I’ve read the regular fat transfer just dissipates over time.

    I am uncertain what to do, I like what I read about the stem cell procedure for Lumpectomy repair but of course, don’t want a reoccurence of cancer due to it. I don’t want to get regular fat transfer if it dissipates. Please give me your opinion on this topic.

    Sincerely,
    Ava

  • avatar Donna Radford wrote
    March 4, 2012 at 3:12 am

    I typed a long letter and it didn’t send it!

  • avatar Dr. Ricardo L Rodriguez wrote
    July 22, 2011 at 9:03 pm

    Cherri:
    To get an idea of prices, you need to contact Kelly at kelly@cosmeticsurg.net.
    We do love fat grafting to the breast, as it is your own tissue and natural. Please consider it seriously, it is a great alternative!
    If you want a more accurate idea of what can be done, contact Kelly for a virtual consult.

  • avatar Cherri wrote
    July 20, 2011 at 2:20 am

    Hi Doctor Rodriguez. I got tons of fats on my thighs and buttocks. Id like to know if it’s safe to have some of my fats be injected on my breasts coz I have small upper body small chested and I feel so insecure with my small breasts which is not prOportinal with my lower curves. I don’t wanna get implants. Im 22 and i want my breasts be a little fuller. How much do u think will it cost me to transfer fats from my thighs to my breasts? And what are the pros and cons as opposed to silicone/saline breast implants? I’m looking forward to ur answers. Thank you!

  • avatar Dr. Ricardo L Rodriguez wrote
    July 8, 2011 at 4:44 pm

    Brenda:
    Yes, you can.
    I have a research protocol approved by my hospital, which will start once funding is available. In the meantime, we are treating post lumpectomy breast defects with stem cells. The results are remarkable, and the tissue softness and return of normal color of the skin are something to behold. I love doing the procedure and the biochemical analysis of my study will show why it works.
    If you are interested, call Kelly at kelly@cosmeticsurg.net.
    There is a good solution to your problem!

  • avatar Brenda Wagoner wrote
    July 8, 2011 at 11:41 am

    I had a lumpectomy 10 years ago, no recurrence. But it left my breast with an unattractive dent in my left breast. Can I still have a stem cell repair done?

  • avatar Dr. Ricardo L Rodriguez wrote
    March 24, 2011 at 10:19 pm
  • avatar Ellie wrote
    March 23, 2011 at 8:37 pm

    Hello Doctor, my breast is very flat. I’m always insecure on it. I’m interested on fat transfer to mybreast. I want to know if results can be permanent or last only for months? Also, I want to know howmuch will it cost to do the procedure? Thanks!

  • avatar Kate Smith wrote
    December 12, 2010 at 2:20 am

    Damn, certainly cool post. How can I find your subscription?

    Kate Smith
    latina female

  • avatar Dr. Ricardo L Rodriguez wrote
    November 7, 2010 at 11:06 am

    Theresa:
    I am presently doing fat injections precisely for lumpectomy repair. Fat injections by themselves do not have to be under study and they work great. As a matter of fact there are already two published series on it, one Italian, and another French.
    It is only if you want stem cell enhancement that you need to be under study. I have such approval in my hospital, but we don’t have funding yet. We are in the process of submitting grant applications.
    We would love to hear from you, and we can put you in contact with patients who have had the procedure.
    Call Kelly at 410 494-8100 or email her at kelly@cosmeticsurg.net

  • avatar Theresa wrote
    November 1, 2010 at 11:15 pm

    Dear doctor, I would like to know if there are any trials going to take place in the near future for the fat or t-cell injections. I had a lumpectomy and radiation due to DCIS 4 years ago. I would love to have my breast repaired if possible. My lumpectomy is at 12 oclock, and I can tell through my clothes that I am not even, I also have a dent. Thank You please help me if possible! Theresa

  • avatar Dr. Ricardo L Rodriguez wrote
    October 10, 2010 at 8:57 pm

    Ryan:
    This is the type of situation where I really need to see a picture to know what we are talking about. To do that we’d need to set up a virtual consultation.
    You should also ask yourself, are you comfortable at this weight? If you are, do you really want to lose 100 pounds? How serious are you about losing your weight?
    Have you started already?
    You have a lot to think about. If a breast lift is what is most important to you, then anytime is the right time.

  • avatar ryan d. wrote
    September 21, 2010 at 1:05 am

    hi i got saggy breast and im plus size and i no i have more than enough to put fat in my breast.but will it work in my butt?and even if i do loose all the weight and weigh 101 pounds, b/c right now i weigh 330 pounds so should i wait until i weigh 200 pounds or is it ok now? and i also wanted to know will it lift my saggy breast up and make it jiggle and bounce? thanks take care bye!

  • avatar Dr. Ricardo L Rodriguez wrote
    July 29, 2010 at 9:58 pm

    April:
    Congratulations!
    Where did you get your procedure done?
    I personally have not had people develop lumps, usually the tissues get soft right away. You should ask your doctor, as he may have a better idea.
    I wish you the best. My daughter is a cancer survivor (ovarian), so I know some of what you have gone through. God Bless you!

  • avatar April wrote
    July 23, 2010 at 10:51 am

    I have just gone through liposuction and fat stem cell injected into my breast two days ago. I am BC survivor and very glad to be able to under such treatment. I have many tiny incisions on my breast now and got some bruising as well. Some places also got lumpy and harden, when can I get this problem resolved?

  • avatar Dr. Ricardo L Rodriguez wrote
    June 19, 2010 at 10:29 am

    Dear Anna:
    Stem cell breast augmentation is great for volume correction, but the actual tubular breast correction needs a surgical reshaping of the breast. Check out this blogpost about tubular breast deformity.
    Contact Kelly at kelly@cosmeticsur.net. We’d love to help you!

  • avatar anna wrote
    June 13, 2010 at 5:56 pm

    hey, doc

    I don’t know if this stem cell breast augementation is right for tubular breast correction?

    tks a lot
    Anna

  • avatar Dr. Ricardo L Rodriguez wrote
    April 7, 2010 at 3:33 pm

    Lynne:
    One of the patient pictures I have on fat transfer to the buttocks is of a thin woman who weighed 95 pounds.
    You don’t need to be fat or heavy. As a matter of fact, what we do is change your body proportions and where your body distributes fat. As you gain and lose weight you will maintain your new body proportions.
    The number of fat cells, although relatively constant, does change according to some conditions. For example, if you gain 30% over your body weight, you will get a lot of fat cell increase to accomodate the need to store the extra fat. Check out this blogpost about patients who lose weight after fat transfer to the butt.
    I have done this procedure on many fit patients.
    To find out if you are a candidate , the only way I could really tell is by looking at pictures. If you are interested, contact Kelly at kelly@cosmeticsurg.net.

  • avatar Lynne wrote
    March 31, 2010 at 5:55 pm

    I am very thin, have been my whole life. I’m afraid that I wouldn’t have enough fat to spare for this procedure. Then I was thinking that I could try to gain weight, but once it was lost, I would still have less fat in he donor areas.

    My understanding is that the number of fat cells never changes, only their size changes. If that is the case, then no thin, fit people could ever have this augmentation done. We would be left behind with silicone and saline.

    Can’t cells be multiplied in a culture of some sort, solving this problem? Isn’t that the point of stem cells?

    http://www.vetscite.org/publish/items/001628/index.html

  • avatar Dr. Ricardo L Rodriguez wrote
    February 27, 2010 at 2:03 pm

    Roslyn:
    Stem cells and fat are the most natural and satisfactory way, but because of the work involved, it is also the most expensive way to get a breast augmentation.
    Silicon is much less expensive, but slightly more expensive than saline implants. Frankly, if my daughter requested implants, I would recommend her silicon.
    Saline implants are the most economical, but unfortunately, after 22 years in practice I am seeing a lot of deflations. The FDA has declared silicon implants to be no more dangerous than silicon, if you are concerned about safety. By the way, just take a look around our blog section on breast, as it has a lot of information regarding types of implants, scars, body types, etc. You will get a lot of information there. Enjoy it and good luck on your research!
    You could also email Kelly at kelly@cosmeticsurg.net to arrange for a virtual consultation.

  • avatar Roslyn wrote
    February 22, 2010 at 11:44 am

    I’m really intrested in a breast augmentation, I am a 32A and I want to go to a 32C maybe a B. I’ve been doing research, but I haven’t found any helpful anwsers. What’s the most inexpensive/effective way to have a procedure like this done? The stem cell as well as the saline gel seems like a good idea, as opposed to silicone. But I’m just unsure and a little confused.
    Thanks!!
    Roz

  • avatar Dr. Ricardo L Rodriguez wrote
    December 12, 2009 at 5:08 pm

    Lou:
    A fat transfer will give you a 1 cup volume augmentation reliably, if done by an experienced surgeon. Make sure he does micro fat grafting.
    You could go from a B to a C, but it is possible to go to a “D”. That would depend on a lot of factors, including what amount of donor fat you have, and the technique of the surgeon.
    The most reliable way would be to do it in more than one session.
    Thanks for checking out our blog!

  • avatar Lou wrote
    December 9, 2009 at 7:56 pm

    Hi, I had a breast augmentation a few years ago and went from an A to a DD. I want to have them removed but I dont want to be completely flat again. Would it be possible to reach a D cup with stem cell fat transfer? And if not, can you have multiple fat transfers to do this?

  • avatar Dr. Ricardo L Rodriguez wrote
    December 3, 2009 at 8:39 am

    Nikki:
    The normal breasts I have done are the contralateral breasts in patients who I have treated for radiation damage. It is no different than a patient done purely for augmentation purposes.
    I think the reason fat injections for breast augmentation have not taken off is that they are too labor and resource intensive compared to a breast augmentation. When offered the alternative, patients end up making the decision based on price alone.
    Unlike the case with Brazilian Butt lifts, where the butt implant record is so poor that fat injections are clearly preferred, breast implants have a great track record.
    In response to your question, permanence of fat grafts in the breast is highly technique dependent. If done correctly, fat grafts should last as long as you keep your weight. Even if you lose weight, the fat cells will be there and regain volume when you gain weight again.

  • avatar Nikki wrote
    December 2, 2009 at 1:04 pm

    Would you please post before & after photos of fat transfers to the breasts that you’ve performed? I am very interested in learning more about it. Are the results permanent if the person maintains the same wieght?

  • avatar Dr. Ricardo L Rodriguez wrote
    October 27, 2009 at 10:52 am

    We have great success with with fat transfer to the buttocks, and have done well over a hundred cases.
    As far as fat transfers to the breast, we had intentionally held off until further studies were available about the longevity and risks of the procedure.
    The American Society of Plastic Surgery has published a new set of guidelines, and the long term risks are much less than what was feared.
    Because of this, we now feel comfortable in recommending the procedure. We have done a few cases with no complications, and the results do hold up very well.
    Contact Kelly at kelly@cosmeticsurg.net, we’ll be happy to hear from you!

  • avatar tina wrote
    October 22, 2009 at 9:05 am

    I have seen a plastic surgeon who is keen to injected the fat from my stomache into my breast, however he cannot guarantee a result and how long it will last, I am a size 10 and I do not have a huge amount of body fat. I have breast feed 3 babies and am a 34b.c but they are saggy, I cannot decide to go with his suggestion or silicone for a guaranteed result?

  • avatar Dr. Ricardo L Rodriguez wrote
    September 10, 2009 at 7:30 am

    I am familiar with a Doctor in Japan and another in Korea who have been doing this for years. There are now clinical trials in Italy.
    As far as saggy breasts, etc., you could consider doing a breast lift, then after a suitable healing period, do the fat injections.

  • avatar Cindy wrote
    September 9, 2009 at 12:22 am

    Hi Doc. From my understanding there is a doctor in China who has been doing this fir years. I also read that they r doing a trial study in europe. I belive it started in 2008. I’m understanding that u can only go up 1/2 to maybe 1 cup size & your breasts need to be fairly firm. Having saggy breast from breast feeding or loosing weight for instance is not a good candidate! Can u confirm any of this .

  • avatar Dr. Ricardo L Rodriguez wrote
    August 26, 2009 at 3:03 pm

    You are correct, there is such a procedure, and we have been successful with it here.
    We’d be delighted to help you with this, contact Kelly, my patient coordinator, at: kelly@cosmeticsurg.net
    Here’s a link to a related subject

  • avatar Maureen Pinon wrote
    August 23, 2009 at 2:03 pm

    HI DOCTOR

    I REALLY AM VERY INSECURE WITH MY BREAST AND I NEED THEM BIGGER. I WANTED TO KNOW IF IT IS TRUE THAT THERE IS A BREAST PROCEDURE WHERE YOU CAN USE YOUR OWN FAT CELLS AND IMPLANTED IN YOUR BREAST,IS THAT TRUE? PLEASE LET ME KNOW. THANK YOU

  • avatar Dr. Ricardo L Rodriguez wrote
    May 21, 2009 at 11:53 am

    Tubular deformity is congenital. That is, you were born with a predisposition to it. As your breasts developed, they followed a pattern that ended up with your particular shape.
    The correction involves surgery to reshape the breast. Often it needs an implant to fill out the breast skin envelope and widen the base of the breast. I doubt that fat injections alone would give you the type of volume augmentation needed to correct a tubular breast deformity.

  • avatar Dr. Ricardo L Rodriguez wrote
    May 13, 2009 at 11:16 am

    There are no long term results in the breast per se, but there are enough long term results in other areas. Technically you are right, there are no long term results, but in real world terms If the fat is there after 4 months, it will survive permanently.

  • avatar Estetik klinikleri wrote
    May 9, 2009 at 4:52 pm

    There is not enough late result to say it is reliable way to make augmentation I think.
    http://www.estetikklinikleri.com

2 Trackbacks

  1. [...] remain highly dependent on a surgeon’s technique and expertise. See our previous blog post, Fat Stem Cell injections to the breast- Risky?, for more [...]

  2. [...] plastic surgeons have been using fat that has been processed  in a centrifuge for 3 minutes. This is known as a fat graft. However, if we process that same fat  for 10  minutes into stem cells, does that now make it a [...]