Stem cell enhanced Fat grafting for Breast reconstruction

A rack of filled fat tubes.

Plastic surgeons have been actively performing fat grafting for decades. In fact,  the first fat transfers to both the face and breast were performed over a century ago. In 1893, a german physician, Dr. Franz Neuber, used fat transfers to correct facial defects. Only two years later, in 1895, Dr. Karl Czerny used fat grafting techniques for Breast reconstruction to restore symmetry of a breast defect.

Fat grafting, also known as Fat injections, takes fat from unwanted areas of your body, carefully processes the fat, and then transfers the fat to areas which need volume. Fat transfers have been successfully performed to the face, hands, buttocks, hips, and the breast.

Although fat transfer results are highly dependent on the technique of the surgeon, fat grafting has long been considered safe. However, some questions did remain about fat grafting to the breast. But in 2009, the American Society of Plastic Surgeons wrote a position paper publishing their conclusion that fat grafting to the breast was safe, but technique dependent. The finding was based on case studies of hundreds of patients who underwent fat grafting to the breast. In over a decade of fat grafting to the breast, there was no evidence of increased incidence of cancer recurrence.

Although the ASPS publication had addressed fat grafts, which naturally contain a population of adipose stem cells (ASC’s), some controversy in the plastic surgery community remained about the safety of stem cell enhanced fat grafts. The addition of adipose stem cells to fat grafts is used to improve fat graft survival rates, in addition to other regenerative functions. Questions remained regarding the use of fat grafting for Breast reconstruction in women who had had been treated for breast cancer. Surgeons did not know if active stem cells in the adipose tissue could facilitate the growth and spread of tumor cells.

This week a study co-authored by Plastic Surgeon, Peter Rubin, MD of the University of Pittsburgh Medical School, with authors Donnenberg and Zimmerlin, reported on the safety levels of culture expanded adipose stem cells in tissues with both active and dormant cancer cells. In the animal model experiment, one population of active and and another population of dormant cancer cells were combined with culture expanded adipose stem cells.

The findings supported the contention that regenerative treatment can be safely given to patients with dormant cancers. Dormant cancer cells are not actively growing or dividing. The study also concluded that active tumors can be stimulated to grow by contact with adipose stem cells, thus asserting that regenerative stem cell therapy should not be performed when cancers are active. The University of Pittsburgh Medical School is a pioneer in the field of adipose stem cell (ASC) research. Much of the original adipose stem cell research originated at labs in the Pittsburgh Medical School in collaboration with researchers from University of California.

A collage of photos of a patient before & after a breast reconstruction procedure.

The new study provides encouragement for researchers, clinicians, and medical device makers who are developing stem cell treatments for post cancer (dormant) treatments. Following reconstructive surgery, many cancer patients are left with severely damaged skin and tissue. Regenerative stem cells have the power to create new blood supply and heal tissue damaged by radiation.

One remaining question is what constitutes a ‘dormant cancer.’ In Breast reconstruction patients, the cancerous tumor is surgically removed and, in many cases, the affected area is irradiated to kill any remaining cancer cells. One may consider cancer cells to be dormant if one year following excision and radiation, there is no evidence of disease. This is usually determined by measuring tumor markers and various diagnostic imaging tests.

The conclusion of Dr. Rubin’s co-authored peer reviewed paper which was published in Tissue Engineering reads as follows:

Taken together with our published results in a xenograft model, which indicate that ASC augment the growth of active but not resting breast cancer cells, the available data suggest that the critical factor determining whether regeneration augments tumor growth is the state of residual tumor: Active disease is promoted, whereas dormant tumor is insensitive. This suggests that reconstructive therapy utilizing ASC-augmented whole fat should be deferred until cancer remission has been firmly established.

By Dr. Ricardo L. Rodriguez MD Board Certified Plastic Surgeon Cosmeticsurg Baltimore, Maryland Ricardo L. Rodriguez on American Society of Plastic Surgeons.

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23 thoughts on “Stem cell enhanced Fat grafting for Breast reconstruction”

  • Angela says:

    Good Afternoon, i am a 64 year old MTF transgender , i underwent a unilateral breast removal (right) due to cancer in 2014, had chemotherapy, no radiation to site. In remission with no signs , so far so good, i am thinking of having a fat transfer from abdominal to breast area to fulfill a gap that doesnt look appealing , i have had a consultation in ny , doing a tummy tuck after the fat transfer all in the same day. i would like to know have you ever done this on MTF transgenders . And how much would the cost be.
    • Dr. Ricardo L Rodriguez says:

      Angela: Sorry for the delay in answering, this blog is more for dissemination of information. I have done scores of transgenders, almost exclusively MTF. This includes several Brazilian Butt Lifts, and fat transfers to face, Lip Lifts (for feminization). Most of the breasts have been implants. Your problem itself is not unique, the fact that you are transgender does not affect it in any way. I will have Kelly contact you, or you may contact her directly at
  • Monique says:

    Is it possible to get fat from the side of my stomach or from my butt and put it in my breast ? Is their risk involved
    • Dr. Ricardo L Rodriguez says:

      Monique: Yes, we do that a lot. The risks are minimal if the fat graft is processed properly so all the delicate fat cells survive. I will let Kelly at about you.We could set up a virtual consult for you so we can talk about it in more detail.
  • Allison Rainey says:

    How do I find a doctor in Maryland that performs the stem cell fat grafting procedure. I had a mastectomy with reconstruction saline implant. I was 32. When I turned 40 cancer came back on same side. Took old implant out took care of cancer put in a saline/silicone implant plus 7 weeks of radiation. Now I have what I think it is called capsulary contraction. I am tired of being cut and scarred. I was told to find a doctor who specializes in radiated breast reconstruction. I was told to cut my stomach under a 8 hour surgery or my back. It needs to come out but isn't there a better solution for me than being scarred worse? Please help. Suzanne Somers had radiation and no breast at all. If they did it for her why not me? There are alot of women out here who need help.
    • Dr. Ricardo L Rodriguez says:

      Allison: I am in Baltimore. We have an IRB approved study at Greater Baltimore Medical Center,if you would like to participate in it. We can also do a lot with just fat grafting. I advise you to contact Kelly at to arrange for a consultation. We can help you.
  • Allison Rainehy says:

    I had a total mastectomy with reconstruction which I hate. They took my nipple. The implate hurts under my arm and has caused a fatty lump on my shoulder which has to be lyposuctioned out. Am I a candidate for fat stem cell grafting. I put on about 20 lbs. weight which I am not working on to rid of.
    • Dr. Ricardo L Rodriguez says:

      Allison: You are a candidate for reconstruction using fat grafts and/or stem cel assisted fat graft. Stem cell assisted fat grafts are not allowed at present in the US, but there are clinical trials going on overseas. I am in negotiations to initiate these treatments in the Cayman islands. We have many patients from out of town and the procedure can be done using intravenous sedation. Contact Kelly at
  • MARIA AUDIN says:

    Had right breast total mastectomy September 2010, had chemotherapy, 35 radiations and already 5 reconstruction surgeries with removal of implant on 6th surgery due to a mild staph infection 12 days ago, which cleared in less than a week. Surgeon wants to start injecting breast tissue with stem cells to prepare breast for implant in 3 months. How safe is this treatment for a woman in my condition? I feel very strong and I'm very active. Thanks for comment, God bless you all!
    • Dr. Ricardo L Rodriguez says:

      Maria: If you are in the USA, fat injections enriched with isolated stem cells are not allowed unless it is in the context of an FDA approved study. However, high density fat grafts are allowed, and they do contain stem cells. High density fat grafting is a good idea and I do it in my practice. You should also consider the newer techniques for Free Flap reconstruction, or DIEA reconstruction, where tissue from your belly is transferred into your breast area. In th erase of a total mastectomy it is a very good alternative.
  • Cindy says:

    Do you have any referrals in Chicago or Texas (Austin) area who have extensive experience in stem cell enhanced fat grafting for breasts? Thank you, Cindy
    • Dr. Ricardo L Rodriguez says:

      Cindy: I don't know anyone specifically. Your best bet is to go through this blog and get informed on the processing, including how they harvest, how they inject, etc., then ask a lot of questions and ask to see pictures. Hope this helps!
  • sharon mcintyre says:

    I saw suzzane somers and was wondering if i would be eligible for the clinical trials and where they are available. I live in Westminster, Maryland.
    • Dr. Ricardo L Rodriguez says:

      We have a clinical trial that is already IRB approved but are awaiting for a grant to come through. Contact Kelly at so we can let you know when we start.
    • Dr. Ricardo L Rodriguez says:

      Meeka: I don't know who would do it well enough in Pa. We do get a lot of patients in our practice from Pennsylvania. Contact Kelly at, she'll give you info on prices, etc.
  • Jen says:

    Hi, First off I want to say... AWESOME SITE! I have done a lot of research online about plastic surgeons, and yours really seems head and shoulders above the rest. You seem very competent, communicative, and cutting edge. I'm not quite ready for surgery yet, but when I am I'll be coming to you!! I have a question about fat grafting in the breasts. I have never had breast cancer, but my breasts are small and asymmetrical. Would fat grafting be an option for me? I really don't want to go the implant route as I would much rather have my own body tissues in there. The research I have done about it indicates that fat grafting for breast enhancement typically isn't used because the results don't last, but after watching your Brazilian Butt lift fat grafting techniques video, I wonder if it is indeed a viable option using your method. Any information you could give would be greatly appreciated. Thanks for your time, Jen.
    • Dr. Ricardo L Rodriguez says:

      Jen: Fat grafting to the breast is a very good alternative but it has not had traction for 2 reasons: 1) It is more expensive 2)The augmentation is usually only about 1 1/2 to 2 cup sizes when performed properly The results, as in buttocks augmentation, are permanent when properly done. I have done it and it works for me. I love doing it. Give us a call when you are ready. Contact Kelly at
  • Samantha Walach says:

    I Had a lumpectomy two years ago. Thankfully it was completely benign. My right breast looks just like the picture in this website. The scar and divot is above my nipple making it imposable to find a bikini or bra top that fits both breasts. The problem being when the bra/bikini top fits my left breast the right side gapes out exposing my right breast, scar and nipple included. I would like to look into getting it repaid. I am very thankful it was benign, however I would like to look my best again. Can you recommend anyone in Canada or the United States to help me with this. I have seen several plastic surgeons. All of them have recommended breast implants. I am not opposed to implants, however I am not convinced it will correct the divot and then I would have the same problem. Can you offer any advise. Thank you for your time, Samantha 905-812-9770
    • Dr. Ricardo L Rodriguez says:

      Samantha: I don't know who does this in Canada. The procedure is not done by many surgeons, and you have to be careful they do it well. I think fat grafts would be great. If you are interested, contact Leeza at, or Kelly at They'll be happy to hear from you.
  • joyce says:

    I have a friend who was advised to undergo radiation theraphy due to breast cancer, what is the survival rate of this kind of treatment?
    • Dr. Ricardo L Rodriguez says:

      Joyce, there are so many factors involved in prognosis. There is no way I would even venture a guess. The radiation itself is not dangerous to life. She will do just fine from the radiation. Sometimes, however, the after effects of radiation can be very disabling. It is in those cases that we can help with stem cells.