Stem Cells Enriched Fat Transfer to Correct Liposuction Contour Deformities
Liposuction is the most commonly performed surgical procedure in the world. One of the most common complication of liposuction specially with limited experience aesthetic plastic surgeon is the “liposuction body deformity or irregularities” that medically called it “Iatrogenic liposuction deformity”. Some of these irregularities are exaggerations of preexisting irregularities, some are cellulite. In patient with previous cellulite or irregularities has the right to know in detail before surgery about the skin condition in the planned liposuction area(s) and the outcome of the procedure in his/her case whether the skin going to be better, same or getting worse by having liposuction to trouble skin area.
However, this problem may not just limited to surface irregularities, but it can change the relationship between a woman’s thighs, hips, and abdomen causing in unnatural or unattractive body shape proportion. For that reason, the liposuction today is not just fat debulking, it is a mixture of art and surgical skill, to reshape any part of the body. For that, today we are uncommonly using the term liposuction surgery but, more body sculpturing or body shape contouring like: Posterior Profiloplasty, Hi definition liposculpture, Circumferential body shape contouring to reestablish a feminine relationship between full back, waist, hips, and thighs (Sand-Glass Figure).
How to Correct “Iatrogenic liposuction Deformities”
Fat grafting or fat transfer is an essential tool for all aesthetic surgeons performing liposuction as it provides the key to address Iatrogenic Liposuction Deformities & Corporal Iatrogenic Deformity, which are the most common complications of liposuction. The successful treatment of body surface irregularities requires a three-dimensional visualization of the problems and solutions. Usually it may need more than one session and can be up to 3 sessions depend on the area how much it has been affected by first surgery. The fact that some plastic surgeons are very aggressive in their liposuction technique, using large aggressive cannula for shorter time surgery and this can cause a lot of indentation and irregularities and even can be hard on touching the area due to fibrosis that built in the area during the recovery period of aggressive liposuction as a consequence and vascular damage and poor vascularity of the area.
Patients who present with iatrogenic body deformities have usually had negative
experiences with aesthetic surgeons. How they perceive themselves is colored by those experiences, so it is often difficult to assess how realistic the patient is about her current appearance as well as expectations, for this reason they do need to spend more time with them than other patients during first consultation.
The fat graft can help in such cases not only to correct the defect deformity but also to improve the shape of the whole area plus softening the area. But, it may need more than 1-2 sessions to reach the satisfactory outcome for the patient and treating plastic surgeon. As the amount of fibrosis more in the area as the percentage of fat survival is less… due to the poor vascularity of the treatment area. The more healthy and vascularized bed, the more chance and percentage of fat graft survival. In such scenarios may need even more than 3 sessions of fat transfer surgery to improve the look of the area.
Adding stem cells to fat can help those patients as the stem cells can give rise to angiocytes which is the blood vessels forming cells and this by itself will form good number of blood vessels in poorly vascularized recipient area. This can give a high chance for the fat graft survival and improve the outcome of the procedure and instead of having 3-4 session to correct severe deformities, 1-2 sessions can give the same outcome with more supple and healthy tissue.
Adding Adipose Derived Stem (ADSCs) Cells to Transplanted Fat
Most of scientific research if not all, have proven that the transplanted fat is retained when small quantities are placed in adequately vascularized areas. When we have a case with history of previous trauma or liposuction, most of the area the quantity of fat that needed is limited but, the donor area (problematic area) most of the time not very well vascularized. For this reason, we do need to add adipose derived stem cells that has ability to service in hypoxic (low Q2) for 72 hours while the fatty tissue cannot servive more than 24 hours. o
- Coleman, S. R., Iatrogenic Corporal Deformities- “Structural Fat Grafting.” Qaulity Medical Publishing, Inc, St. Louis Missouri, 2004 PP. 147-175.