[Autologous fat grafts and supportive enrichment with adipose tissue stromal cells]

Liposuction is a most common surgical procedure in aesthetic surgery that aims at the local fat reduction. The obtained adipose tissue is currently used as a biocompatible filler. Autologous fat transplantation, also known as lipofilling, has become an attractive treatment method in the field of aesthetic facial surgery and scar tissue reconstruction. Lipofilling may also offer an alternative method to prosthetic breast surgery. Nevertheless, postoperative fat tissue resorption is still a limitiation to lipofilling in breast reconstruction leading to multiple revisions in order to reach the requested clinical outcome. The therapeutic effect of autologous fat grafts does not solely lie in its role as a filler material, but also in its wound healing and angiogenetic properties. The latter is not attributed to the mature adipocytes, but rather to the undifferentiated adipose derived stromal cells (ASC). Thus enrichment of the fat graft with autologous ASC, known as cell-assisted lipotransfer (CAL) may lead to further optimisation of lipofilling concerning fat graft survival. Still aiming to establish the application of autologous fat grafts and ASC in breast reconstruction, there is a necessity for systematic analyses in order to resolve questions regarding the operational technique and qualitative aspects of the ASC manufacturing in accordance with pharmaceutical guidelines and regulations in Germany. Besides, some open questions need to be addressed regarding the ASC differentiation potential in vivo.