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Updated: Jul 10, 2026
The Combination of Mechanically Isolated Stromal Vascular Fraction and Fibrin Hydrogel: A Processing Protocol
Published on: November 17, 2023
Cell-Assisted Lipotransfer (CAL) and Stromal Vascular Fraction (SVF) in Combination with Autologous Breast
Tung Dinh Nguyen1, Hung Kim Tran2, Phung Van Truong2
1EMCAS Plastic Surgery Hospital, 14/27 Hoang Du Khuong Street, Hoa Hung Ward, Ho Chi Minh City, 700000, Vietnam. ngdtung1@gmail.com.
Background:
Cell-assisted lipotransfer (CAL) with stromal vascular fraction (SVF) enrichment has gained increasing interest as a regenerative adjunct in breast reconstruction. However, standardized reporting of volumetric outcomes and reproducibility data remains limited. This study reports our preliminary feasibility experience integrating CAL/SVF into autologous and hybrid breast reconstruction with MRI-based volumetric assessment.
Methods:
Six patients undergoing breast reconstruction with CAL/SVF enrichment were prospectively evaluated. Reconstructive modalities included TRAM flap, latissimus dorsi flap, implant-based, and hybrid techniques. Intraoperative SVF isolation was performed using enzymatic digestion (0.075% type I collagenase, 30-40 minutes at 37 °C) followed by centrifugation and admixture with purified fat. Fat graft survival was assessed at 12 months using 3.0-Tesla MRI volumetry with VOI freehand segmentation. Interobserver reliability was evaluated using intraclass correlation coefficient (ICC).
Results:
Twelve-month fat retention ranged from 76.4% to 84.0%. No major complications occurred; one minor fat necrosis resolved without intervention. Descriptively lower retention values were observed in previously irradiated breasts. Interobserver agreement for MRI volumetry was excellent (ICC[1, 2] = 0.995; 95% CI, 0.975-0.996), supporting reproducibility of segmentation.
Conclusions:
CAL/SVF integration in breast reconstruction demonstrated favorable intermediate-term volumetric retention and safety within this small feasibility cohort. MRI-based volumetric analysis showed excellent interobserver reliability. Given the limited sample size and cohort heterogeneity, findings should be interpreted as preliminary and hypothesis-generating. Larger studies with extended follow-up are warranted to validate long-term durability and the impact of prior radiation.
Level Of Evidence Iv:
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