Melvin A. Shiffman, Alberto Di Giuseppe and Franco Bassetto (eds.)Stem Cells in Aesthetic Procedures10.1007/978-3-642-45207-9_56

56. Editor’s Commentary

Melvin A. Shiffman¹

(1)

Section of Surgery, Newport Specialty Hospital, 17501 Chatham Drive, Tustin, CA 92780-2302, USA

Melvin A. Shiffman

Email: shiffmanmdjd@gmail.com

56.1 Introduction

This commentary is a means for the editor to critically analyze the research and uses of stem cells in aesthetic procedures. A dispassionate look at the material available and long experience in fat transfer and aesthetic surgery has shown many aspects to aesthetic procedures and the use of stem cells that need special attention.

There is no doubt that stem cells have an important role in the treatment of diseases and hereditary disorders. The obtaining of stem cells from a human embryo has been challenged in the courts and has stymied one source of stem cells. Autologous stem cells are the primary source.

56.2 How Stem Cells Are Obtained

There are different methods to obtain stem cells including the Celution device, Lipokit, centrifugation, and liposuction. Obviously there are stem cells already in all liposuctioned fat from the pericytes around blood vessels. The best method used to obtain a higher fraction of stem cells has not been determined. Comparisons need to be made of the various techniques.

56.3 Percentage of Stem Cells Compared to Autologous Fat Cells

Since most estimates of stem cells compared to autologous fat cells are volume related, it would appear that most physicians using stem cells in aesthetic surgery procedures use an estimate that is not predetermined. Usually the more autologous fat cell volume, there is an increase in the volume of stem cells added. There is a need for some research to find out the volume of stem cells with autologous fat cells and the method of retrieval of stem cells that will give the best number of surviving fat cells.

56.4 Washing of Stem Cells and Autologous Fat Cells

It is essential to remove blood and blood products from autologous fat so that the macrophages do not remove fat cells with the removal of blood cells. Yet some physicians use the unwashed product to inject into the defective region. This may reduce the percentage of survival of the fat cells. The retrieval of stem cells should be free of blood in order to obtain better fat cell survival as well.

56.5 Calcifications from Fat Necrosis

Excess fat transferred to a single area in the breast may result in fat necrosis. The ruptured degenerating fat cells spill triglycerides into the space and break down to fatty acids provoking an inflammatory response. Healing occurs by fibrosis that begins at the periphery of the cyst areas [1

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