1. Breast augmentation by water-assisted lipotransfer (WAL) without stem cell enrichment was faster and more cost effective.
2. WAL alone resulted in at least an equal take rate when compared to WAL with stem cell enrichment.
Evidence Rating Level: 3 (Average)
Study Rundown: Water-assisted lipotransfer reduces the amount adipose-tissue derived stem cells in the harvested fat grafts. Some have suggested enriching the lipoaspirate with stem cells in order to achieve a cell count that is closer to that of native adipose tissue. The authors of this study set out to examine how this enrichment impacted the perioperative outcomes of breast augmentation. The authors found prolonged operation time with the patients receiving enriched grafts, but no significant difference in the mean survival volume of the whole graft between groups. Because the enrichment process was both more expensive and showed no significant benefit to the patients, the authors discontinued the study for ethical and economic reasons. A larger study, in which the additional expenses for the enriched procedure are defrayed, could result in further insights.
In-Depth [prospective cohort]: This study compared the perioperative results of breast augmentation by WAL alone and WAL with enrichment. 18 women underwent breast augmentation with WAL. Outcomes, including volume of the graft, was assessed by MRI preoperatively and 6 months postoperatively. The enrichment process was not only more costly, but also prolonged operation time by 2-2.5 hours. There was no statistically significant difference in the mean survival volume of the whole graft between groups (54% in the WAL alone and 50% in the WAL with enrichment).
By Amir Tarsha and Allen Ho
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