WSJ Examines Increasing Use, Concerns Over Breast Surgery Using Fat Augmented With Stem Cells

Main Category: Women's Health / Gynecology
Also Included In: Cosmetic Medicine / Plastic Surgery;  Stem Cell Research
Article Date: 21 Aug 2008 - 8:00 PDT

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The Wall Street Journal on Tuesday examined procedures increasingly being conducted in Japan and Europe and developed in the U.S. that use a combination of fat and adult stem cells for breast reconstruction and augmentation. According to the Journal, attempts to use human fat to enhance the size of women's breasts have been made for more than 100 years but usually have failed because most of the fat "died, turning into hard lumps and calcifications." The theory behind the new procedures is that fat might be "processed or handled in a way that allows fragile stem cells to create a blood supply for the transplant that helps the fat survive," the Journal reports. According to the Journal, harvesting stem cells from fat avoids the ethical issues involved in retrieving stem cells from human embryos.

Kotaro Yoshimura -- a Yokohama, Japan-based plastic surgeon -- said that since 2003 he has conducted about 200 procedures that he calls "cell-assisted lipotransfer." The three- to four-hour procedure begins with a liposuction procedure to acquire fat. About half of the fat collected is "processed through a centrifuge, yielding a concentrated stem-cell mixture." The two halves then are put back together and injected into four sites into the breast via a syringe. San Diego-based Cytori Theraputics said it has invented a machine that "combines fat with a mixture of stem cells and other regenerative cells," which can then be injected into patients to reconstruct breasts after cancer treatments or used in augmentation procedures. The company has sold the machine for $75,000 to $100,000 to plastic surgeons in France, Israel, Italy and Japan. In addition, Cytori is sponsoring studies at hospitals in Europe and is seeking FDA approval for human tests in the U.S. next year to reconstruct breasts damaged by cancer surgery. The Journal reports that the cost of the procedures vary "widely" -- from $15,000 to more than $30,000.

According to the Journal, some experts said that the new techniques are being used too quickly and that the safety of the procedures has not been established. Some doctors said that fat could calcify and disrupt mammography. The procedures also could increase breast cancer risk among some women because fat tissue contains estrogen and some anticancer drugs inhibit production of estrogen in postmenopausal women, the Journal reports. Although FDA does not regulate procedures, the agency has said the "biological product" created from "fat augmented with stem cells" would require regulation (Rundle, Wall Street Journal, 8/19).

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