Dr. De Fazio Plastic Surgeon :: Procedures :: Breast :: Breast Augmentation by lipofilling with stem cells: Celution

Lipofilling with regenerative cells

seno_lipofilling_staminali_celution.jpgThe results of Breast Augmentation without implants (Breast Lipofilling) are now more long-lasting thanks to the use of Adipose Derived Regenerative Cells (ADRCs).
It is possible to process the adipose tissue grafted from the patient enriching it with autologous regenerative cells, in the surgery room sterile environment and during the procedure itself (as day-hospital surgery).

ANESTHESIA:
spinal + sedation / general
TREATMENT LENGTH:
3,5 - 4 hours
STAY IN HOSPITAL:
1 day / day surgery
RECOVERY TIME (BACK TO SOCIAL LIFE):
2 weeks
The benefits of autologous regenerative cells

Breast Lipofilling has many benefits compared to other materials used to enhance volume or reshaping parts of the body:

  • It is minimally invasive: only small incisions are necessary in order to introduce cannulas for harvesting and grafting

  • Body reshaping: a combination of liposuction and volume enhancement in one procedure

  • More natural results: autologous fat gives a more natural result compared to artificial fillers

  • No rejection: the adipose tissue is autologous, thus coming from the same patient

  • Less reabsorption compared to artificial fillers (i.e. Hyaluronic Acid)

Using this technique, it is possible to process the adipose tissue grafted from the patient enriching it with its regenerative cells, in the surgery room sterile environment and during the procedure itself (as day-hospital surgery). Thanks to this system and to the powerful nature of the adipose derived regenerative cells, a real tissue regeneration takes place.

The benefit of stem cells has been confirmed by comparing the condition of the patients treated with the Celution® technique before and after surgery, using Computed axial tomography (CAT) and Magnetic resonance imaging (MRI): the partial reabsorption of the grafted adipose tissue is much lower than in the patients treated with the traditional Lipofilling technique (thus without stem cells).

Reduced volume, asymmetry and tuberous brest are ideal conditions to be treated with this technique.

Breast Augmentation by LIpofilling with autologous regenerative cells implies harvesting adipose tissue (liposuction) , which can be minor or major according to the indiviadual needs and goals. Therefore, this procedure actually consists of two combined procedures (Liposuction and Lipofilling); The donor sites in this case are normally the hips, the abdomen, the trochanteric region, the thighs, or the knees. As a consequence, the result will be breast and body reshaping at the same time.

Once harvested, the adipose tissue is processed to remove fluid excess and charged into 1cc syringes and then, using very thin needles, it is injected bilaterally, both above and under the mammary gland.
This process can be repeated as many times as needed, until the desired correction is achieved.
As a consequence, the procedure will have a dual result: reducing adipose tissue in the areas where it is excessive and increase the breast volume.

On the breast there will be no visible scars since the needles used leave no marks.

The adipose tissue is a source of adult regenerative cells similar to the ones extracted from the bone marrow. Nevertheless, adipose tissue had advantages compared to bone marrow:

• easier to collect
• higher amount of regenerative cells than can be extracted

Research studies have shown that the adipose tissue in obese patients and in patients with a normal weight (standard BMI) have the same quantity of regenerative cells.

The procedure

The grafted fat tissue is permanent and, since it is enriched with autologous regenerative cells, no allergic reactions can occur.
Lipofilling can also correct post-traumatic and post-surgical defects.

Benefits of the system:
- the fat tissue grafted is permanent, thus lasting a lifetime
- it is affordable
- no allergic reaction can occur
- the result is extremely natural.

Lipofilling is performed in a surgery room if the areas to be treated, like the breast, need a big quantity of adipose tissue and, as a consequence, the harvesting (liposuction) must be from several parts of the body. In these cases, anesthesia must be spinal or general. 
Dr. De Fazio uses lipofilling by Dr. Coleman's technique.
For this kind of lipofilling procedure, the surgeon uses a small needle or cannula attached to a surgical vacuum or syringe, harvesting the fat tissue from the donor site, preferably from the parts of the body where fat tissue is firmer: abdomen, hips or thighs. Once harvested, the adipose tissue is processed to remove fluid excess and charged into 1cc syringes and then, using very thin needles, it is injected bilaterally, both above and under the mammary gland.
This process can be repeated as many times as needed, until the desired correction is achieved.
The harvesting of fat tissue for breast lipofilling is normally performed in combination with a small liposculpture. In most of the cases, to get the desired volume enhancement, it is necessary to harvest an adequate quantity of material, considering that breast augmentation requires in average 250-300 cc of adipose tissue for each breast.
During the procedure, the harvested fat tissue can be centrifuged and, as a consequence, half of the quantity is lost. For this reason, the patients who decide to undergo this procedure must have the necessary quantity of adipose tissue available for liposuction. As a consequence, the procedure will have a dual result: reducing adipose tissue in the areas where it is excessive and increase the breast volume. On the breast there will be no visible scars since the needles used leave no marks. In the donor sites, there will be a small scar of about 3 mm (the needle size).
The procedure is performed as day-hospital surgery except from the cases when it is performed late in the afternoon or upon the patient's request.
This procedure is very safe, since it is minimally invasive.

Preoperative Preparation

The preoperative preparation implies blood tests, an ECG and, according to surgeon's assessment, an ultrasound of the mammary area.
Two weeks prior to surgery, as well as two weeks after, aspirin should be avoided. Aspirin can reduce blood coagulation and can cause complications.
It is recommended to female patients taking oral contraceptives to stop taking them one month before surgery.


Post-operative care

Although this is a low complication risk procedure, antibiotics are anyhow prescribed to prevent any possible infection risk. In addition, an anesthetic with vasoconstrictor is injected and a compression garment is applied in order to avoid any risk of subcutaneous hematoma.
Some edema or swelling might appear from the day after surgery, but is normal and will gradually disappear within 7-10 days. The same applies to some redness or ecchymosis (bruises) in the area that has been filled.

After the procedure

Already from the first day after surgery, a course of Tecar® Therapy is recommended to facilitate the absorption of edema (swelling) and ecchymosis (bruises). The surgeon, together with the physiotherapist performing the therapy, will decide the number of sessions.

Possible complications

Although this is a low complication risk procedure, antibiotics are anyhow prescribed to prevent any possible infection risk. In addition, an anesthetic with vasoconstrictor is injected and a compression garment is applied in order to avoid any risk of subcutaneous hematoma.
Some edema or swelling might appear from the day after surgery, but is normal and will gradually disappear within 7-10 days. The same applies to some redness or ecchymosis (bruises) in the area that has been filled.

Recovery time (back to social life)

Social activities will be reduced for one week after surgery if involving the treated areas (such as thighs, knees, hips, tummy and buttock) . Long walks should be limited, as well as strains and sports, for one month; yet, already from the day after, office work can be resumed. Pain is normally not occurring and can anyhow be easily controlled by proper therapy.
Recovery of the normal physical activities does not get longer because of edema and swelling. If some redness occurs, even though rare for this procedure, it normally involves the lower breast quadrants. In this case, sun exposure should be avoided until the redness is gone but, anyhow, for not more that 30 days after surgery. Pain and discomfort can last for 2-3 weeks and could reduce the functionality of the arms if straining, such as lifting heavy objects.
Sports can be resumed during the 3rd or 4th week after surgery.
Driving is not affected in this procedure, but the breast should not be pressed or massaged for 30 days.

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