Cell-Assisted Lipotransfer (CAL) & Facial Wasting
Jan 12, 2012
Hello: Cell-Assisted Lipotransfer (CAL)is currently being used in breast restoration. Do you see any possible application of this procedure in treating facial lipoatrophy?
Response from Dr. Pierone
Hello, and thanks for posting.
Autologous fat transfer has been attempted for the management of facial lipoatrophy and has met with mixed success. The first hurdle to overcome is whether there is sufficient subcutaneous fat available to perform liposuction in order to harvest the fat. This is not a problem for most people, but many with facial lipoatrophy also have subcutaneous fat atrophy. Although some individuals have significant visceral fat because of coexistent lipohypertrophy, this fat is not available for fat harvesting.
In its current form, autologous fat grafting is plagued by inconsistent results, contour irregularity, and unnatural appearing results. The durability of the grafted fat is variable as well, some people get stable long-term persistence of the grafted fat and others notice gradual loss of the fat similar to the disappearance of a temporary facial filler.
Cell-assisted lipoatransfer is a modification of autologous fat transfer. When fat is harvested through liposuction, there are fewer adipose derived stromal (stem) cells then are normally present in fat. These stem cells are multi-potential cells and appear to support the growth and persistence of transferred fat. The cell-assisted lipotransfer process involves processing a portion of the harvested fat to isolate the adipose derived stem cells which are then used to enrich the fat before it is injected.
Cell-assisted lipotransfer has been shown to improve fat transfer survival and is a promising approach to improve the outcomes with autologous fat grafting. There are no studies that I am aware of for facial lipoatrophy, but as the technology evolves I would expect to see it used.
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