Background: Autologous Fat Grafting (AFG) is a common method for soft volume augmentation enabling safer and more natural breast filling. However, outcomes are often evaluated only in the relatively short term, based on surgeon and/or patient satisfaction or on poorly reliable methods (1). Graft survival rates are widely inconsistent, and up to 84% of the transplanted volume is lost in a few months (2). Expanded Adipose-Derived Stem Cells (ADSCs) were suggested to have a supportive effect on fat graft (3).
Methods: We report the long-term follow-up of 5 women who underwent expanded ADSCs-enriched lipofilling. Breast volume was monitored by Magnetic Resonance Imaging (MRI) before the injection of expanded ADSCs (T0), 7 days post-injection (T1), and 5 to 16 months and 46 to 50 months post-injection (T2 and T3). Body Mass Index (BMI) was determined at T0, T2 and T3.
Results: In 9 out of 10 injected breasts ADSC expansion allowed 100% retention of the achieved volume, with BMI and further breast volume increase in both the short (up to 128%) and the long-term (up to 135%). The injection of 1x105 to 2.75x105 ADSCs/ml enabled long-term volume retention in all patients, for grafted volumes comprised between 192 and 652 ml..
Conclusions: ADSCs when mixed with autologous fat grafts at a sufficient concentration (1x105 to 2.75x105cells/ml) helped to achieve better retention of the graft volume, regardless of fat graft size. The increase in volume was stable over 46-50 months post grafting.
References
1. Wang CL, Luan SS, Panayi AC, Xin MQ, Luan J. Methods used for evaluation of volume retention rate in autologous fat grafting for breast augmentation: A systematic review. Chin Med J (Engl). 2019;132(18):2223-2228.

2. Boyce M, Radtke C, Vogt PM. The volumetric analysis of fat graft survival in breast reconstruction. Plast Reconstr Surg. 2013;132(5):862e-863e.

3. Kølle SF, Fischer-Nielsen A, Mathiasen AB, et al. Enrichment of autologous fat grafts with ex-vivo expanded adipose tissue-derived stem cells for graft survival: A randomised placebo-controlled trial. Lancet.