Adipose-derived stem cells (ASCs) can be isolated from human adipose tissue with the exceptional potential for differentiation into mature adipocytes. Utilization of this system is very promising in developing improved techniques to repair soft tissue defects. Current reconstructive procedures, especially after trauma and oncological surgery, transfer autologous soft tissue grafts having limitations. However, ASCs offer the ability to either generate soft tissue with no donor-site morbidity (with the exception of a minor loss of adipose tissue) or enhance the viability and durability of other grafts. This review will discuss the relevant properties of human adult adipose-derived stem cells for the regeneration of adipose tissue. Discussion will focus on the biology of ASCs, cell delivery vehicles/scaffolds useful in applying ASCs as a therapy, and suitable IN VIVO animal models for studying adipose tissue engineering. Also included is a description of the current clinical studies with ASCs in Europe and Asia.
"In addition, ADSCs have a differentiation potential similar to other MSCs as well as a higher yield upon isolation and a greater proliferative rate in culture when compared to BMSCs [18-20]. The discovery that ADSCs are not only precursor to adipocytes, but are multipotent progenitors to a variety of cells  was a milestone that has allowed scientists to utilize the true potential of ADSCs to derive several additional cell types including osteoblasts, chondrocytes, myocytes, epithelial cells and neuronal cells . For the plastic surgeon, they are an abundant source of multipotent stem cells that can be easily accessed during many routine procedures. "
[Show abstract][Hide abstract] ABSTRACT: Stem cells are a unique cell population characterized by self-renewal and cellular differentiation capabilities. These characteristics, among other traits, make them an attractive option for regenerative treatments of tissues defects and for aesthetic procedures in plastic surgery. As research regarding the isolation, culture and behavior of stem cells has progressed, stem cells, particularly adult stem cells, have shown promising results in both translational and clinical applications.
The purpose of this review is to evaluate the applications of stem cells in the plastic surgery literature, with particular focus on the advances and limitations of current stem cell therapies. Different key areas amenable to stem cell therapy are addressed in the literature review; these include regeneration of soft tissue, bone, cartilage, and peripheral nerves, as well as wound healing and skin aging.
The reviewed studies demonstrate promising results, with favorable outcomes and minimal complications in the cited cases. In particular, adipose tissue derived stem cell (ADSC) transplants appear to provide effective treatment options for bony and soft tissue defects, and non-healing wounds. ADSCs have also been shown to be useful in aesthetic surgery.
Further studies involving both the basic and clinical science aspects of stem cell therapies are warranted. In particular, the mechanism of action of stem cells, their interactions with the surrounding microenvironment and their long-term fate require further elucidation. Larger randomized trials are also necessary to demonstrate the continued safety of transplanted stem cells as well as the efficacy of cellular therapies in comparison to the current standards of care.
Archives of Plastic Surgery 11/2013; 40(6):666-675. DOI:10.5999/aps.2013.40.6.666
[Show abstract][Hide abstract] ABSTRACT: Facial rejuvenation is a significant process involved in restoring youthfulness. The introduction of less invasive procedures has increased acceptance of such procedures. Often a combination of different techniques allows individualized treatment with optimal outcomes. Furthermore, this leads to a natural look without a significant downtime. We report herein the use of such a combined approach in middle-aged women with particular emphasis on botulinum toxin type A, dermal fillers, and chemical peels.
[Show abstract][Hide abstract] ABSTRACT: In parallel with aging, increasing skin laxity and subcutaneous atrophy occur in many regions of the human body. Apart from the most obvious facial region, where most aesthetic operations for rejuvenation are done, also the dorsum of the hand is continuously visible in daily life. This region exhibits skin laxity, subcutaneous atrophy and age-related pigmentations in a comparable manner to the face. Autologous transplantation of fatty tissue (structural fat grafting, lipofilling) enables subcutaneous regeneration by refilling the subcutaneous space and hence reducing some of the age-related degenerative process. This paper illustrates the special operative technique on the hand in the form of a case report. Furthermore, 3D surface laser scanning permits an objective evaluation of the permanent volume effect over time. In the presented case a volume effect of 69% of the injected volume was measured after 6 months follow-up time. This amount of injected tissue seems to be integrated as a graft and results in a reduction of subcutaneous atrophy in terms of a true regeneration. Structural fat grafting of the dorsum of the hand is thus a method of regenerative medicine. Together with other methods which reduce the age-related pigmentations, it plays a key role in our treatment concept for rejuvenation of the hand.
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