Tuesday, July 10, 2007

Patient's Own Body Fat Used in Breast Remodeling

(HealthDay News) -- Injecting a woman's own fat from her belly or thigh into the breast to reconstruct it after breast cancer lumpectomy shows real promise, the developers of the new technique say.

Called "Celution," the investigational procedure involves "supercharging" the fat cells so they will stay where they are injected, explained Dr. Eric Daniels, senior director of business development for Cytori Therapeutics in San Diego, which developed the approach.

Celution is not yet available in the United States. However, later this year, the company expects to launch a breast reconstruction study in Europe for women who had undergone partial mastectomy. The procedure is expected to be available in Europe in 2009.

The news sparked a story in the London-based industry publication Chemistry & Industry, headlined "Breast Boost in Your Lunch Hour."

That's misleading, said Daniels and Tom Baker, Cytori's director of investor relations, since the process takes at least two or three hours. And while breast augmentation with the procedure is a possibility in the future, the target patient right now is a woman with breast cancer who needs breast defects filled in after a partial mastectomy or "lumpectomy."

A plastic surgery expert not involved in the company said the approach might work if issues surrounding fat injections -- such as the likelihood of fat being absorbed by the body -- can be worked out.

In the technique, adipose (fat) tissue is taken from the patient, using a minor liposuction-like procedure. The tissue is then placed into the Celution system, and processing begins. An hour or so later, a dose of regenerative cells is delivered back to the patient, injected in the breast.

Fat tissue contains many types of cells, Baker said, but the stem cells and regenerative cells are the "stars" that make the reconstruction possible.

"We are trying to restore a defect," said Daniels. "We are trying to match the contralateral (opposite) breast." There are few reconstructive options to achieve that type of balance for these patients, Baker and Daniels said.

Fat injections have become common practice among plastic surgeons during the last 15 years or so, according to Dr. Brian Kinney, a Beverly Hills, Calif., plastic surgeon, and clinical assistant professor of plastic surgery at the University of Southern California Keck School of Medicine.

Kinney, who is also past president of the Plastic Surgery Educational Foundation of the American Society of Plastic Surgeons, said that, "It's become common practice for plastic surgeons to use [the patient's own] fat in filling in defects such as around the eyes, in the nasolabial (nose to mouth) folds, and in the body, especially after liposuction that leads to irregular contours."

"About 6 or 8 years ago, [some] doctors started talking about injecting fat into the breast," he said. Not many plastic surgeons do the procedure, he said. "The science is not worked out, and we don't encourage it," Kinney said.

Besides the issue of fat cell reabsorption, Kinney worried that injected fat that reabsorbs may look like breast cancer on a mammogram. "We've had some radiologists that come to our [plastic surgery] meetings and say, 'I can tell the difference,' and others say, 'I don't think so,' " Kinney said.

Because of these difficulties, any woman who did opt for a procedure such as Celution, "would need to seek out a radiologist experienced in reading mammograms on breasts with fat injected," Kinney added.

"Lumpiness could be a problem," he added. "We don't have good statistics on that."
However, if the fat absorption issue could be worked out, "It would not be surprising in the future -- with refinement in technique -- that this could be of benefit to women who need augmentation or reconstruction," Kinney said. "But it may be many years, and it's far too early to know before large, well-controlled case-control clinical trials are done and peer-reviewed by other experts," he added.

As for the lunch-hour time frame? "Just a few years ago, lots of attention focused on the weekend face lift," Kinney said. "A lunchtime breast augmentation is equally implausible."

More information
To learn more about cosmetic surgery procedures, visit the American Society of Plastic Surgeons

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