Keeping Abreast (or two) of Regenerative Medicine

Regenerative medicine is based upon thebody's ability to build itself -- and to often re-build itself after injury.  We are seeing breakthroughs in stem cell technologies virtually every week.  New technologies that allow physicians to use a patient's own cells to re-build a lost or damaged body part will avoid problems with immune rejection and ethical objections.  And if the touchstone for the explosion of regenerative medicine happens to be the human breast -- who can complain?

How to Build a New Breast

Cytori’s process for reconstructing or augmenting breasts relies on the recent discovery that human fat contains an amazing concentration of stem cells—cells that can be separated out using a centrifuge. That’s the science part. The artistry comes in when the surgeon makes tiny incisions for depositing the enriched fat cells, building a breast one dot-sized injection at a time like a 3-D pointillist. Here’s how it works.

Step 1 Liposuction

Breast reconstruction usually starts in the abdomen, using liposuction to harvest fat cells. Each liposuction syringe holds about 60 cc (2 fluid ounces) of fat cells and takes five minutes to fill. Repairing the divot caused by an average lumpectomy requires eight to 10 syringes to get about 360 cc of fat tissue. Half the fat is used to create the volume needed to fill the divot and half is processed to isolate stem and regenerative cells. A typical augmentation requires 800 cc (27 ounces) of liposuctioned fat: Volume varies, but in one study 160 cc of injected stem-cell-enriched tissue boosted breast circumference an average of 4 centimeters (1.6 cup sizes).

Step 2 Centrifugation

The liposuctioned fat is injected into the Celution System. ›› The fat cells are then “washed” with proprietary enzymes that break down the scaffolding that holds the fat cells together. ›› Next, a centrifuge separates the fat cells from the stem and regenerative cells, concentrating them into a pellet, which is then extracted. ›› The pellet of cells is added back to some of the liposuctioned fat cells, producing a liquid suspension enriched with stem and regenerative cells and ready for injection.

Step 3 Injection

Using a tool called the Celbrush, the surgeon repeatedly deposits the enriched cells in the breast, either at the site of a lumpectomy or throughout the breast for augmentation or repair of a mastectomy.

With reconstruction patients, the tip on the brush makes tiny cuts that perforate scarred areas, transforming the bed of damaged tissue into a biological mesh. The Celbrush releases 0.5 cc of cell-enriched tissue each time the surgeon moves its control wheel. The process typically takes a couple of hours, depending on the extent of treatment. The deposited tissue bonds quickly to the existing tissue. Within 48 hours, new capillaries and blood vessels entwine through the new cells, supplying oxygen and nutrients to the now-stable tissue. ›› The injection area isn’t painful afterward; patients go home the same day.

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