Ex vivo-expanded autologous adipose tissue-derived stromal cells ensure enhanced fat graft retention in breast augmentation: A randomized controlled clinical trial.

Autologous fat grafting and implant surgery are used for volume restoration in plastic surgery. With the aim of producing a treatment superior to current solutions, we report a randomized, controlled, data assessor-blinded clinical trial comparing fat grafts enriched with ex vivo-expanded autologous adipose-derived stromal cells (ASCs) to nonenriched fat grafts in breast augmentation. The intervention group received ASC-enriched fat grafts (≥20 × 106 viable ex vivo-expanded ASCs per milliliter fat), and the control group received conventional nonenriched fat grafts. Volume retention was measured by magnetic resonance imaging, and clinical photographs were taken simultaneously for outcome evaluation. ASC-enriched fat grafts had significantly higher retention rates (mean = 80.2%) compared with conventional fat grafts (mean = 45.1%). Clinical photos showed statistically significant superior results in the intervention group, assessed by independent clinical experts. These results improve the prospects for using culture-expanded ASCs in both reconstructive and cosmetic volume restoration and make the procedure an attractive alternative to conventional fat grafting and implants. This study is registered at www.ClinicalTrials.gov, number H-16046960.

Hyperspasticity After Partial Neurectomy for Treatment of Myospasms Following Subpectoral Breast Reconstruction.

Breast reconstruction using tissue expander is a frequently used method of reconstruction after mastectomy. We describe a rare complication of myospasms after subpectoral tissue expander reconstruction with acellular dermal matrix. The patient gradually developed disturbing pectoral muscle spasms lasting almost a year. Botulinum toxin A was undesired due to its transient effect. Selective denervation of the medial pectoral nerve branches was performed and resulted in worse spasms where the breast bounced at a rapid speed. Complete denervation of the pectoral nerves led to immediate liberation. We recommend a cranial denervation of both medial and lateral pectoral nerves to secure complete denervation leading to permanent relief of involuntary spasms where selective denervation may lead to hyperspasticity.