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Fett bietet neben seinem volumisierenden Effekt ein reichhaltiges Reservoir fur regenerative Zellen, die eine wichtige Rolle fur den Einbau und das Uberleben eines Fettgrafts spielen. Wir haben den Unterschied zwischen dermalem weisem Fettgewebe (dWAT) und subkutanem weisem Fettgewebe (sWAT) als auch die Auswirkungen der maschinellen und manuellen Fettabnahme mit verschiedenen Kanulen- bzw. Perforationsgrosen auf die Viabilitat der Adipozyten und der aus dem Fettgewebe isolierten stromalen vaskularen Fraktion (SVF) untersucht. Zusatzlich verglichen wir, ob eine hohe Zentrifugation sowie die Tumeszenzlosung einen Effekt auf diese Zellen haben. Es zeigte sich, dass mit einer dWAT-Kanule mehr tote Adipozyten hervorgebracht werden, jedoch mit einer hoheren SVF-Zellausbeute. Die aus dWAT isolierten SVF-Zellen zeigten eine leicht erhohte Zelldichte und metabolische Aktivitat nach Isolierung im Vergleich zu aus sWAT isolierten SVF-Zellen. Im Gegensatz zur 2‑mm-Kanule war die 1‑mm-Kanule schonender in der Fettentnahme und brachte signifikant viable SVF-Zellen hervor. Einen negativen Effekt auf das Uberleben der Adipozyten zeigte unser Versuch, Fettgrafts mittels 2 Spritzen und Sieb herzustellen. Das Waschen mit NaCl, um die Tumeszenzlosung zu entfernen, resultierte in weniger toten Zellen im Liposuktionsmaterial. Auch die vielerorts verwendete Zentrifugation des Liposuktionsmaterials hatte einen negativen Einfluss auf das Uberleben der Adipozyten. Ein Eigenfetttransfer besteht aus vielen einzelnen Schritten. Das Ergebnis hangt nicht nur von der Wahl der Kanulen, sondern auch von der Verarbeitung und Reinjektionstechnik des gewonnenen Gewebes ab. Ziel ist, jeden einzelnen Verarbeitungsschritt zu verbessern, um dem transplantierten Gewebe die bestmoglichen Uberlebenschancen zu bieten und dadurch das Endergebnis zu optimieren.

Positive Effekte der extrakorporalen Stoswellentherapie (ESWT) konnten zuvor auf Wundheilung, Nervenregeneration und Gefasneubildung bewiesen werden. In dieser Studie haben wir die radiale ESWT zur Gesichtsrejuvenation untersucht, wobei bereits die direkte ESWT-Behandlung erste Wirkung gezeigt hat. Fur eine gesteigerte Volumisierung wurde zusatzlich Eigenfett mit ESWT-Vorbehandlung des Spender-und Empfangerareals appliziert. Die Vorbehandlung des Empfangerareals mit ESWT ist fur das Anwachsen des Transplantats notwendig, da mittels ESWT die Angiogenese und somit ein erfolgreicher Einbau der Grafts im Zielgewebe erfolgen kann.

Background aims Lipedema is a hormone-related disease of women characterized by enlargement of the extremities caused by subcutaneous deposition of adipose tissue. In healthy patients application of autologous adipose tissue–derived cells has shown great potential in several clinical studies for engrafting of soft tissue reconstruction in recent decades. The majority of these studies have used the stromal vascular fraction (SVF), a heterogeneous cell population containing adipose-derived stromal/stem cells (ASC), among others. Because cell identity and regenerative properties might be affected by the health condition of patients, we characterized the SVF cells of 30 lipedema patients in comparison to 22 healthy patients. Methods SVF cells were analyzed regarding cell yield, viability, adenosine triphosphate content, colony forming units and proliferative capacity, as well as surface marker profile and differentiation potential in vitro. Results Our results demonstrated a significantly enhanced SVF cell yield isolated from lipedema compared with healthy patients. In contrast, the adipogenic differentiation potential of SVF cells isolated from lipedema patients was significantly reduced compared with healthy patients. Interestingly, expression of the mesenchymal marker CD90 and the endothelial/pericytic marker CD146 was significantly enhanced when isolated from lipedema patients. Discussion The enhanced number of CD90+ and CD146+ cells could explain the increased cell yield because the other tested surface marker were not reduced in lipedema patients. Because the cellular mechanism and composition in lipedema is largely unknown, our findings might contribute to a better understanding of its etiology.

Background Cell-based therapies with autologous adipose tissue–derived cells have shown great potential in several clinical studies in the last decades. The majority of these studies have been using the stromal vascular fraction (SVF), a heterogeneous mixture of fibroblasts, lymphocytes, monocytes/macrophages, endothelial cells, endothelial progenitor cells, pericytes and adipose-derived stromal/stem cells (ASC) among others. Although possible clinical applications of autologous adipose tissue–derived cells are manifold, they are limited by insufficient uniformity in cell identity and regenerative potency. Methods In our experimental set-up, low-energy extracorporeal shock wave therapy (ESWT) was performed on freshly obtained human adipose tissue and isolated adipose tissue SVF cells aiming to equalize and enhance stem cell properties and functionality. Results After ESWT on adipose tissue we could achieve higher cellular adenosine triphosphate (ATP) levels compared with ESWT on the isolated SVF as well as the control. ESWT on adipose tissue resulted in a significantly higher expression of single mesenchymal and vascular marker compared with untreated control. Analysis of SVF protein secretome revealed a significant enhancement in insulin-like growth factor (IGF)-1 and placental growth factor (PLGF) after ESWT on adipose tissue. Discussion Summarizing we could show that ESWT on adipose tissue enhanced the cellular ATP content and modified the expression of single mesenchymal and vascular marker, and thus potentially provides a more regenerative cell population. Because the effectiveness of autologous cell therapy is dependent on the therapeutic potency of the patient's cells, this technology might raise the number of patients eligible for autologous cell transplantation.

In the past decade, adipose tissue became a highly interesting source of adult stem cells for plastic surgery and regenerative medicine. The isolated stromal vascular fraction (SVF) is a heterogeneous cell population including the adipose-derived stromal/stem cells (ASC), which showed regenerative potential in several clinical studies and trials. SVF should be provided in a safe and reproducible manner in accordance with current good manufacturing practices (cGMP). To ensure highest possible safety for patients, a precisely defined procedure with a high-quality control is required. Hence, an increasing number of adipose tissue-derived cell isolation systems have been developed. These systems aim for a closed, sterile, and safe isolation process limiting donor variations, risk for contaminations, and unpredictability of the cell material. To isolate SVF from adipose tissue, enzymes such as collagenase are used. Alternatively, in order to avoid enzymes, isolation systems using physical forces are available. Here, we provide an overview of known existing enzymatic and non-enzymatic adipose tissue-derived cell isolation systems, which are patented, published, or already on the market.