Bioshaping – new therapy using patient’s own body fat

Author: Dr. med. Petra Berger

An interview with plastic surgeon Dr. Petra Berger (Frankfurt am Main and Zurich) about the newest therapy trends using the patient’s own body fat.

Dr. Berger, patients are currently having their silicone implants removed because they are defective. How does the current situation in therapy using the patient’s own body fat appear in relation to this?

Dr. Berger: Well, there is a lot of panic surrounding this subject at the moment – coming from the media and colleagues who want to promote themselves. Of course we also offer silicone implants, with very good results. But more and more patients are starting to prefer breast augmentation using their own body fat, because they reject silicone implants on principle, which is understandable given the current results. But this is only one field of application of the many that have been available since scientists discovered and developed the regenerative power of adult adipose-derived stem cells.

What can they also be used for?

Dr. Berger: They are basically suitable for practically all areas of the body that need to be renewed or enlarged. Whether this involves cheeks, breasts, buttocks or calves – almost any area can be treated using this method with a simultaneous improvement in the skin’s appearance. Capsular fibrosis of silicone implants can also be treated by softening the encapsulating tissue using simple adipose tissue injections.

Congenital or acquired facial or bodily deformities can also be corrected. Adipose tissue injections can also be used to reduce hard, raised or contracted scars, for instance from burns or after a caesarean section. Or this therapy can be used for problematic wounds, which refuse to heal, to close them.

Even cases of paralysis of the vocal chords can be treated with targeted therapy using the patient’s own adipose tissue to renew the patient’s phonetics.

That’s an extensive list of treatments.

Dr. Berger: And it is not exhaustive. Asymmetric breasts can be naturally corrected using the patient’s body fat, amputated breasts after the removal of cancerous tissue can be restored. Health insurance companies are even currently willing to cover the costs of these operations. Subsequent developments will be of particular interest to men.

That seems interesting.

Dr. Berger: Adipose-derived stem cells can be used to cultivate hair and other types of cells in the laboratory, and the result can then be injected into the scalp. This is a revolutionary technique compared to existing methods, because it is much less complicated and involves less blood loss.

To make things clear: You are not talking about embryonic stem cells in relation to the initial material, but always about adult adipose-derived stem cells.

Dr. Berger: Yes, that is accurate.

Won’t this result in easier general acceptance of therapy using the patient’s own body fat?

Dr. Berger: I’m sure it will. I should point out that the current European legal situation and legal liability regulations about stem cell therapy, which is currently being advertised, do not allow extensive use of this therapy on a commercial basis at the moment. Please don’t misunderstand me; I am also fascinated by the opportunities this therapy offers. However, it is currently experimental. Serious physicians should always accurately inform their patients of the circumstances related to legal liability. With regard to therapeutic methods that are not yet permitted and therefore cannot be insured, in the worst case the patient will not be compensated for potential damage. This should be clearly stated.

What is more, enrichment of stem cells, for instance to increase the degree of adipose tissue growth, is no longer necessary. We use a special centrifuge and achieve equivalent results without needing additional stem cells.

Doesn’t this situation interest colleagues who don’t take these finding seriously yet?

Dr. Berger: Yes, chiefly operators from other fields, the so-called “Aesthetic Surgery Taliban”. They are called that because they proceed in a similarly aggressive manner and with the same insufficient legitimacy. Treatment using the patient’s own body fat is a therapeutic method developed for plastic surgeons. Only individuals who have been educated in this field and have the required experience can truly master these large amounts of new, sophisticated methods. In particular knowledge about removing adipose tissue, processing it and transferring it is required.

Rapid and unrealistic results are frequently promised as a result of their desire for profit. It is clear that one session cannot produce an increase in adipose tissue of more than 50%. Even if high-tech procedures are used an increase in volume of 100% only exists in fairy tales by the brothers Grimm and I hope you know what you should think about such outrageous promises. These operations are frequently performed without an anaesthesiologist and are not completely sterile. I have seen television shots of an “aesthetic surgeon” whose long plait interfered with the surgical field during the operation. This does not have anything to do whatsoever with surgical principles or sterility.

What other mistakes are common?

Dr. Berger: Frozen and defrosted adipose tissue is sometimes also injected, even though it has been known for a long time that cells do not survive freezing temperatures, so they cannot multiply.

In my practice we have a slightly different concept of what a first rate operation should be.

The operation is performed by a six-member team of specialists, which naturally also includes an anaesthesiologist. We maintain the strictest possible sterility and naturally provide correct pre and post-surgical care, which also includes a pre and post-surgical mammogram, prophylactic antibiosis and thromboembolytic prophylaxis. This could mean up to ten days of heparin injections after surgery. Patients should not accept less care than this.

Germany still seems to be slightly behind on the subject of therapy using the patient’s own body fat. Or is this a false impression?

Dr. Berger: Yes, this is true. This method of therapy is still very new. What is being presented on podiums at German congresses at present is more and more reminiscent of Shakespeare’s comedy “Much ado about nothing“.

Do you see any chance of a change?

Dr. Berger: Yes, I am an optimist about this. If professional know-how wins, bioshaping using the patient’s own body fat will also become of appropriate importance here.

Thank you very much Dr. Berger. I expect we will meet again during a number of interesting interviews on this subject.

Updated: 2011-11-29

Dr. med. Petra Berger

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