New stem-cell enhanced breast reconstruction: Ground-breaking or risky? Breast cancer is the most common form of cancer in women and a good number of women will suffer from it in their lifetime. In the United States, 200,000 women are diagnosed each year with this cancer, and a fourth of them will go on to die of the dreaded disease.
But while breast cancer survivors are grateful for their chance at a new life, they are also bogged down by pain, disfigurement and the psychological distress that comes with having to have both breasts, one or a part of their breast removed.
What most women don’t know is that surgery, combined with high-dose radiation, causes severe damage to breast tissues, resulting terrible disfigurement.
For many women, reconstructive surgery is done, and a silicone or saline-filled implant [Related: Silicone vs Saline Breast Implant] is used to replace the lost breast. Women who don’t want artificial implants can opt for the surgical stripping of abdominal or back muscles, which are then used to reconstruct the breast.
But reconstruction surgeries often come with chronic pain and many side effects: discomfort in the breast area, pain from hernias, weakness from the donor site of the body, including muscles in the back or the abdomen.
Seldom do any of the conventional reconstruction surgeries restore the breast to its original sensation, mobility, comfort and appearance.
Some plastic surgeons graft fat from another part of the patient’s body and transplant this to the breast area. But scientific studies have failed to show clear evidence of the long-term viability of the fat transplanted into the breast.
Cell-assisted lipotransfer
A new, experimental surgery using stem cells promises to revolutionize breast reconstruction.
The new procedure takes the concept of transplanting fat a step further: fat is enriched with concentrated stem cells so it can regenerate the breast at the cell level.
The technique, conceived by Japanese scientist Dr. Kotaro Yoshimura is being touted by its first American recipient, the actress and fitness personality Suzanne Somers, who recently underwent the procedure to reconstruct a breast she lost to the cancer.
Diagnosed with breast cancer at age 50 in 2001, Suzanne went on to have a lumpectomy to remove the tumor, followed by intense radiation therapy.
“Now if you say ‘I’m just going to do a lumpectomy, I thought it’d take like a quarter’s worth out. But when they took the bandages off, there was like, two-thirds of my breast gone,” says Suzanne in a candid interview on the Dr. Oz show last December (2011). “Now throughout my career, I’ve been kind of known as a sex symbol…how ironic here I am, sex symbol, and I have one and a third breasts!” she adds.
“I think that over the years, I’ve been able to camouflage it pretty well. I’ve worn prosthetics so I could push the side up, and for the past eleven years I haven’t had a breast there,” says Suzanne. In the interview, she discusses her personal battle with cancer and endorses the new procedure, which she says brought her impressive results.
Dissatisfied with current cancer treatments and conventional breast reconstruction therapies, Suzanne Somers took her health in own hands and found a new surgical technique that she claims gave her a natural-appearing and feeling breast to replace the one she had lost.
According to Suzanne, the new technique — called cell-assisted lipotransfer — uses autologous adipose-derived stem cells in combination with liposuction techniques. It involves using these stem cells to enhance survival rate of the fat grafts and to reduce postoperative atrophy or shrinkage.
To start off, a breast cancer survivor undergoes a liposuction. Then doctors use fat obtained from liposuction, which is relatively poor in stem cells—called “adipocyte-stem cell poor” fat or ASC-poor fat, and convert it into “adipocyte stem cell-rich” (ASC-rich fat).
This is done by taking half of the fat obtained from liposuction and concentrating its stem cells. These stem cells, ASC-rich fat, are then attached to the other half, ASC-poor fat, of the aspirated fat. The combined ASC-rich and ASC-poor fat is then implanted into the patient. This other half of the aspirated fat acts as a scaffold for the stem cell concentrate.
“In layman terms, they removed the fat by liposuction from my abdominal area,” explains Suzanne. “They took that fat and spun it at supersonic speed, separating it into three layers—like a mousse. The first layer was fat, second, blood, third, stem cells.”
She continues: “They took the stem cells, cleaned them, separated them, discarding the weak ones, then converged the strongest stem cells back into the fat and whipped those strong stem cells which were now in high concentrations together.”
“And with a ‘turkey baster’—my terms—they injected the stem cell laden fat into my breast until it was of the correct volume. Poof! There it was,” she tells Bill Faloon of Life Extension Magazine in an exclusive interview last December. It took the doctors 90 minutes to separate the strong stem cells in the laboratory.
Double purpose
“Really the whole procedure is a win, win, win — you get a new real breast, plus you get rid of unwanted fat!” Suzanne enthuses.
For her surgery, Suzanne used fat removed from her abdomen to derive the stem cells used to regenerate her breast tissue. But, she says, fat can be taken from any part of the body. “I would imagine each individual woman would have her favorite places for removal: love handles, thighs, inner thighs,” she said.
Speaking in the Dr. Oz show, Suzanne said she discovered the new procedure through a surgeon in Japan who has performed hundreds of these procedures on Japanese women.
So is the new stem-cell enhanced breast reconstruction revolutionary or risky?
“Clearly no operation is for everybody,” says Dr. Aronowitz, the surgeon who performed the surgery on Suzanne. Dr. Aronowitz is a plastic surgeon, a diplomate of the American Board of Plastic Surgery, an ambassador of the American Society of Plastic Surgeons, a member of the American Society of Bariatric Plastic Surgeons and the California Society of Plastic Surgeons. He is also founder of University Stem Cell Center.
“But this is a new alternative that is going to be available to a lot of women because you don’t have to have scars elsewhere on your body,” Dr. Aronowitz says. According to him, the new surgery does not pose the same complications that can come from having an implant.
There are complications, he says, but these are limited to the same complications that come with liposuction.
The cell-assisted lipotransfer breast rejuvenation procedure has not been approved by the U.S. Food and Drug Authority.
So in order to have it done in the country, Suzanne was required by the Hollywood Presbyterian Hospital to obtain an Institutional Review Board (IRB) approval qualifying one for a clinical trial. Under this restraint, the FDA did not allow Suzanne to use her banked stem cells, only stem cells taken from her fat on the spot.
“Other doctors around the country are doing autologous fat transplantation for cosmetic breast surgery, but I am the first to have Dr. Yoshimura’s advanced technique utilized, legally, using only my fat enriched with adipose-derived stem cells.”
In an article on The Dr. Oz Show website, Dr. Peter Rubin, Chief of Plastic and Reconstructive Surgery at the University of Pittsburgh Medical Center praised the results of using stem cells in reconstructive surgery.
This type of stem cell therapy, currently being tested for use in healing many types of injuries in war veterans, shows great promise, he said.
But he cautions that the procedure is still in its experimental stages and women need more data to make informed decisions.
In particular, he warns that because stem cells release chemicals that cause the development of new blood vessels, this could also stimulate the growth of a new cancer from any cancer cells that may remain after cancer treatment.
This raises vital questions: “When is the optimal timing after breast cancer surgery to perform this procedure? And another question, of course, is how will this procedure impact cancer screening?” Dr. Rubin asks.
But according to Dr. Aronowitz, the more breast tissue is removed, the more likely all of the cancerous cells are removed. He also says there is no indication that injecting fat and stem cells will cause cancer to develop any more than exercise — that increases blood flow and stimulates blood vessel growth — will.
Small cysts of fat cells that do not survive can form into small calcifications that may be confused later with cancer during a mammogram or manual breast exam, he warned however.
Suzanne also wants women to know that when she took her health into her own hands, she made sure that what she did was legal and was done in FDA approved clinical trials.
Women should avoid unsafe, illegal services that perform fat injections without authorization, she warned.
Considering this type of breast procedure?
Suzanne says there are several centers that do this type of surgery and that a woman can contact the Breast Preservation Foundation for recommendations.
“It’s important to know that to get a nice result like Suzanne has, you have to preserve the skin envelope of the breast so that there is something to fill up, because we are not replacing the skin,” says Dr. Aronowitz.
Mastectomies often involve removing both the nipple and the breast skin, but women who are looking to have a procedure like Suzanne’s both have to be left intact.
“It was quite emotional,” says Suzanne, “to look down there and suddenly see them there. And I thought, ‘What a great advancement for women.’”
“Compared to what I have now, I cannot imagine any woman wanting to choose implants over it…Gosh! It’s so nice to look down and see two again,” she says laughing.