How Your Belly-Fat Is Transforming Patient Care

For those of us wondering how we could put unwanted belly fat to good use, just know there are a least a few plastic surgeons pondering the same thing. Typically, we associate belly fat and plastic surgery with procedures like liposuction and tummy tucks, but new research has plastic surgeons aiming higher.

According to a study published in the August issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS), plastic surgeons are investigating the use of high-pressure oxygen treatments to convert those extra fat cells into stem cells, which could then be transformed into various cell types of the body.

Fat stem cells – technically called adipose-derived stem cells, or ASCs – have "revolutionized regenerative plastic surgery in recent years," according to Bong-Sung Kim, MD, Department of Plastic Surgery and Hand Surgery – Burn Center of the University Hospital RWTH Aachen, Germany and colleagues. Like other stem cells, these fat-derived cells can transform into many different kinds of specialized cells – including fat, bone, and cartilage cells, among others – and could be used for an expanding range of reconstructive and cosmetic procedures.

The challenge is to find the best ways of encouraging fat stem cells to develop into the types of cells needed for specific purposes. Dr. Bong-Sung Kim, Yuriko Yoshinoya, Arne H. Böcker, Tim Ruhl, Ullrich Siekmann, Norbert Pallua and Justus P. Beier from the University Hospital RWTH Aachen explored the use of high-pressure oxygen treatment – as a new approach to guiding stem cell development.

High-pressure oxygen, also known as hyperbaric oxygen, is used to treat various medical conditions – for example, to promote healing of critical wounds in patients with diabetes. The authors designed a series of experiments to see how hyperbaric oxygen affects the development of fat stem cells.

Over several days, fat-derived stem cells were treated in a portable hyperbaric oxygen chamber, at pressures of 2 or 3 atmospheres (ATM) – in other words, two or three times the normal air pressure. The experiments used stem cells developed from samples of belly fat from patients undergoing abdominoplasty ("tummy tuck") surgery – a convenient source of unneeded fat cells.

Samples treated with high-pressure oxygen – particularly at the 3 ATM pressure – had a larger proportion of living stem cells and more active reproduction of stem cells. They also showed increases in growth factors favorable for wound healing and tissue regeneration. Stem cells exposed to hyperbaric oxygen also had an increased tendency toward developing into fat cells. In contrast, they were less likely to develop into bone and cartilage cells.

Based on those qualities, high-pressure oxygen treatment of belly-fat stem cells is a feasible option for procedures where regeneration of fat cells is needed. Examples include breast reconstruction, wound and burn care and fat grafting, as well as new tissue engineering approaches – all using the patient's own, newly generated fat cells.

Drs. Kim, Yoshinoya, Böcker and colleagues emphasize that their experiments are "solely descriptive," and that more research is needed to move the new technique out of the laboratory and into the operating room – to see how well hyperbaric-oxygen treated, fat-derived stem cells work to restore form and function.

Plastic and Reconstructive Surgery® is published by Wolters Kluwer.

Click here to read "The Effect of Hyperbaric Oxygen Therapy on Human Adipose-Derived Stem Cells"

Article: "The Effect of Hyperbaric Oxygen Therapy on Human Adipose-Derived Stem Cells" (doi: 10.1097/PRS.0000000000007029)