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Background <p>Cell-assisted lipotransfer (CAL) with stromal vascular fraction (SVF) enrichment has gained increasing interest as a regenerative adjunct in breast reconstruction. However, standardized reporting of volumetric outcomes and reproducibility data remains limited. This study reports our preliminary feasibility experience integrating CAL/SVF into autologous and hybrid breast reconstruction with MRI-based volumetric assessment.</p> Methods <p>Six patients undergoing breast reconstruction with CAL/SVF enrichment were prospectively evaluated. Reconstructive modalities included TRAM flap, latissimus dorsi flap, implant-based, and hybrid techniques. Intraoperative SVF isolation was performed using enzymatic digestion (0.075% type I collagenase, 30–40 minutes at 37&#xa0;°C) followed by centrifugation and admixture with purified fat. Fat graft survival was assessed at 12 months using 3.0-Tesla MRI volumetry with VOI freehand segmentation. Interobserver reliability was evaluated using intraclass correlation coefficient (ICC).</p> Results <p>Twelve-month fat retention ranged from 76.4% to 84.0%. No major complications occurred; one minor fat necrosis resolved without intervention. Descriptively lower retention values were observed in previously irradiated breasts. Interobserver agreement for MRI volumetry was excellent (ICC[<CitationRef CitationID="CR1">1</CitationRef>, <CitationRef CitationID="CR2">2</CitationRef>] = 0.995; 95% CI, 0.975–0.996), supporting reproducibility of segmentation.</p> Conclusions <p>CAL/SVF integration in breast reconstruction demonstrated favorable intermediate-term volumetric retention and safety within this small feasibility cohort. MRI-based volumetric analysis showed excellent interobserver reliability. Given the limited sample size and cohort heterogeneity, findings should be interpreted as preliminary and hypothesis-generating. Larger studies with extended follow-up are warranted to validate long-term durability and the impact of prior radiation.</p> Level of Evidence IV <p>This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors <a href="http://www.springer.com/00266">www.springer.com/00266</a>.</p>

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Cell-Assisted Lipotransfer (CAL) and Stromal Vascular Fraction (SVF) in Combination with Autologous Breast Reconstruction: A Preliminary Feasibility Case Series

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月8日

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  • Tung Dinh Nguyen,
  • Hung Kim Tran,
  • Phung Van Truong,
  • Thao Phuong Ngoc Tran,
  • Hoang Que Tran,
  • Bao Cong Duong Vo,
  • Nhu Ngoc Quynh Dinh,
  • Nhien Do An Nguyen,
  • Aiden Pham

摘要

Background

Cell-assisted lipotransfer (CAL) with stromal vascular fraction (SVF) enrichment has gained increasing interest as a regenerative adjunct in breast reconstruction. However, standardized reporting of volumetric outcomes and reproducibility data remains limited. This study reports our preliminary feasibility experience integrating CAL/SVF into autologous and hybrid breast reconstruction with MRI-based volumetric assessment.

Methods

Six patients undergoing breast reconstruction with CAL/SVF enrichment were prospectively evaluated. Reconstructive modalities included TRAM flap, latissimus dorsi flap, implant-based, and hybrid techniques. Intraoperative SVF isolation was performed using enzymatic digestion (0.075% type I collagenase, 30–40 minutes at 37 °C) followed by centrifugation and admixture with purified fat. Fat graft survival was assessed at 12 months using 3.0-Tesla MRI volumetry with VOI freehand segmentation. Interobserver reliability was evaluated using intraclass correlation coefficient (ICC).

Results

Twelve-month fat retention ranged from 76.4% to 84.0%. No major complications occurred; one minor fat necrosis resolved without intervention. Descriptively lower retention values were observed in previously irradiated breasts. Interobserver agreement for MRI volumetry was excellent (ICC[1, 2] = 0.995; 95% CI, 0.975–0.996), supporting reproducibility of segmentation.

Conclusions

CAL/SVF integration in breast reconstruction demonstrated favorable intermediate-term volumetric retention and safety within this small feasibility cohort. MRI-based volumetric analysis showed excellent interobserver reliability. Given the limited sample size and cohort heterogeneity, findings should be interpreted as preliminary and hypothesis-generating. Larger studies with extended follow-up are warranted to validate long-term durability and the impact of prior radiation.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.