SEFFI (Superficial Enhanced Fluid Fat Injection) for Aesthetic and Clinical Regenerative Treatments

Authors

  • Alessandro Gennai Plastic Reconstructive and Aesthetic Surgeon Medical Director STUDIO GENNAI, Bologna, Italy
  • Silvia Zia Stem Sel srl, Bologna, Italy
  • Barbara Roda Stem Sel srl, Bologna, Italy and Department of chemistry, University of Bologna, Italy
  • Alessia Maggio Stem Sel srl, Bologna, Italy
  • Laura Bonsi Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Italy
  • Francesco Alviano Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Italy
  • Andrea Zattoni Stem Sel srl, Bologna, Italy and Department of chemistry, University of Bologna, Italy
  • Pierluigi Reschiglian Stem Sel srl, Bologna, Italy and Department of chemistry, University of Bologna, Italy
  • Francesco P. Bernardini Oculoplasty Private practice in Genova, Italy

DOI:

https://doi.org/10.12970/2310-998X.2020.08.05

Keywords:

 Liposuction cannula, fat graft, ASCs, regenerative medicine, cell production quality control system.

Abstract

Aim: In the field of regenerative applications, new fat preparations are an interesting perspective for easily available sources of highly potent staminal cells. In order to support the development of new robust techniques for regenerative purposes, stemness and proliferative properties of cellular content should be addressed.

Methods: SEFFI is standardized technique and published by two of the Authors (AG, PFB). These technique aim to harvest and re-inject autologous microfragmented adipose tissue with minimum manipulation. In this study the harvesting and preparation procedure was performed by disposable kits SEFFILLER™ and SEFFICARE™ (Produced by SEFFILLINE srl Bologna Italy). These cannulas performed a selection of clusters dimension and therefore microfragmented adipose tissue were immediately plated in colture dishes to allow liberated cells to attach to plastic. Cellularity from both cannulas was calculate and adipose stem cells (ASCs) from SEFFILLER and SEFFICARE were characterized by proliferation assay and differentiation capacity towards mesenchymal lineages. Moreover, as a quality control system, a new technology named Celector® was used to identify cell heterogeneity and viability of expanded ASCs which can be used for further cell therapy approaches.

Results: Microfragmented tissue, harvested by both cannulas, showed good number of adherent cells. Cells were vital and with an optimal proliferation ability. Celector® analysis confirmed the highly cell viability and sharing physical properties between ASCs from both cannulas. Isolated cells showed stemness characteristics due to their ability to differentiate towards adipogenic and chondrogenic lineages.

Conclusion: These results confirmed the presence of regenerative elements in autologous graft of SEFFI tissue. With perspectives of applications in aesthetic and clinical field.

References

Zuk PA, Zhu M, Mizuno H, Huang J, Futrell JW, et al. Multilineage cells from human adipose tissue: implications for cell-based therapies. Tissue Eng 2001; 7(2): 211-228. https://doi.org/10.1089/107632701300062859

Zuk PA, Zhu M, Ashjian P, De Ugarte DA, Huang JI, et al. Human adipose tissue is a source of multipotent stem cells. Mol Biol Cell 2002; 13(12): 4279-4295. https://doi.org/10.1091/mbc.e02-02-0105

Zuk PA. The adipose-derived stem cell: looking back and looking ahead. Mol Biol Cell 2010; 21(11): 1783-1787. https://doi.org/10.1091/mbc.e09-07-0589

Crisan M, Yap S, Casteilla L, Chen CW, Corselli M, et al. A perivascular origin for mesenchymal stem cells in multiple human organs. Cell Stem Cell 2008; 3(3): 301-313. https://doi.org/10.1016/j.stem.2008.07.003

Tallone T, Realini C, Bohmler A, Kornfeld C, Vassalli G, et al. Adult human adipose tissue contains several types of multipotent cells. J Car- diovasc Transl Res 2011; 4(2): 200-210. https://doi.org/10.1007/s12265-011-9257-3

Huang JI, Beanes SR, Zhu M, Lorenz HP, Hedrick MH, et al. Rat extramedullary adipose tissue as a source of osteochondrogenic progenitor cells. Plast Reconstr Surg 2002; 109(3): 1033-1041; discussion 42-43. https://doi.org/10.1097/00006534-200203000-00037

Fraser JK, Schreiber R, Strem B, Zhu M, Alfonso Z, et al. Plasticity of human adipose stem cells toward endothelial cells and cardiomyocytes. Nat Clin Pract Cardiovasc Med 2006; 3(Suppl 1): S33-37. https://doi.org/10.1038/ncpcardio0444

Caplan AI. Adult mesenchymal stem cells for tissue engi- neering versus regenerative medicine. J Cell Physiol 2007; 213(2): 341-347. https://doi.org/10.1002/jcp.21200

Caplan AI, Dennis JE. Mesenchymal stem cells as trophic mediators. J Cell Biochem 2006; 98(5): 1076-1084. https://doi.org/10.1002/jcb.20886

Blaber SP, Webster RA, Hill CJ, Breen EJ, Kuah D, et al. Analysis of in vitro secretion profiles from adipose-derived cell populations. J Transl Med 2012; 10: 172. https://doi.org/10.1186/1479-5876-10-172

Coleman SR. Structural fat grafts: the ideal filler? Clin Plast Surg 2001; 28(1): 111-119. https://doi.org/10.1016/S0094-1298(20)32343-9

Li K, Li F, Li J, Wang H, Zheng X, et al. Increased survival of human free fat grafts with varying densities of human adipose-derived stem cells and platelet-rich plasma. J Tissue Eng Regen Med 2017; 11(1): 209-219. https://doi.org/10.1002/term.1903

Sultan SM, Barr JS, Butala P, Davidson EH, Weinstein AL. Fat grafting accelerates revascularization and decreases fibrosis following thermal injury. J Plast Recon- str Aesthet Surg 2012; 65(2): 219-227. https://doi.org/10.1016/j.bjps.2011.08.046

Del Papa N, Di Luca G, Sambataro D, Zaccara E, Magli- one W, et al. Regional implantation of autologous adipose tissue-derived cells induces a prompt healing of long-lasting indolent digital ulcers in patients with systemic sclerosis. Cell Transplant 2015; 24(11): 2297-2305. https://doi.org/10.3727/096368914X685636

Rigotti G, Marchi A, Galie M, Baroni G, Benati D, et al. Clinical treatment of radiotherapy tissue damage by lipoaspirate transplant: a healing process mediated by adipose-derived adult stem cells. Plast Reconstr Surg 2007; 119(5): 1409-1422; discussion 23-24. https://doi.org/10.1097/01.prs.0000256047.47909.71

Mojallal A, Lequeux C, Shipkov C, Breton P, Foyatier JL, et al. Improvement of skin quality after fat grafting: clinical observation and an animal study. Plast Reconstr Surg 2009; 124(3): 765-774. https://doi.org/10.1097/PRS.0b013e3181b17b8f

Sterodimas A, de Faria J, Nicaretta B, Pitanguy I, et al. Tissue engineering with adipose-derived stem cells (ADSCs): current and future applications. J Plast Reconstr Aesthet Surg 2010; 63(11): 1886-1892. https://doi.org/10.1016/j.bjps.2009.10.028

Gennai A, Bernardini FP. R3 facial rejuvenation through minimal incisions vertical endoscopic lifting (MIVEL) and superficial enhanced fluid fat injection (SEFFI): endoscopic repositioning, tissue regeneration, volume restoration. Aesthetic Med 2015; 1(21): 54-60.

Bernardini FP, Gennai A, Izzo L, Zambelli A, Repaci E. Superficial Enhanced Fluid Fat Injection (SEFFI) to correct volume defects and skin aging of the face and periocular region. Aesthet Surg J 2015; 35(5): 504-515. https://doi.org/10.1093/asj/sjv001

Bernardini FP, Gennai A. Fluid fat injection for volume restoration and skin regeneration of the periocular aesthetic unit. JAMA Facial Plast Surg 2016; 18(1): 68-70. https://doi.org/10.1001/jamafacial.2015.1146

Gennai A, Zambelli A, Repaci E, Quarto R, Baldelli I, et al. Skin rejuvenation and volume enhancement with the Micro Superficial Enhanced Fluid Fat Injection (M-SEFFI) for skin aging of the periocular and perioral regions. Aesthet Surg J 2017; 37(1): 14-23. https://doi.org/10.1093/asj/sjw084

Bernardini FP, Gennai A, Izzo L, Devoto MH. Minimal incisions vertical endoscopic lifting and fat grafting as a systematic approach to the rejuvenation of the periocular esthetic unit. Ophthal Plast Reconstr Surg 2013; 29(4): 308-315. https://doi.org/10.1097/IOP.0b013e318291662a

Gennai A. Endochirurgia estetica del volto: SEE Editrice, Firenze, 2011.

Gennai A, Saponaro A, Iozzo I. El rol del lifting endoscópico fronto-témporo-orbitario enel nuevo concepto de rejuvenecimiento facial: mini invasivo, tensión moderada, restauración de volúmenes. The importance of brow-temporal-orbital endoscopic facelift in the new concept of facial rejuvenation: low invasiveness, moderate tension, volume restauration. Cirugia Plástica Ibero-Latinoamericana, 2009; pp. 27-34. https://doi.org/10.4321/S0376-78922009000100008

Nguyen PS, Desouches C, Gay AM, Hautier A, Magalon G. Development of micro-injection as an innovative autologous fat graft technique: the use of adipose tissue as dermal filler. J Plast Reconstr Aesthet Surg 2012; 65(12): 1692-1699. https://doi.org/10.1016/j.bjps.2012.06.014

Zeltzer AA, Tonnard PL, Verpaele AM. Sharp-needle intradermal fat grafting (SNIF). Aesthet Surg J 2012; 32(5): 554-561. https://doi.org/10.1177/1090820X12445082

Bourne DA, James IB, Wang SS, Marra KG, Rubin JP. The Architecture of Fat Grafting: What Lies beneath the Surface. Plast Reconstr Surg 2016; 137(3): 1072-1079. https://doi.org/10.1097/01.prs.0000479992.10986.ad

Roda B, Lanzoni G, Alviano F, Zattoni A, Costa R, et al. A novel stem cell tag-less sorting method. Stem cell Rev. reports 2009; 5: 420-7. https://doi.org/10.1007/s12015-009-9088-7

Lattuada D, Roda B, Pignatari C, Magni R, Colombo F, et al. A tag-less method for direct isolation of human umbilical vein endothelial cells by gravitational field-flow fractionation. Anal Bioanal Chem 2013; 405: 977-984. https://doi.org/10.1007/s00216-012-6337-4

Roda B, Reschiglian P, Zattoni A, Alviano F, Lanzoni G, et al. A tag-less method of sorting stem cells from clinical specimens and separating mesenchymal from epithelial progenitor cells. Cytometry B Clin Cytom 2009b; 76: 285-90. https://doi.org/10.1002/cyto.b.20472

Rossi M, Roda B, Zia S, Vigliotta I, Zannini C, Alviano F, Bonsi L, Zattoni A, Reschiglian P, Gennai A. Characterization of the Tissue and Stromal Cell Components of Micro-Superficial Enhanced Fluid Fat Injection (Micro-SEFFI) for Facial Aging Treatment. Aesthetic Surg J 2018. https://doi.org/10.1093/asj/sjy142

Klein JA. Tumescent technique chronicles. Local anesthesia, liposuction, and beyond. Dermatol Surg 1995; 21(5): 449-457. https://doi.org/10.1111/j.1524-4725.1995.tb00212.x

Trivisonno A, Di Rocco G, Cannistra C, Finocchi V, Torres Farr S, et al. Harvest of superficial layers of fat with a microcannula and isolation of adipose tissue-derived stromal and vascular cells. Aesthet Surg J 2014; 34(4): 601-613. https://doi.org/10.1177/1090820X14528000

Palumbo P, Lombardi F, Siragusa G, Cifone MG, Cinque B, et al. Methods of Isolation, Characterization and Expansion of Human Adipose-Derived Stem Cells (ASCs): An Overview. Int J Mol Sci 2018; 19(7): 1897. https://doi.org/10.3390/ijms19071897

Zannettino AC, Paton S, Arthur A, Khor F, Itescu S, et al. Multipotential human adipose-de- rived stromal stem cells exhibit a perivascular phenotype in vitro and in vivo. J Cell Physiol 2008; 214(2): 413-421. https://doi.org/10.1002/jcp.21210

Cai X, Lin Y, Hauschka PV, Grottkau BE. Adipose stem cells originate from perivascular cells. Biol Cell 2011; 103(9): 435-447. https://doi.org/10.1042/BC20110033

Corselli M, Chen CW, Crisan M, Lazzari L, Peault B. Perivascular ancestors of adult multipotent stem cells. Arterioscler Thromb Vasc Biol 2010; 30(6): 1104-1109. https://doi.org/10.1161/ATVBAHA.109.191643

El-Mrakby HH, Milner RH. Bimodal distribution of the blood supply to lower abdominal fat: histological study of the microcirculation of the lower abdominal wall. Ann Plast Surg 2003; 50(2): 165-170. https://doi.org/10.1097/01.SAP.0000032305.93832.9B

Torres Farr, Angelo Trivisonno Differential fat harvesting Sebastian Plast Aesthet Res Vol 1 Issue 3 December 2014. https://doi.org/10.4103/2347-9264.143556

Nguyen PSA, Desouches C, Gay AM, Hautier A, Magalon G. Development of micro-injection as an innovative autologous fat graft technique: The use of adipose tissue as dermal filler. Journal of Plastic, Reconstructive & Aesthetic Surgery 2012; 65: 1692e1699. https://doi.org/10.1016/j.bjps.2012.06.014

Zeltzer AA, Tonnard PL, Verpaele AM. Sharp-Needle Intradermal Fat Grafting (SNIF). Aesthetic Surgery Journal 2012; 32: 554. https://doi.org/10.1177/1090820X12445082

Tonnard P, Verpaele A, Peeters G, Hamdi M, Cornelissen M, Declercq H, Grafting N. Basic Research and Clinical Applications Plastic and Reconstructive Surgery 2013; 132(4). https://doi.org/10.1097/PRS.0b013e31829fe1b0

Tesauro P, Trivisonno A, Gennai A, Marliani A, Clauser L. Hair Transplantation in Cicatricial Alopecia: The Role of Autologous Fat Transfer. International Journal of Regenerative Medicine 2020; 3(2): 2-8. https://doi.org/10.31487/j.RGM.2020.02.06

Di Taranto G, Cicione C, Visconti G, Isgrò e coll MA. Qualitative and quantitative differences of adipose-derived stromal cells from superficial and deep subcutaneous lipoaspirates: a matter of fat. Cytotherapy 2015; 17(8): 1076-89A. https://doi.org/10.1016/j.jcyt.2015.04.004

Trevisonno, Di Rocco G, Cannistra C, Finocchi V, Torres S, et al. Harvest of superficial layers of fat with a microcannula and isolation of adipose tissue-derived stromal and vascular cells Aesthet Surg J 2014; 34(4): 601-13. https://doi.org/10.1177/1090820X14528000

Menkes S, Luca M, Soldati G, Polla L. Subcutaneous Injections of Nanofat Adipose-derived Stem Cell Grafting in Facial Rejuvenation Plast. Reconstr Surg Glob Open 2020; 8(1). https://doi.org/10.1097/GOX.0000000000002550

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2020-04-20

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