Commentary on: Clinical Applications of Mesenchymal Stem Cells in Soft Tissue Augmentation

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The article by Drs. Hanson, Gutowski, and Hematti is timely, as the focus on regenerative medicine is increasing and cell therapy modalities are becoming more available in multidisciplinary clinics and hospitals around the world. Several of these therapies are potentially useful in aesthetic applications. Although the number of publications concerning fat grafting has increased exponentially in the past decade, most are based only on an expert’s clinical experience and opinions, for which the evidence-base is perhaps weaker than we would like. Surgeons need more data to be able to determine the appropriate therapy for each patient, as well as to determine the ideal source of multipotential stem cells—autologous bone marrow or adipose tissue–derived mesenchymal stromal stem cells (MSC) from liposuction aspirate. The authors unfortunately focus on MSC, which are rare cells found in bone marrow aspirate and subsequently replicated extensively in tissue culture, resulting in a homogenous, fibroblast-like population of cells.1 MSC clearly have a regenerative capacity and treatments are under development to investigate presumed immunomodulatory properties of MSC in the treatment of disorders such as Crohn disease and acute respiratory distress syndrome, as well as neuroinflammatory disorders such as multiple sclerosis. The results of clinical trials with MSC for medical indications have yielded mixed results and near-term or broad-based aesthetic applications are unlikely because of regulatory, cost, sourcing, and harvesting issues. In contrast, cultured autologous fibroblasts, although not true stem cells, have been …