Can adipose stem cells heal scars?

The short answer is yes, and we are using Fat grafts and Adipose stem cells more and more for this purpose. We are just beginning to understand how this process works, and it has to do with the nature of scar tissue itself and the basic behaviors of stem cells.

How does a scar form?

Let’s first describe how a scar forms. After an injury, whether it was radiation therapy, burn, or trauma, the body responds by activating a sequence of responses. The responses can be summarized in three stages:

Stage 1 – Damaged tissue destroyed

First the body tries to get rid of the damaged tissue. It does this by the inflammatory process, which destroys bacteria, foreign objects as well as partially damaged native tissues. If the damage is severe, a lot of native tissue can be destroyed by inflammation causing a tissue deficit.

Stage 2 – New cells for repair

The second stage of healing is the proliferative phase where the body brings in new cells to begin the repair process. It is in this phase that there is a lot of collagen deposition.  It is this abnormal amount of collagen that makes the tissue stiff and bulky.

Stage 3 – Remodeling Phase

The final stage of healing is the remodeling phase. Here the body slowly pares away the excess collagen and restores the surrounding tissues to normal function. That is why in the normal scar process the scar initially feels thick but then softens with time.

How do fat grafts and stem cells help?

A patient's breast after a Lumpectomy and radiation.
Lumpectomy and Radiation performed
A patient's breast with a Lumpectomy scar after fat injections.
Lumpectomy scar after fat injections.

Plastic surgeons have been performing Fat grafting, aka Fat transfer, for more than 100 years. Fat grafts contain a small population of adipose stem cells, and we are currently using them to help heal scars.

To perform a Fat transfer procedure, adipose tissue is extracted from unwanted areas of your body, processed to remove the mature and dead cells, and reinjected into the damaged scar.

The stem cells in a fat graft help to heal a scar in several ways:

  1. Stem cells have anti-inflammatory properties that prevent excessive scarring
  2. Stem cells help replenish normal cells in the tissue by differentiation or directing other cells in the tissue to multiply. Since the normal population of cells under the skin is fat tissue anyways, the fat graft itself provides most of the tissue that is needed.
  3. Adipose stem cells dissolve the excess collagen in scar tissue by secreting large amounts of enzymes whose specific function is to dissolve scar tissue.

Carefully processed fat grafts can restore the missing tissue under the skin, dissolve the tight and bulky scar tissue, as well as helping restore better function to tissues surrounding the scar. All of these things help to repair the scar.

Supercharged fat grafts

If certain enzymes are added to adipose tissue during processing, a 10 fold  higher population of stem cells can be yielded. This is referred to as the Stromal Vascular Fraction (SVF). Using the SVF with fat grafts is a way to supercharge the healing process.  many clinical trials and investigators are currently using Stromal Vascular Fraction (SVF) with Fat Grafting  for an even better scar result!

By Dr. Ricardo L. Rodriguez MD Board Certified Plastic Surgeon Cosmeticsurg Baltimore, Maryland Ricardo L. Rodriguez on American Society of Plastic Surgeons.

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34 thoughts on “Can adipose stem cells heal scars?”

  • Shane says:

    Thank you for explaining this process. After an injury to the private area 6 months ago the area has healed 75 percent but the tissue is stiff and bulky. I"ve had an adipose derived stem cell Injection with PRP Will this help to remodel the tissue back into a soft flexible tissue again ? May I also know how long this takes with stem cells. I had the procedure 4 weeks ago . Am I looking at a year to two years until big changes occur? Thanks
    • Dr. Ricardo L. Rodriguez says:

      Apologize for this late reply. How is your problem coming along? Was the treatment successful?
  • Gio says:

    Oh my god, I'm sorry I forgot I have another question (sorry for all my comments). Is fat grafting permanent in changing the stretch mark texture and removing indentation in the stretch mark completely? My stretch marks on my stomach are quite deep so would fat grafting completely remove the indentation? Also I plan on going to dubai to get the procedure liposkill. Would I go to you to get the laser to destroy the stretch mark, go to dubai to get the adipose stem cell, and then come back to you to get the fat graft?
    • Dr. Ricardo L Rodriguez says:

      Gio: You are better off getting all your therapy plan from one person rather than having many doctors do this and that. As they say, "too many cooks spoil the broth".
  • Gio says:

    Oh and lastly do you think microneedling and adipose stem cells together would also work? Microneedling also injures the skin. Again thank you for answering!
    • Dr. Ricardo L Rodriguez says:

      Gio: Microneedling injures the skin, which elicits a healing response. The stem cells hen insure there is a good healing response. There is a lot of interest in this area of regenerative medicine but so far no convincing evidence. Time will tell.
  • Gio says:

    Also I am an African American who has stretch marks. What laser would I use to injure the skin because I heard that some lasers are not good for ethnic. So what laser would you recommend to injure the stretch marks? Thank you so much!
    • Dr. Ricardo L Rodriguez says:

      Gio: As I said in another response, I don't think anything really gets rid of stretch marks. The one thing Laser for stretch marks removes effectively is money from your wallet.
  • Gio says:

    Will the melanocytes in white stretch marks before COMPLETELY restored with the transfers? And if not what can be recommended for a permanent restoration of melanocytes? Thank you much!
    • Dr. Ricardo L Rodriguez says:

      Gio: I don't think melanocytes are restored completely by stem cell transfers. For that matter I don't think anything completely eliminates stretch marks.
  • Yohannes Demissie says:

    Regeneration has a very limited stake in human healing process, our body rather heals with scar. As you know scar is the enemy of plastic surgeons. I am so fascinated reading your blogs and I found your work the real future of plastic surgery. Miracles of fat graft is there for 100 years but its application as a stem cell towards modulating a scar is a transformation carry on and let us know the good news as it appears!!!
    • Dr. Ricardo L Rodriguez says:

      Thank You! You might think of attending the IFATS conference, a once yearly conference dealing with the role of Adipose Tissue in regenerative healing.
  • Eric says:

    And getting adipose derived stem cells through iv drip cause cancer or other complications? I need your opinion thanks.
  • Eric says:

    One last question, How long after a minor liposuction do you thing I should wear the compression strap on? I want your opinion. Thanks.
  • Eric says:

    Also does the stem cell need to be injected right after the laser procedure? Also I be doing 1 treatment first to see the outcome. How many time should you recommend it to be done and how long should the gap between treatments be? I appreciate your responds.
    • Dr. Ricardo L Rodriguez says:

      Eric: The Laser serves as an "injury". The stem cells are then injected to help heal the injury. As to how many times and all that I cannot tell as I have no idea what your surgeons methods are.
  • Eric says:

    Hi doc, i'm in the process of getting stem cell therapy. Had a minor liposuction two days ago. Got the stem cells through IV. After amonth i'm going to do a combination of laser and stem cells injections. Fat grafts is not necessary since i'm getting adipose stem cells injected into my stretch marks, right? Newayz will keep you posted on the results.
    • Dr. Ricardo L Rodriguez says:

      Eric: THANKS fot the feedback!!!! I pray everything goes well. Send me pictures! Fat is not "necessary" but I like to use it as a tissue matrix.But nobody has done enough work on this to say what is best. I'm just happy for you that you are getting the therapy! I'm so excited for you!
  • Eric says:

    Roger! Thanks for the information given. I hope whatever way your trying to use stem cells, you succeed at it as it can change people's life.
  • Eric says:

    Thanks Doc for the reply. But I'm just curious regarding the cost of this treatment and do you have to do this treatment together with a laser treatment. This is regarding stretch marks scars.
    • Dr. Ricardo L Rodriguez says:

      Eric: For the cost, you should contact Kelly at kelly@ cosmeticsurg.net. In the US we cannot use stem cells per se, but we can use concentrated fat grafts which have a high proportion of stem cells. We can combine it with Laser for stretch marks. You should know; however, that this is not a proven therapy and results are not always what the patients expect.
  • Eric says:

    I was just wondering how much will this treatment cost? Also do you know if this treatment is offered in South East Asia?
    • Dr. Ricardo L Rodriguez says:

      Eric: It probably is but I would not know where or what clinics offer it. Sorry I could not be of more help!
  • M Bob says:

    Hello, Thank you for the prompt response. I just wanted to know whether you believe that this type of treatment could be repeated until the stretch marks completely diminish, or could only serve to treat stretch marks up until a certain point - current treatments only seem to have an effect up until a certain point, but I don't see why stem cells couldn't be used endlessly. I am in the process with using stem cell therapy to treat stretch marks, and will hopefully keep you informed of the results. Thank you
    • Dr. Ricardo L Rodriguez says:

      MBob: I'm happy and excited for you to hear you are doing this. I would be delighted to see pictures of your before and after photos. How exciting!
  • M Bob says:

    I am interested in the potential of stem cell therapy as a response to stretch marks also. I believe that there is potential in stem cells regenerating the stretch marks and my belief has been bolstered by this submission to the world stem cell summit. Granted this study was small in scale, but it provides a clear picture of the potential stem cells and skin regeneration. http://www.worldstemcellsummit.com/files/2012-AbstractSubmissions.pdf The submission doesn’t provide a clear picture as to how many treatments where undergone, it seems to intimate one session of mesenchymal stem cells derived from bone marrow as well as svf. Significant results where noted after 12 months. One of the authors of this study is a plastic surgeon in Lebanon who offers stem cell therapy for stretch marks; noting that a 30-60% difference could occur after one treatment, he also uses adipose derived stem cells as opposed to bone marrow – possibly due its abundance, ease and the fact its richer is source for stem cells.
  • M Bob says:

    I am interested in the potential of stem cell therapy as a response to stretch marks also. I believe that there is potential in stem cells regenerating the stretch marks and my belief has been bolstered by this submission to the world stem cell summit. Granted this study was small in scale, but it provides a clear picture of the potential stem cells and skin regeneration. http://www.worldstemcellsummit.com/files/2012-AbstractSubmissions.pdf The submission doesn’t provide a clear picture as to how many treatments where undergone, it seems to intimate one session of mesenchymal stem cells derived from bone marrow as well as svf. Significant results where noted after 12 months. One of the authors of this study is a plastic surgeon in Lebanon who offers stem cell therapy for stretch marks; noting that a 30-60% difference could occur after one treatment, he also uses adipose derived stem cells as opposed to bone marrow – possibly due its abundance, ease and the fact its richer is source for stem cells. It strikes me as the most logical and sensible solution for stretch mark therapy. I do believe effectiveness is contingent on the therapy being used with other modalities. I believe the stretch marks need to be injured in order to start the repair response – this may especially be the case of older stretch marks. The FDA approved laser therapy works on this proviso, that injuring stretch marks sufficiently will enact a repair response, but the bodies natural repair response doesn’t seem to efficiently repair the stretch marks fully. This is where I believe stem cells will enact an even more potent regenerative response. I understand that therapies like these are open to inconsistent outcomes especially when compared with other non-surgical therapies like botox and fillers. However, stem cell therapies are contingent on the individual’s propensity to heal and so on – factors like age, lifestyle choices and so on will undoubtedly effect the response. What I’m curious about the ability for stem cell therapy to regenerate the stretch completely. It strikes me as strange that some therapies will only allow regeneration up until a certain point – as though there is a set point at which stretch marks can no longer regenerate. This doesn’t make sense to me. Granted it may take longer for others – possibly due to severity or the factor I’ve mentioned – but I don’t see how and why stem cells and stretch marks wouldn’t be indiscriminate in their healing response and not just heal until there is nothing no longer left to heal. Would it not be possible to use these therapies until all of your marks have completely diminished? Apologies for the length of the post, but I think this is important for those looking for a solution. I want to also know your thoughts on the possibilities of using blood stem cells to combat stretch marks. There is a company trialing this for wrinkles this year and they have expressed in their literature that these stem cells are richer in stem cells (500 million in one dose) and less mature than fat stem cells Kind Regards
    • Dr. Ricardo L Rodriguez says:

      M Bob: I also agree with those who propose treating Stretch marks with a combination of laser and stem cells. The rationale is as follows: 1) Stem cells usually will help acutely injured tissue rather than go to an area that is "stable" such as a mature healed stretch mark. 2) The Laser serves as a controlled injury to only the stretch mark area and not the surroundinfg skin 3) The stem cells are subsequently injected and try to repair tissue not by differentiating themselves into new skin tissue but by stimulating adjacent skin cells to grow into the area. As to the source of stem cells, fat makes sense to me because itt's very easy to harvest and process.
  • Abdul Halim says:

    I just want to be clarified on this, can it heal stretch marks because they are essentially scar tissue right? Correct me if I'm wrong on this; I have been doing my research thouroughly and have thought about treating my stretch marks which are basically everywhere due to weight loss, and from what I know the stem cells have the capability of turning into skin cells and any other type of cell although Adult stem cells are limited to what they can turn into. My question is will it be able to heal stretch marks?
    • Dr. Ricardo L Rodriguez says:

      Abdul: There is a misperception as to what is meant to "heal scar tissue". You seem to think it means that the scar tissue disappears and is replaced by intact newly reconstituted tissue. This is not the case. Stem cells can break up scar tissue collagen fibers with collagenases, and stimulate adjacent normal cells to divide and reproduce, but that may not result in the disappearance of stretch marks completely. An approach that is being proposed is to destroy the stretch mark tissue by Laser, then have the stem cells come in and reconstitute the normal appearance by getting adjacent normal cells to reproduce. There are no long term studies, or ongoing studies that I can refer you to but it is an approach that in theory makes sense. We can try this approach, but you would have to be aware that it is not proven. If you are interested, contact Kelly at kelly@cosmeticsurg.net