Autologous lipotransfer (fat transfer) in scleroderma

Autologous lipotransfer, or fat transfer, is a form of stem cell therapy, or regenerative therapy. It is a surgical procedure that may help in scleroderma, to treat skin tightening and fibrosis around the face and the mouth.

Tightening of tissues in the face (facial fibrosis), is a very common aspect of scleroderma, that can alter facial appearance and cause problems with eating, talking, and even accessing adequate dental care.

In the general population, lipotransfer for soft-tissue filling is already being used an elective or cosmetic treatment, and is broadly considered safe and well-tolerated. However, this also has potential as a therapeutic medical technique, when tissues have been damaged by disease. In some cases, lipotransfer can be used in scleroderma, to rejuvenate affected tissues and improve symptoms around the mouth and the face.  

Stem cells have the unique ability to generate new cells. They are created within the bone marrow and found within most tissues of the body. In scleroderma, lipotransfer uses fat cells from elsewhere in the body to repair and rejuvenate diseased and damaged tissues using the regenerative power of stem cells. “Autologous” simply means that the person’s own stem cells are used for the procedure, which can be carried out as a day surgery, usually with a general anaesthetic. 

During the surgery, the person’s own fat tissue is collected from another part of the body, such as the abdomen or the thighs. This is then enriched with their own stem cells before being carefully microinjected into affected areas around the face and the mouth. It is usually possible to go home later the same day.

It is very important to note that this is not simply a cosmetic procedure in people with scleroderma, but a medical treatment aimed at preserving mouth health, that targets the hardening of skin and tissues around the mouth and the face. These effects can often have a devastating impact on a person’s life, such as microstomia when mouth opening is restricted, that go far beyond the aesthetic aspects of scleroderma.

SRUK is supporting groundbreaking research that aims to improve our understanding of how autologous lipotransfer works. In the future, we hope that this treatment could be developed and used to treat other forms of fibrosis in scleroderma. Professor Butler, director of the Charles Wolfson Centre of Reconstructive Surgery, is currently working on this project, in collaboration with Professor Chris Denton and Professor David Abrahams of the Centre of Rheumatology at the Royal Free Hospital. The team have now treated well over 100 patients using this technique, and the results have been extremely encouraging. The evidence so far suggests that for many people, the surgery has been a success and has produced excellent results. Within this study alone, the procedure has produced profound benefits for many people, including:

• Reducing the effects of facial fibrosis,

• Restoring facial mobility and mouth function,

• Improving mouth opening,

• Softening of the facial tissues,

• Enhancing facial volume,

• Enabling severely affected people to receive proper dental care again,

• Improving quality of life, sense of wellbeing and outlook.

We are still learning more about the true potential of stem cell therapy across different areas of medicine. In time, lipotransfer could enable us to make use of a valuable source of regenerative properties within a person’s own body, with the potential to have a significant impact in the future for treating fibrotic conditions.

In scleroderma, these techniques could be developed even further and adapted to treat scleroderma-related fibrosis in other parts of the body. For some people living with more severe disease, therapies such as these could become more widely available and make a big difference in the longer term. It is vital that the work continues to accelerate to the progress of the research, so that these benefits can reach more people, sooner.

“Fat transfer is emerging as a really promising treatment for facial fibrosis in systemic sclerosis and we are delighted that SRUK have helped to fund this research that explores some of the biological mechanisms that explain the clinical benefit. This is a real-world example of a regenerative therapy and one that may actually reverse the effects of scleroderma, rather than only prevent progression” 

Prof. Chris Denton, Royal Free Hospital, London

Page last updated: October 2024