What stem cells are, and why they are taken from fat
Stem cells are cells whose role has not yet been determined. They can turn into several different kinds of cells as needed and can multiply on their own, so they take part in the process of repairing damaged tissue. Our bodies still carry such cells after we reach adulthood, and these are called adult stem cells. Because they do not involve embryos, they are free from ethical controversy, which is one reason adult stem cells were the first to be used clinically.
There are broadly four places from which adult stem cells can be obtained. Cord blood, taken from the placenta, yields young cells but only in limited quantity. Bone marrow is harvested from inside the bone, but the yield is very small and the harvesting process places a burden on the patient. With blood, the sample is drawn and then centrifuged to obtain growth factors. The last one is fat.
The reason fat draws attention is quantity. Adipose tissue is known to contain roughly 100 to 1,000 times as many stem cells as bone marrow yields. The fact that it can be harvested with relatively little burden through liposuction also played a part. That is the background to why research in this field has continued at plastic surgery clinics, which work with fat extensively.
| Source | Characteristics |
|---|---|
| Cord blood (placenta) | Yields young cells, but only in limited quantity |
| Bone marrow | Harvested from inside the bone; the yield is very small and harvesting places a burden on the patient |
| Blood | The sample is drawn and then centrifuged to obtain growth factors |
| Fat | Known to contain roughly 100 to 1,000 times as many stem cells as bone marrow |
Are SVF and stem cells the same thing?
SVF, which appears often in clinic materials, stands for stromal vascular fraction. It refers to the mixture of cells that remains after harvested adipose tissue is treated with an enzyme and centrifuged. It contains not only adipose-derived stem cells but also fibroblasts, immune cells, microvascular endothelial cells and preadipocytes.
So SVF and stem cells are not precisely the same thing. SVF is a bundle of several cell types that includes stem cells, and when only the stem cells are selected from it and cultured to increase their number, they are distinguished by the term adipose-derived stem cells (ADSC). Whether culturing has taken place is what separates the two terms.
This distinction matters because of regulation. Culturing and expanding cells is handled differently in law from separating harvested tissue on the same day and applying it as is. When you go for a consultation, rather than letting the phrase "stem cell injection" pass, it is worth asking whether the cells are cultured or separated and used on the same day.
What is fresh, non-cultured SVF?
The method of processing on the same day without culturing is called fresh SVF. A small amount of fat is harvested in the operating room and moved straight to the cell processing lab, where it goes through separation and concentration and is applied the same day. Because tissue from the patient's own body is used, the burden of immune rejection is described as relatively low, and that is a characteristic of this method.
TheLINE Plastic Surgery operates a dedicated laboratory for handling cells on the fifth floor of the clinic. A sterile environment is maintained with an air shower, HEPA filters and clean benches, and cells are stored in liquid nitrogen tanks at minus 196 degrees so they can be used again when needed. In 2023 the clinic was recognized by the Ministry of Science and ICT as a dedicated SVF research department.
When the operating room and the laboratory are in the same building, the time harvested tissue spends in transit is reduced. That said, having the facilities does not in itself guarantee any individual's result. The condition of the cells varies with age, general health and the harvest site, and effects differ from person to person.
How have the laws and regulations changed?
Since 2020, regenerative medicine has been governed by the Act on Safety and Support of Advanced Regenerative Medicine and Advanced Biopharmaceuticals. At first it was limited to research purposes targeting patients with serious or rare intractable diseases.
When the act was amended in February 2024, that structure changed. The restriction on who could be included in clinical research was lifted, and a treatment system was newly introduced under which patients not participating in research can also receive cell therapy within the standards set by law. The amended act took effect on February 21, 2025.
The key point is that this is not something that can be done just anywhere. To provide regenerative medicine, an institution must meet the personnel, facility and safety management standards required by law and be designated as a treatment institution by the Ministry of Health and Welfare. Areas involving autologous cells classified as low risk, such as autologous SVF, are open to hospital-level and clinic-level institutions as well as tertiary general hospitals. TheLINE Plastic Surgery has also met these standards and been designated as an advanced regenerative medicine treatment institution.
What should you check when choosing a clinic?
First is whether the clinic is a designated treatment institution. Rather than relying on the wording on a website, it is more reliable to ask directly about the designation.
Second is where the cells are processed. Whether processing happens inside the clinic or is outsourced, and whether storage facilities are in place, changes the procedure.
Third is the medical team in charge. It is worth confirming who performs the harvesting and the procedure, and what their specialty is. At TheLINE Plastic Surgery, Dr. Jaeho Cho, a board-certified general surgeon, and Dr. Yoosuk Chung, a board-certified plastic surgeon, handle everything from harvesting to the procedure.
Fourth is how things are explained. A clinic that explains the limits, the recovery process and the expected side effects along with the benefits is easier to judge than one that talks only about improvement.
Limits and precautions worth knowing
Stem cell procedures are not a way to solve every problem. The indications are defined (knee joint, scars, hair and so on), results differ from person to person, and in many cases the treatment has to be divided over several sessions.
Care is also needed regarding anesthesia. In 2024 the Korean Society of Anesthesiologists issued an opinion that, for procedures using autologous adipose-derived stem cells, at least 6 hours of inpatient observation, and in some cases more than a day, is appropriate. After anesthesia, side effects such as respiratory depression, low blood pressure, vomiting and aspiration pneumonia can occur, and recovery may take longer in older patients or those with underlying conditions. On the day of the procedure, activities that require judgment, such as driving or exercise, are best avoided.
The process of harvesting fat is itself a procedure. Reactions such as bleeding, infection or bruising can occur, so please make your decision after hearing a full explanation beforehand.
Frequently Asked Questions
If I have an SVF procedure, am I receiving stem cells?
SVF contains adipose-derived stem cells, but it does not contain only those. It is a mixture of cells that also includes fibroblasts, microvascular endothelial cells and growth factors. It is a distinct concept from cells that have been isolated as stem cells alone and cultured.
Which is better, cultured stem cells or non-cultured SVF?
Their purposes differ, so they are hard to rank against each other. Culturing can increase the number of cells but requires time and a separate process, while fresh SVF can be handled the same day but the number of cells obtained depends on how much tissue is harvested. Which one suits you depends on your condition.
How much fat has to be harvested?
It depends on the area and the purpose of application. The amount harvested is not the same for local use, such as on the skin or scalp, as it is when the procedure is combined with surgery. The order is to establish the purpose in the consultation first and then calculate the amount needed.
Can cells harvested once be used again later?
Where a liquid nitrogen tank at minus 196 degrees is available, the cells can be stored and reused. However, the storage period, the conditions and the number of times they can be reused differ by institution, so this needs to be confirmed in advance.
When do the effects appear?
It is described as a gradual change that appears over time rather than something confirmed immediately, and individual differences are large. It is difficult to state a fixed period, so it is best to review your progress together with your medical team.
How is stem cell care carried out at TheLINE Plastic Surgery Clinic?
TheLINE operates a dedicated cell laboratory inside the clinic and separates and stores adipose SVF directly. In 2023 it was recognized by the Ministry of Science and ICT as a dedicated SVF research department, and it is designated by the Ministry of Health and Welfare as an advanced regenerative medicine treatment institution. Harvesting is performed by Dr. Jaeho Cho, a board-certified general surgeon, and Dr. Yoosuk Chung, a board-certified plastic surgeon.
