SVF BROCHURE

STROMAL VASCULAR FRACTION & ADIPOSE STEM CELL PLASTIC SURGERY Rejuvenation by your own cells Face rejuvenation Various methods are used in plastic surgery for facial rejuvenation. Mostly it’s based on surgical intervention or application of foreign substances which are also being occluded and thus requirerepeated applications. This leads to unnatural face expression and disruption of facial muscles function. Unlike the procedures mentioned above, use of your own tissue guarantees natural rejuvenation. Several rejuvenating procedures are possible to be performed in facial area with a use of your own tissue enriched with stem cells. It is possible to be used as a filling in the correction of eyelids,correction of under eye circles, filling of deep nosolabial furrows, correction of drooping mouth corners, scar correction etc. Hand rejuvenation Area of the back of the hand is the place where aging is also very noticeable. With growing age subcutaneous fat disappears from our hands and thus veins, tendons and bones become more visible.With our method of applying your own fat tissue enriched with stem cells we are able to regain the lost fullness which leads to smoothing of the hand and its rejuvenation. Lip augmentationEveryone is certainly familiar with the method of lip enlargement using hyaluronic acid and other filling materials. Women often gain fuller lips this way, on the other hand it leads to unnatural appearance and in case of Botox application reduced function of facial muscles.

The modern trend of using your own tissue finds its use also in the field of lip modeling and enlargement. Moreover, our technology of enrichment of the fat tissue with your own stem cells provides better engraftment of filling tissue and so even more permanent result. Breast augmentation Natural breast enlargement is something lot of women dream about. Upon till now it has been successfully performed only by insertion of silicone implants. The technique of fat filling implantation has been used for a long time but hardly ever for the purpose of breast augmentation. That has changed during last few years and now it is being used for this purpose more and more often. Use ofbody’s own tissue doesn’t require any foreign materials to be applied and thus the risk of complications is significantly lower. Moreover, our technique of preparing lipoaspirate enriched with your own stem cells guarantees better engraftment than ever before and thus leads to perfect result. Apart from women who have always wanted larger breasts our method can be used also for those whose breasts have lost the shape as a result of breastfeeding or big change of body mass. Thanks to body’s own tissue enriched with stem cells breasts can be one size bigger without any disruption of their function.Fat filling enriched with stem cells also provides an alternative in repairing the surgery related damage in patients who underwent mastectomy due to a breast cancer.OUR APPROACH:We all know it – increasing age won’t spare anyone. Over time, our skin slackens loosing strength andelasticity, wrinkles get deeper and the fat is being stored at unwanted locations. Changes connected toskin aging are unfortunately mostly noticeable on the most visible parts of the body – face, dekolt andhands.Although we are not able to stop the time, we can return the young look to your skin with use of thecombination of exceptional patented technologies which we put together for you into one uniquemodern approach.Use the potential of your body for its natural rejuvenation without any foreign substances!Gentle, natural, safe!Stem cellsThe revolutionary innovation in plastic surgery is represented by the use of stem cells which havehuge regenerative and healing potential.Where to get those cells with “superpower”? Latest research shows the richest reservoir of stem cells ispatient’s own fat.Adipose tissue contains blood vessels which provide blood supply and nutrition. Around these vesselsthere is a thin connective tissue (stroma) which is extremely rich for regenerative stem cells.One of the basic functions of mesenchymal stem cells (the cells with regenerative potential) obtainedfrom the adipose tissue is the ability to renew and repair the damaged cells and tissues. These cells areable to be turned into fully maturated differentiated cells of various kinds such as cartilage, bone,muscle, nerve tissue, adipose tissue and other cell populations with special function. It means thatthese cells are able to become any tissue of human body and this way provide damage repair at any

location. If the fat filling is enriched with these cells, the formation of new blood vessels is easier, helping the engraftment in the area of application. The principle of our method is to apply these valuable cells in sufficient number to desired location in the fat filling and thus enable better engraftment and longer natural effect. Benefits of the method it is possible to undergo it in local anesthesia, recovery is faster with minimal risk of hematoma formation, it provides the opportunity to obtain homogeneous fat without admixture of other cells. Such fat is highly suitable for use in aesthetic surgery applications. Addition of stem cells to the fat tissue obtained this way creates unique product which guarantees maximal possible engraftment of the applied fat tissue. The whole process from fat harvesting to final application represents the use of unique set of technologies, medical and laboratory procedures which in completely innovative way use the latest techniques and medical research knowledge. ORTHOPEDICS Help for the osteoarthritis patients with use of their own cells The principle of our method Arthritis of the big joints (mostly knee and hip) represents degeneration of joint cartilage which is being enhanced by age. The cartilage in the most exposed areas is being attenuated, becomes more vulnerable and thus causes huge pain and mobility problems. Current arthritis treatment options mostly focus on reducing the pain and possible inflammatory reaction. Physical therapy such as special exercises, yoga or acupuncture can also partly help. The revolutionary innovation in treating arthritis-related problems is represented by patient’s own SVF cells which have a huge regenerative and healing potential. The stromal vascular fraction (SVF) cells are situated in connective tissue (stroma), contain mesenchymal stem cells (the cells with regenerative potential) and also another valuable cell types which can significantly help the regeneration of various tissues in case of damage. One of the basic functions of mesenchymal stem cells from SVF is ability of renewal and repair of damaged tissues and cells. These stem cells are capable of transformation in differentiated cells of cartilage, bone, muscle, nerve tissue, adipose tissue and other cell populations with specialized functions. It means that these cells are able to form any tissue of human body and thus secure damage repair at various locations. However, stem cells are not able to get to the damaged area just by themselves. But it is enough to isolate and transfer them near the desired location and they are than able to initiate the healing process and renewal of damaged tissue just with their own activity. This effect is used in orthopedics for arthritis cartilage regeneration. The principle of our method is transferring these valuable cells in sufficient number to the affected location and thus enabling the regeneration of damaged cartilage with patient’s own cells.

How do we proceedOur procedure consists of four parts – obtaining patient’s own suitable cells,transorting, preparation of SVF cell concentrate containing the stem cells and application into afflicted joint. Total time of this procedure is approximately 48 hours and it is all done at one place.At first, it is necessary to obtain patient’s cells that will be used for preparation of the cell concentrate. Adipose tissue is very rich for SVF stem cells. It contains 500 to 1000 times more mesenchymal stem cells than the same volume of bone marrow. Adipose tissue can be also easily collected using liposuction in local anesthesia. The best accessible adipose tissue is located in the area of abdomen, lower abdomen and buttocks. Miniliposuction is performed by experienced plastic surgeon. First of all the numbing solution which takes effect in few minutes is injected into the area of fat harvesting. This is done just with a needle and leaves no scar. After that the liposuction itself can be initiated. The process is painless and basedon sucking the fat out of the body via cannula. Volume of fat required for treatment of one big joint (or several small joints) is 100 ml, for two joints it is about 200 ml. The whole procedure takes an hour during which the patient can communicate with the surgeon any time. SVF containing stem cells is than isolated from the collected fat using specialized process and the cell concentrate is prepared for application. In the last stage of the process, experienced orthopedic surgeon applies the SVF cell concentrate by injection to the affected location. Painfulness of this injection is comparable with classic jointneedling and is mostly well tolerated by patients. The injection point is than covered by bandage which can be removed after few hours. It is usually not necessary to reduce any daily activities including work after undergoing the procedure. After being transferred, the stem cells by themselves initiate regeneration and renewal of damaged tissues. Joint cartilage becomes more durable and quality. Who is this method suitable for Our method is suitable for patients with following conditions Arthritis (or osteoarthritis) of joints such as knee, shoulder, hock, elbow, hip, small joints etc. in stage 1, 2 or 3. – cartilage is still present in the joint. In more than 80% of patients the pain is reduced, mobility of the joint improved, quality of life better and it is possible to return to the sport activities. In case of arthritis stage 4 the treatment options are very limited. Cartilage is already absent in the joint and the usual solution is the replacement with artificial joint. However, there was some positiveexperience with pain reduction in case of application in stage 4 patients. This suggests that our method can be also used as a painkiller for patients with arthritis stage 4 who suffer from a lot of pain but for

some reason cannot undergo the joint replacement or permanently use anti-inflammatory medication with number of side effects.More possibilities for use of your own cells:  Bearing defects of joint cartilage, mostly after injury, osteochondrosis dissecans  Joint cartilage disorders (chondromalacia, chondropathy)  Acute and chronic inflammations of tendons and ligaments  Entesopathy (tennis elbow, golf elbow, heel spur, painful groin etc.)  Healing support in case of injuries or after surgery of ligaments, muscles, tendons and bones  Acute damage of meniscus and ligaments of knee joint  Acute and sub-acute partial damage of joint ligaments (shoulder, knee, hock etc.)  Sport injuries and overload injuries  Rheumatoid arthritis Frequntly Asking Question It is natural that you have many questions about the newly utilized regenerative procedures. We address here a number of questions that are most frequently asked. Is application of stem cells safe? To date, thousands of patients all over the world have had their own stem cells implanted in order to treat arthritis or for breast enlargement, and there has never been a reported case of serious side effects such as tumors or autoimmunity disease arising in relation to the application of these cells. Inrare cases, a temporary increase in body temperature can occur. Very rarely (less than 0.1% of cases), infection can develop at the location where the cells were applied. Possible side effects related to the application of stem cells are also closely monitored by the International Cellular Medicine Society, which provides a detailed information that is gathered worldwide at its web site www.cellmedicinesociety.org. Is the use of stem cells suitable for me? If you have problems with joints (pain, limping, stiffness), need to use analgesics (painkillers), considering a surgery (artificial joint replacement), then it is certainly appropriate to contact our experts and consult the option of using your own stem cells contained in SVF cells to slow down the degenerative changes in cartilage. Who cannot undergo stem cells treatment? Patients actively being treated for serious infectious diseases or cancer cannot undergo stem cell therapy. Patients using large doses of pain relieving drugs (nonsteroidal anti-inflammatory drugs) cannot undergo stem cell treatment or using such drugs need to be minimized one week before surgery (liposuction). Is liposuction painful?The first puncture by the needle through which the anesthetic solution is injected beneath the skin can be painful. Subsequently, the extracted adipose tissue is anesthetized and there is no pain. How long does the extraction and application of stem cells take? Our procedure consists of four parts – obtaining patient’s own suitable cells,transporting, preparationof SVF cell concentrate containing the stem cells and application into afflicted joint. The preparation for the liposuction (marking the extraction area and local anesthesia) takes approximately half an hour, the liposuction itself, depending on the amount of extracted adipose tissue, requires 15–30 minutes, transporting to the laboratory,processing and isolation of stem cells from adipose and transporting to

the clinic again takes about 45 hours,after that the application to the intended location, depending on the type of procedure, takes less than an hour. Total time of this procedure is approximately 48 hours and it is all done at one place. How long does recovery after liposuction take? Liposuction (extraction of adipose tissue) is performed under local anesthesia on an outpatient basis. Complete recovery after liposuction normally takes several days, with no limitations on usual day-to- day activities. The physician performing the liposuction will specify the length of recovery in consultation with the client. Which orthopedic treatments can stem cells be used for? The best explored area is the use of stem cells in the treatment of degenerative changes of articular cartilages - arthritis. Arthritis affects especially large joint cartilages, i.e. knees, hips, ankles, shoulders. It is a very unpleasant disease, characterized mainly by joint pain, often stiffness and jointswelling can also occur. The exact diagnosis and extent of impairment is determined by an experienced orthopedist. Arthritis is currently treated with painkillers (analgesics), which do not treat the basiccause of the problems. Thus, the disease even can reach a stage where the damaged joint needs to beartificially replaced. Currently, so-called chondroprotective agents are used, which can bring temporaryrelief from arthritis. A new approach is to use the patient’s own plasma (the liquid component of blood) enriched with blood platelets for treating arthritis of less serious stages. Stem cells represent a revolutionary and entirely new treatment method, leading to regeneration and renewal of the cartilage after local application directly to the affected joint. If the joint space is inflamed, stem cells will inhibit the inflammation. Stem cells are usually applied once. The best therapeutic effect isobtained if the stem cells are applied along with plasma, which supplies them with important nutrients. How quickly do stem cells treat arthritis? Regeneration of damaged cartilage usually takes 2–3 months, although significant improvement (especially pain relief) can be expected already within 1–2 weeks. After 4–6 weeks it is advisable to examine the clinical condition. In severe cases (stage III arthritis) the cartilage had been greatly damaged before treatment, a second application of stem cells may be considered. What is the success rate for arthritis treatment with stem cells? According to the data published in the international journals the therapeutic effect of stem cells is expected in 90% of patients with osteoarthritis of grade II-III. In patients with osteoarthritis of grade IV, the therapeutic effect is expected to be lower. Approximately 86% of patients (from a total 556 patients treated at the University Hospital at theUniversity of South Florida in the U.S.) responded in a survey that they were fully satisfied with theresults of the treatment and would be willing to undergo it again. Moreover, patients with extensivedamage to the knee or hip and who were recommended for the artificial joint replacement respondedas follows:89% of patients with serious arthritis of the knee responded that they observed at least 50%improvement in their problems, and half of these even reported 75% improvement;75% of patients with serious arthritis of the hip reported at least 50% improvement of their problems, and 88% of these reported 75% improvement. Which medications should one not use during stem cells treatment?

One should not use or at least minimize using of non-steroidal anti-inflammatory drugs for one week before the procedure and 4–6 weeks after the procedure, unless your specialist tells you otherwise. What can negatively affect treatment of arthritis using stem cells?Alcohol decreases the healing potential of stem cells, so you should limit its consumption to a minimum one week before the planned procedure and for at least 4–6 weeks after the procedure. What can positively affect treatment of arthritis using stem cells? American scientists have discovered that vitamin D3, blueberry extract and green tea extract support the multiplication and effectiveness of the stem cells. Chondroprotective agents also can contribute to improving the process of healing the damaged joint cartilage. I am waiting for an artificial joint replacement. Can I undergo a stem cell treatment before that? Yes, stem cells are able to regenerate even severely damaged cartilage, and therefore this treatment method can be administered without the risk of extensive surgery. Some patients thus avoid the surgery entirely or at least postpone it significantly, are relieved from pain and their quality of life improves significantly. What are the side effects of stem cell therapy compared to artificial joint replacement? Side effects of SVF cells application are minimal and, in most patients, side effects were not observed.Experience of the International Consortium for Cell Therapy and Immunotherapy (ICCTI) www.iccti.eu, which associates more than 50 world-renowned experts in the area of cell therapy, also show that there were no adverse events or serious side effects during treatment of osteoarthritis with stem cells derived from adipose and connective tissue. It includes more than 400 patients with osteoarthritis of the large joints and more than 600 joints treated in the U.S., Switzerland, Czech Republic, Lithuania, Slovakia, Poland, Russia, Serbia and Thailand,. It is important that in neither case serious side effects associated with this treatment were reported. In the follow-up of 1-5 years (median follow-up 2 yearsand 3 months), there was no case of infectious complications, the occurrence of cancer or autoimmune disease. However, it should be noted that the length of follow-up of patients is still relatively short for a final evaluation of all possible side effects. For this reason, monitoring of patients still continues. On the other hand, there were quite a large number of complications including serious side effects reported in 1-10% of patients undergoing the surgical joint replacement. Is age any limitation for SVF cells application? Age is not the limiting factor. The eldest patient was 94 years old and underwent the whole procedurewithout any problem. We can treat any patient from the age of 18 if his or her medical condition allows it. That is assessed by our specialized orthopedic surgeon.SCIENTIFIC LITERATURE  Yoshimura K, Sato K, Aoi N, et al. 2008a; Cellassisted lipotransfer for cosmetic breast augmentation: supportive use of adiposederived stem/stromal cells. Aesth Plast Surg 32: 48–55.  Yoshimura K, Sato K, Aoi N, et al. 2008b;Cell-assisted lipotransfer for facial lipoatrophy:efficacy of clinical use of adipose-derived stem cells. Dermatol Surg 34: 1178–1185.  Ichim TE,et al:Autologous stromal vascular fraction cells:a tool for facilitating tolerance in rheumatic disease.Cell Immunol 2010,264(1):7-17  Jorge Paz Rodriguez,Michael P Murphy,et al 2012, Autologous stromal vascular fraction therapy for rheumatoid arthritis: rationale and clinical safety.2012;5: 5.

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