The surgery consist in transplanting the patient own adipose tissue or adipose tissue-derived stem cells as well as platelet-rich plasma containing large quantities of various growth agents mainly in the natural fat located in the sub-mammary layer thus increasing the cells survival rate. The significant differences with conventional fat injection are the collection and concentration from the drained solution of the adipose tissue-derived stem cells capable of proliferate, differentiate and grow and the safety of the in vivo adipose tissue-derived stem cells growth. Transplantation of fat cells or adipose tissue-derived stem cells has a poor graft survival rate. The main cause is the necrosis of the transplanted cells due to unresolved problems as oxygen-deficient blood flow, lack of nutrients and cytocidal agent, etc.
In our clinic, we developed a proprietary technology to protect the transplanted fat cells from the destructive agents as toxins and other oxygen reactive agents by incorporating in vivo enzyme and various nutrients. We are the first in this industry to achieve a stable high level of survival rate.

There are about 60 trillions cells to make a fully grown up body. Majority of them are mature cells constituting fat, muscle, visceral tissues and organs but at their source there are special cells. Those cells are capable to multiply, to change into various types of mature cells. They are called adult stem cells. Hematopoietic stem cells are typical stem cells. For example; Hematopoietic stem cells can change into red blood cell (erythrocyte), white blood cell (leukocyte) or lymphocytes, but can not change into eyeball, liver, etc.

• Unlike “embryonic stem cells” able to change into any kind of cells, fat stem cells have limited nature change capacity, and once injected into the body mainly transform into fat cells. There is no risk of them changing into organs cells.
• Their scientific name is “adipose tissue-derived stem cells” also referred as “fat precursor cells” and as is capable to transform into fat cells easily.
• In conventional fat injection, fat stem cells are also injected but in small quantity. The Kuno clinic in vivo (stem cells) regenerative medicine is the evolution of the conventional method and has a safer reproduction technology than in vitro.
• Unreasonable multiplication and differentiation do not happen unless cytokines and nutrient conditions are reached.
• Fat cells or fat stem cells may in extremely rare case turn into a benign sarcoma, but never into a cancerous tumor.

Our original in vivo regenerative medicine compared with the in vitro one is a more evolved form of regenerative medicine with more benefits and less risk.

Our original in vivo regenerative medicine compared with the in vitro one is a more evolved form of regenerative medicine with more benefits and less risk.

	In vivo regenerative medicine	In vitro regenerative medicine
treatment contents	Use of stem cells capable of growth and differentiation as platelet found in the patient own blood to regenerate tissue in the body.	・Proliferation and differentiation of stem cells outside the body. ・For skin regeneration, the patient own dermal fibroblasts is cultivate in vitro to regenerate the skin. (Number of division is limited as they are not stem cells)
Therapeutic objective	Face, neck, neckline, back of the hand rejuvenation. Recessed grooves, wrinkles, defect formation, breast augmentation, etc. improvements	Small wrinkles and skin restoration, nerves, bones, muscles, gums, blood vessels, mucous membranes defects improvement
Merits	・Treatment possible in only one visit to the hospital. ・Relatively inexpensive. ・Security cells infection or contamination almost impossible. ・The autologous transplantation allow to relatively keep the cells activity.	・Easy to collect cell sample in the case of dermal fibroblasts. ・Cells proliferation process observable. ・Cells can be artificially manipulated.
Demerits	・Higher technologies required. ・Inducing stem cells differentiation to targeted cells in vivo is usually uncertain. (Induce differentiation in vivo can be achieve safely with a special method)	・Several visits to the hospital are required for treatment. ・Expensive ・Increasing the number of cells division may diminish the cells life expectation. ・In culture, foreign substances contamination, bacteria or virus infections are possible. ・Using vectors (viral carriers) induct risk of carcinogen. ・Possibility of misleading other cells than the designed one. ・Other unknown risk, must be approved by an Ethics Committee.
Demerit	With the use of a centrifuge, the treatment can be quickly and safely achieved.	Facilities with special equipment such as sterilized room, management system, etc. are needed for handling and manage human cells treatments.

The congress was hold from the 12th to the 14th of November 2009 in Zhi jiang Hotel in Hangzhou city, China. 11 Japanese doctors, 38 Chinese doctors, 22 Korean doctors and many different professors participated and presented papers on the latest cosmetic medicine.
Kuno Clinic’s director presented the following topics: (Replacing the Implant with Cultured Adipose-Derived Stem Cells(AdSCs)in Vivo）, (In vivo multiplication and growth of stem cells derived from adipose tissue new technology used in surgery to regenerate breast made “unnatural” with silicon bags use or complications due to silicon bags into real breasts.)

In the recent years, silicon bags surgery has developed and grown popular as a unique intervention to effectively obtain larger breast. However the numbers of people suffering from complications caused by their silicon artifact or unsatisfied with the surgery result have been steadily increasing.
One of the reasons of the silicon bag popularity is the result expectation in comparison with fat injection technique.
In our clinic patients satisfied with breast augmentation with our unique advanced regenerative medicine technology have surpassed the one for silicon prosthesis. The finish obtained with our technique is not only natural but just real. Plus, we have patient achieving a larger breast result with our technology rather than silicon bag.
We would like people,especially people experiencing complications with bags prosthesis or concerned about it, to feel the texture and see the result of those “real breasts”.

Thanks to professors as the French Dr. Illouz and Dr. Fournier in the 70s, and to the current type of cannula, a safe liposuction method has emerged and has spread around the world. This method not only is characterized by a faster recovery, no heavy bleeding and no skin necrosis, but also has the benefit of removing fat with almost inconspicuous scars. Thanks to the achievement of Dr. Katsuya Takasu, Japan entered quickly the group of the world developed country regarding liposuction. In 1990, the Dr. Klein developed the “wet method” liposuction using tumescent anesthesia technique improving the safety and the efficiency of the suction. The vasoconstriction and fat layer expansion due to the use of epinephrine create a double haemostatic effect which reduce the unevenness of the suction and avoid irregularities to form. With the ultrasonic liposuction, the probe tip reduces the thermal damage on the surrounding tissue.
Recently, different devices have been added to this surgical procedure. Ultrasonic or laser equipment have been developed but their use is expensive and they raise different issues such as frictional heat temperature and incompatibility not allowing them to be use with fat injection.In 2006 Dr. Hoyos from Colombia has furthermore developed the conventional method of LipoSelection with the revolutionary VASER HiDef LipoSculpture (VASER HiDef Michelangelo) fat sculpture method. In 2007 the method was academically presented. Then Dr. Hoyos moved to the United States and started to do limited professional training.

The VASER®Michelangelo was elaborate in Colombia, South America, and now, in Beverly Hills, is the most fashionable cosmetic technology and the most advanced too. Using this equipment to produce the state of the art in a beautiful body looking like a Michelangelo’s sculpture. As a sculptor extracting from a block of marble a beautiful goddess, find your ideal body removing the extra fat with the VASER™ Michelangelo treatment. The VASER™ Michelangelo is more an instrument to produce your ideal line body than a treatment for obesity. That is why it is called body design art. Special ultrasonic waves "VASER ® wave” and a special suction tube “VentX ™” (International patent) with a special structure without blade allow to sculpt the body in 3 dimensions and safely remove the excessive fat without damaging important tissues as blood vessels, nerves, etc.Things that traditional liposuction treatment could not achieve such as removing safely and three-dimensionally fat located near the skin is not only possible but the removed fat can be used and injected back to the patient. “Streamline the waist and augment just a little bit the breast” or “I would like a more feminine hips line”, those subtle body design requests are now possible.

The most important in this treatment are the technique and the sense to imagine and create the ideal body design for the patient.
Even with the most advanced equipment, the surgery result will not satisfy the patient if the performing doctor uses traditional liposuction technique. He must acquire the knowledge and skill to be able to remove fat cells located near the skin, and the artistic ability to design the ideal body line.This is why training at a professional VASER Michelangelo ™ training center must be undertaken, in order to become a certified licensed doctor. The training center is only open to most experienced world’s top surgeon acknowledged by the developers of the VASER Michelangelo technique; Dr.Hoyos and Dr. Millard. In our clinic, although there are still few in the world, we do have certified licensed doctors to treat you without having you to worry about anything.