alloClae Explained: Donor Fat for Breast and Body Contouring
San Francisco plastic surgeon Usha Rajagopal, MD, was recently interviewed by Harper’s BAZAAR about alloClae, a newer option for restoring and enhancing volume using donated human adipose tissue. In the interview, Dr. Rajagopal discussed where alloClae comes from, how it differs from traditional fat transfer and other injectable treatments, how she uses it in her practice, and what patients should know about treatment and recovery.
Below, Dr. Rajagopal answers some of the most common questions about alloClae.
alloClae at a Glance
What is alloClae? Processed donor-derived human adipose tissue used to restore or add volume where fat naturally exists
Does it require liposuction? No
Common treatment areas: Breasts, hips, buttocks and areas with contour irregularities
Can it be used without implants? Yes. Dr. Rajagopal uses alloClae as an option for patients seeking modest breast volume enhancement without implants
Anesthesia: Many body treatments can be performed under local anesthesia; sedation may be preferred for larger-volume breast treatments
Downtime in Dr. Rajagopal’s practice: Many patients return to normal activities within approximately 24 hours
When are results visible? Volume is visible immediately after treatment
How long does it last? Dr. Rajagopal has followed patients for approximately 18 months with encouraging results; longer-term clinical data continue to develop
Best suited for: Patients seeking targeted volume enhancement, including patients who may not have enough of their own fat for traditional fat transfer
What is alloClae?
alloClae is a processed human adipose tissue product made from donated fat tissue. It contains non-living fat cells along with the natural extracellular matrix and other structural components found in human adipose tissue.
Unlike traditional fat transfer, alloClae is ready to use and does not require fat to first be harvested from another part of the patient’s body.
For aesthetic treatments, alloClae can be used to restore or enhance volume in areas where fat naturally exists. In my practice, I use it for areas including the breasts, hips and buttocks, as well as for selected contour irregularities.
Is alloClae really made from donated or “cadaver” fat?
Yes. alloClae is made from donated human adipose tissue.
There has been a lot of conversation about this because using donated fat for aesthetic procedures is unfamiliar to many patients. However, donated human tissue has been used throughout medicine for many years.
When someone becomes a tissue donor, many different tissues may potentially be recovered and used. Donated skin, tendons, cartilage, bone and other tissues are routinely used in reconstructive and orthopedic procedures. For example, donor tendon can be used during an ACL repair.
Historically, donated fat tissue had far fewer clinical applications. alloClae represents a way of processing and utilizing this tissue for areas of the body where adipose tissue naturally exists.
The donated tissue goes through donor screening, testing, processing and sterilization before clinical use.
How is alloClae different from traditional fat transfer?
The biggest difference is that alloClae does not require liposuction to obtain the fat.
With traditional fat transfer, we first need to identify an area of the patient's body that has enough fat available to harvest. Liposuction is performed, the harvested fat is processed, and then that fat is transferred to the desired area.
That means the patient has two treatment sites: the area where we remove the fat and the area where we place it.
With alloClae, we bypass the harvesting portion of the procedure. There is no donor site and no recovery associated with liposuction.
This can be particularly helpful for patients who are very thin and simply do not have enough body fat available for traditional fat transfer. It can also be attractive to patients who want to add volume but do not want the additional procedure and recovery associated with liposuction.
How is alloClae different from Renuva?
Renuva and alloClae are both derived from donated human adipose tissue, but they work differently.
Renuva primarily consists of an extracellular matrix that is placed into an area where fat normally exists. Over time, the patient's body gradually creates additional volume in the treated area.
With alloClae, the volumetric change is visible immediately because the product itself provides structural volume when it is placed.
In my clinical experience, that immediate and predictable volume is one of the reasons alloClae has been particularly exciting to work with.
What areas can be treated with alloClae?
alloClae can be considered for areas of the body where adipose tissue naturally exists and where additional volume or contour correction may be beneficial.
Some of the areas I use it for include:
Breast volume enhancement
Breast implant rippling or visible implant edges
Hip dips and hip contouring
Buttock contouring
Divots or contour irregularities
Selected irregularities following liposuction or previous surgery
It can also be useful in reconstructive situations. For example, a breast reconstruction patient with an implant directly underneath relatively thin tissue may have visible rippling or noticeable implant edges. Adding adipose tissue over those areas can help soften the contour and create a more natural transition.
Can alloClae be used for breast augmentation without implants?
Yes. This has become one of the more interesting applications of alloClae in my practice.
Some patients want more breast volume but do not necessarily want a traditional breast implant. Others may be very thin and do not have enough body fat available for a traditional fat-transfer breast augmentation.
For appropriately selected patients, alloClae can be used as a standalone treatment to add volume to the breasts without placing an implant.
It can also be used as part of a larger breast treatment plan. For example, some patients may be removing their implants, having a breast lift and then adding fat or alloClae to help restore volume and shape.
This is not intended to create the same degree of enlargement that can necessarily be achieved with a larger breast implant. The amount used and the expected change depend on the patient's anatomy, existing breast tissue and goals.
Who is a good candidate for alloClae?
One group I find particularly interesting is patients who are very thin.
If someone wants additional volume in her breasts, hips or buttocks but has very little body fat, we may not have enough donor fat to perform a meaningful traditional fat transfer.
alloClae gives us another option because we do not have to harvest that fat from the patient's body first.
It may also be considered for patients who:
Want targeted volume enhancement without implants
Want to avoid liposuction solely for the purpose of harvesting fat
Have breast implant rippling or contour irregularities
Have hip dips or localized areas of volume deficiency
Have irregularities after previous liposuction or surgery
Want a smaller procedure with less recovery than traditional fat harvesting and transfer
Candidacy still needs to be determined during an individual consultation.
According to alloClae's official safety information, the product should not be used in patients with severe allergen sensitivities, a history of anaphylaxis or an active infection. As with any medical procedure, patients should discuss their complete medical history and potential risks with their treating physician.
What happens during an alloClae treatment?
The procedure depends on the area being treated and the amount of alloClae being placed.
For areas such as the hips or buttocks, I can generally perform the treatment under local anesthesia. I first numb the area with lidocaine.
Because alloClae has a relatively thick consistency, it is placed using a cannula rather than a very small injectable needle. I make a small opening for the cannula and then carefully distribute the alloClae throughout the treatment area.
I typically place a small stitch at the cannula entry point. That stitch generally comes off on its own within approximately one to three weeks.
For larger breast treatments, I may recommend sedation.
If I am placing approximately 100 cc per breast, for example, I extensively pretunnel the breast tissue with a cannula before placing the alloClae. Because that portion can be uncomfortable, I prefer to offer the patient sedation.
The actual treatment is still relatively short. For these larger breast treatments, the anesthesia portion may be approximately 20 to 30 minutes.
What is recovery like after alloClae?
Recovery has generally been very straightforward in my practice.
I typically tell patients they can shower after approximately 24 hours and return to most of their normal activities within 24 hours.
Patients can expect some soreness for approximately two to three days. Some patients take Tylenol for discomfort, while others do not feel they need pain medication.
The main restriction I give patients is to avoid soaking the treatment area for approximately one month. This means avoiding baths, swimming pools and hot tubs while the small cannula entry point completely heals.
Beyond that, I tell patients to use common sense as they return to their normal activities.
One of the advantages compared with traditional fat transfer is that there is no liposuction recovery. We are treating only the area that needs volume rather than creating a second surgical site to obtain the fat.
How much alloClae is needed?
This varies significantly depending on the treatment area and the patient's goals.
A small contour irregularity may require a relatively limited amount, while treatments involving the breasts, hips or buttocks may require substantially more volume.
One of the things I have observed in my own practice is that alloClae has provided a fairly direct relationship between the amount I place and the resulting volume.
For example, if I place approximately 25 cc in an area, I have generally observed approximately 25 cc of corresponding volumetric enhancement.
This is my clinical observation, rather than a guarantee that every patient will experience identical volume retention. Individual results can vary, and longer-term clinical research on alloClae continues to develop.
How is that different from traditional fat-transfer retention?
Traditional harvested fat and alloClae are physically different.
When we harvest someone's own fat through liposuction, the material contains fluid in addition to fat. It has a more aqueous consistency.
alloClae is considerably thicker and more concentrated.
With traditional fat transfer, surgeons generally expect that some of the transferred volume will not survive long term. In my practice, I typically counsel patients that we may see approximately 50% retention following a traditional fat transfer, although this varies significantly between patients and procedures.
With alloClae, I have personally observed much more direct volumetric retention so far. Again, this reflects my own clinical experience and should not be interpreted as a guarantee of 100% long-term retention in every patient.
How long does alloClae last?
Because alloClae is still relatively new, we continue to learn more as patients are followed over longer periods of time.
At this point, I have approximately a year and a half of experience following some of my alloClae patients, and I have been very pleased with the volume I have observed.
I also already have patients who have returned for additional treatments.
I think it is important to distinguish what I am personally seeing in my practice from what has been established through longer-term published studies. I am encouraged by my clinical experience, but I would still like to see more long-term data as alloClae becomes more widely used.
Does alloClae affect mammograms or breast MRIs?
This is an especially important question for patients considering alloClae in the breasts.
Any procedure that changes breast tissue raises reasonable questions about future breast imaging.
I have had alloClae breast patients undergo both mammograms and MRIs following their treatments. In my personal experience so far, their imaging has looked fairly normal, which has been reassuring.
However, I think this is an area where we need more published research.
I would like to see dedicated studies evaluating how alloClae appears on mammograms, MRIs and other breast imaging over time. My observations are based on the patients I have personally treated and should not be interpreted as definitive evidence regarding future imaging for every patient.
Patients should always inform their breast-imaging provider about previous breast procedures and injectable treatments.
Is alloClae safe?
alloClae is a human cell and tissue product made from donated human adipose tissue. Donors and donated tissue undergo screening and testing for transmissible diseases, and the tissue is processed before clinical use.
As with any procedure, there are potential risks and complications.
The manufacturer's safety information lists potential complications including pain, infection, hematoma, cyst or nodule formation, allergic or immune responses, anaphylaxis and skin discoloration at the treatment site.
This is one of the reasons a consultation and appropriate patient selection are important.
Patients should discuss the potential risks, benefits, alternatives and limitations of treatment with a qualified physician before deciding whether alloClae is appropriate for them.
What do you see as the future of alloClae?
I am excited to see where this technology goes.
I have heard about the development of a more injectable product intended for facial applications called DermalClae, and I am interested to see how that evolves.
More importantly, I am looking forward to additional clinical research.
I have my own experience with alloClae patients, including patients who have returned for repeat treatments, but I would like to see more published studies examining long-term volume stability, tissue response and imaging after treatment.
As physicians, having both our clinical experience and stronger long-term data will help us better understand where alloClae fits within the growing range of options for aesthetic breast and body contouring.
Interested in alloClae in San Francisco?
Dr. Usha Rajagopal offers individualized consultations for patients interested in alloClae for breast and body contouring at San Francisco Plastic Surgery & Laser Center.
During your consultation, Dr. Rajagopal can evaluate your anatomy and goals, discuss how much volume may be appropriate, and help determine whether alloClae, traditional fat transfer, implants or another treatment would be the best option for you.
Individual results vary. The information provided here is for educational purposes and is not a substitute for an individual medical consultation.