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In order to provide advanced cosmetic surgery, it is essential to maintain a high level of quality of facilities and of medical process management.

In the CAL tissue augmentation procedure Nirunda Clinic provides, stem cells to be transplanted are extracted from aspirated fat. In addition, stem cells are also extracted from the liquid obtained from liposuction, which is normally discarded when traditional liposuction/lipoinjection procedures are performed, and then processed in order to increase the concentration of stem cells in the fat that will be re-injected. Since processed stem cells are transplanted into a patient’s body, the environment where those procedures are performed should be sterilized and well-equipped.

Operating rooms are directly connected to the CPCs, so that procedures such as liposuction, cell extraction, and lipo-transplant can be completed as a set of procedures in a sterilized environment. These operating rooms that are directly connected to CPCs are critical to performing the procedures that are at the heart of Nirunda Clinic.

In addition, during cell processing, accidents and mistakes are unacceptable. Therefore, this procedure is performed in accordance with the regulations which stipulate all the processes of the procedure in detail.


cell extraction procedure


  1. Fat mixed with a liquid is harvested from the donor site(s)
  2. The liquid is extracted and set aside
  3. The fat (adipose) is divided into two parts, one part stored for transplant
  4. As many stem cells as possible are extracted from the other part of the fat, hence Adipose-Derived Cells (ADC)
  5. The ADC extracted are mixed with the stored fat
  6. Stem cells are then extracted from the liquid that has been extracted first
  7. These stem cells, too, are added to the stored fat
  8. The stem cell enriched fat is transplanted back into the patient’s body, hence “Cell-Assisted Lipotransfer (CAL)”

In the case of patients with insufficient fat to allow division into two parts, the fat is not divided. However, steps 3 – 5 are left out. Stem cells are only extracted from the liquid and these are then added to the fat. This shortened process is referred to as ‘miniCAL’.

The entire CAL extraction process lasts 1 – 2 hours. The stem cell enriched fat is transplanted within a few hours without freezing.


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