Saturday, May 23, 2009

The Stem Cell Facelift: A Promising Plastic Surgery Innovation

The world of plastic surgery seems poised for innovation once again! How about a facelift without surgery? Sounds too good to be true? Stay tuned.


By lifting the ban on federal funding for promising stem cell research, on March 9, 2009 President Obama brought this highly charged topic to the forefront once again. Not surprisingly, anti-abortion rights activists condemned Obama’s decision. Although I strongly applaud his stand, I certainly would never support the use of our finite supply of embryonic stem cells for beauty enhancement treatments – nor have I heard of any reputable surgeon who advocates such research and application for anything short of curing human disease and restoring body parts. But anti-aging specialists and plastic surgeons now have discovered other sources of stem cells - unburdened by moral and ethical decisions. Enter adult stem cells.


Understanding Stem Cells

A stem cell is a cell from which other types of cells develop. Stem cells have the ability to make more of themselves and to differentiate as they do so, in order to grow a wide variety of tissues. While embryonic stem cells are the most well-known type, not all multi-potent cells come from embryos. An abundant source of stem cells also can be harvested from our own fat. Within this past decade, researchers have begun to recognize that these pre-fat cells were actually stem cells that could be coaxed into becoming not just more fat, but cartilage, bone, and even neurons and heart muscle. Because of their diverse capablilities, these stem cells are known as multipotent.


Researchers are discovering that the lipoaspirate from liposuction, which we make in our bodies, can be converted into cells having the ability to differentiaten and replicate. By capitalizing on stem cell biology, plastic surgeons are beginning to implement methods for using those cells to reconstruct lost tissue and to build new tissue in less invasive ways than ever before.


Fat Grafting in Development

Plastic surgeons, recognizing that fat is an ideal material for soft tissue augmentation with the most natural-appearing results, have been reinjecting fat into faces for decades. The biggest problem with this procedure has been the resorption or breakdown of the reinjected fat, with resulting impermanence to the improvement.


“The grafted fat must gain its own blood supply in its new location in order to persist long-term, and this generally is not possible when large amounts are

injected at once and when specialized instrumentation and techniques are not employed,” explains board certified plastic surgeon, Dr. Michael Law.            


Structural fat grafting, also known as lipostructure or microfat grafting, has been a step forward in establishing permanence of the reinjected fat. With this process, small amounts of fat (less than 0.1 cc at a time) are carefully microinjected in a series of discrete layers to gradually build new soft tissue structure. As there is space between each microinjection, new blood vessels are able to grow into the grafted fat, allowing it to persist.


This procedure requires specialized training and specialized surgical instruments, as well as patience on the part of both surgeon and patient, but when performed properly, permanent improvement in facial plastic contours is possible.  

Stem Cell Plastic Surgery


Researchers are experimenting with new ways to process fat so that these fragile stem cells can create a blood supply for the transplanted cells to help them survive. One experimental method has involved separating out multipotent adult stem cells and growing them in a petri dish, while coaxing them to differentiate into specific tissue types such as fat or cartilage.  Those differentiated cells are then injected into the patient, where they continue to grow and divide, creating a small amount of natural tissue.

                                         Stem Cells, Facelift  






Photos courtesy of Dr. Vincent Makhlouf - Des Plaines


A second method uses mechanized means to accomplish similar goals. Cytori is a San Diego-based company that makes equipment to process fat stem cells immediately after the doctor liposuctions off some of the patient’s fat. Half that fat gets set aside, while the other half is processed to extract a condensed mixture rich in stem cells. That mixture is then injected back into the reserved fat, producing a fat graft supercharged with stem cells, ready to be reinjected into the patient. The result is an immediate fat graft supercharged with stem cells. An additional benefit is that because the patient is the donor, there is no risk of tissue rejection.


Stem Cells, Plastic Surgery


Photos Courtesy of Skin Essentials@bod:evolve 


The Facelift of the Future

Today many diverse procedures are being utilized to rejuvenate the face. While some involve surgery such as eyelifts and facelifts, other non-surgical options have emerged in the past ten years as a means to temporarily rejuvenate the face. Enter muscle relaxers as Botox (and more recently Reloxin), and fillers such as Juvederm, Radiesse and Restylane. These options can provide patients with a younger, more rested appearance, but because they are only temporary measures, injections need to be periodically repeated.


Plastic Surgery, Face Lift, Stem Cells 

Photos courtesy of Dr. Vincent Makhlouf - Des Plaines


If clinical trials continue to show promise, the “Stem Cell Facelift” may just be the next huge step forward in facial rejuvenation. This Stem Cell Facelift would involve removing fat from a patient’s body – typically from the thigh or abdomen - processing it in some way and then injecting it back into that same person’s face - all in a single procedure. Anti-aging specialist and plastic surgeon, Dr. Vincent Giampapa, Assistant Clinical Professor at UMDNJ Medical Center in Newark, New Jersey and Director of The Plastic Surgery Center Internationale and the Giampapa Institute for Age Management, has pioneered this procedure and has been performing it for the last four years. He claims that the patients he has treated have exhibited not only marked improvement in both the underlying soft tissue contours of the face but also in skin quality and tone and that the results it yields are extremely natural. Priced at $5,000, it is considerably less costly than a surgical facelift that typically costs triple that amount.

Face Lift, Plastic Surgery, Stem Cells                               

Photos courtesy of Dr. Vincent Makhlouf - Des Plaines


Dr. Renato Calabria, a plastic surgeon with offices in both Italy and Ca., is slowly integrated this technique, which he calls the “Stem Cell Enhanced Facelift”, into his own practice. By introducing these reengineered stem cells into specific layers of facial tissue during the surgical facelift, he claims to see dramatic improvement in not just facial contour, but in skin quality and tone as well. He believes that the growoth factors contained in the implanted  cells stimulate skin renewal properties.


Will this change the way facelifts are done in the future or better yet, provide us with that dream come true -  a cost effective, knife-free facial rejuvenation procedure performed in an office setting requiring only local anesthesia, with shorter downtime and natural, long lasting results.


The hope for the future is that one day we will be able to say yes to all of the above and that these reengineered stem cells will be used not only to fill out wrinkles on an aging face, but also to replace lost breast tissue or augment the breast without the insertion of an implant.

Source: 22 May 2009


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