DERMAL ROLLER Stem Cells in the News


by Dr. Alan Kisner *

Innovations in the field of plastic surgery are happening so rapidly that what is considered cutting edge today might become a mainstream practice of tomorrow, or on the other hand, might disappear from the radar screen entirely. The technology within the aesthetic field of plastic surgery is very much propelled by demand, with consumer needs driving the science behind many of its innovations. We know that women are the consumers of approximately ninety percent of all cosmetic procedures. Today many of these women are in the job market, pressured to keep pace with their careers, looking for quick resolutions requiring little downtime. Science scrambles to keep pace.

Ultimately we - the developers of these technologies, plastic surgeons and patients - all want the same things: safe, rewarding, long lasting results with less body trauma and rapid healing. In an effort to meet demand, a diverse array of products are brought to market with great fanfare, frequently touted by the industry and mass media as the newest miracle to some form of aesthetic enhancement. Frequently they do not live up to their original promise. One merely has to glance through the For Sale ads placed in the plastic surgery journals to see the number of surgeons selling slightly used equipment at highly reduced prices, to know these products have not met their mark.

The very word plastic comes from the Greek word plastikos (to move or mould). We are trained to move tissues and reshape them to reconstruct defects acquired through injuries and congenital deformities. In order to improve our arsenal, we have used autologous tissues (tissues from our bodies) such as skin, bone and fat as well as products from cadavers, new manufactured products, such as the many fillers available (e.g. hyaluronic acid, collagen, silicone and hyroxylapatite). In an ideal world it would be of great benefit to use our own tissues to regenerate or replace missing palates, lips, breasts and cartilage.

Stem cells offer this promise for the future. Multipotential embryonic stem cells offer the most possibilities since they differentiate into all cell types. Encapsulating the stem cells in different shaped biomaterials could create new cartilage for joints, craniofacial reconstruction and new dermal fillers. Stem cells are unspecialized and can be encouraged to convert into specialized cells such as heart muscle or in our ideal world, into Islet pancreatic cells to produce insulin and to cure diabetes. In an ideal world it would be of great benefit to use our own tissues to regenerate or replace missing palates, lips, breasts and cartilage.

Stem Cells From Fat

An abundant source of stem cells can be harvested from our own fat. The lipoaspirate (the fluid containing fat cells) from liposuction can be converted and potentially used for multiple benefits. One major advantage of using adult stem cells is that they can be obtained unburdened from the legal and ethical problems associated with the procurement of embryonic stem cells. Adult stem cells can and have been used in ongoing trials to treat congenital facial deformities, breast asymmetries and breast reconstructions as well as for aesthetic enhancement. For the cosmetic surgery patient, fat sounds like an ideal material for soft tissue augmentation, but it has been impermanent due to resorption (breakdown of the grafted fat). In order to become permanent, grafted fat must establish its own blood supply, which is generally not possible when large amounts are injected at once.

One technique being used to circumvent the impermanence of the grafted fat is known alternately as fat grafting, lipostructure or microfat grafting. This procedure involves injecting small amounts of fat (less than 0.1 cc at a time) in discrete layers to gradually build new soft tissue. By allowing time and space between these microinjections, new blood vessels are able to grow within the grafted fat, allowing it to establish permanence. This procedure requires specialized training and specialized surgical instruments, as well as patience on the part of the surgeon and patient.

Researchers are experimenting with new ways to process fat so that these fragile stem cells can create their own blood supply more readily, enabling the t ransplanted cells to survive. Dr. Giampapa, a board certified plastic surgeon at the forefront of age management medicine has been working with a California based company named Cytori. They have taken a further step forward in adult stem cell research and development by producing equipment to process the patientís fat cells immediately after the surgeon liposuctions it from the patient. During this same procedure, half that liposuctioned fat gets set aside, while the other half is processed to extract a condensed, richer stem cells mixture and integrate it with the reserved fat. This new fat graft, supercharged with stem cells, is then reinjected into the patient with no risk of tissue rejection because the patient is the donor.

The Stem Cell Facelift is much in the news today, but it is too early to know if it will achieve FDA approval and become a viable contender. Stem cell biology is now in its infancy. Science is investigating the viability of using supercharged fat grafts to reconstruct lost tissue or augment areas of the human form with new tissue. The possibilities stretch as far as the imagination and beyond into many fields of medicine, including those of reconstructive and cosmetic surgery.

Some Concluding Thoughts

In this increasingly competitive world of cosmetic surgery, some technicians scramble to distinguish themselves by touting new procedures that are nothing more than minor variations to well established practices, simply renamed to impress the uninformed. Other new procedures have not been adequately tested or FDA approved. In our continual quest toward perfection, a few of what are touted as new will meet the mark as true innovative steps forward in the field of cosmetic surgery. Stem cell therapies might very well be one of them.

But in this continual quest for new and improved procedures and technologies, the health and well being of the patient must remain our number one concern. I have learned to approach new with open-minded interest tempered by judicious amounts of skepticism, and encourage prospective cosmetic surgery patients to adopt a similar perspective. Ultimately we are reaching for the same goals, with safety our first priority.

*This article is excerpted from a portion of a chapter written by Doctor Alan Kisner for my book, Tick Tock, Stop the Clock ~ Getting Pretty on Your Lunch Hour

© 2013 by Lois W. Stern

Lois W. Stern is the author of Sex, Lies and Cosmetic Surgery and Tick Tock, Stop the Clock ~ Getting Pretty on Your Lunch Hour as well as numerous magazine articles.

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