CosmeticSurg Blog
Thoughts relating to the practice of Plastic Surgery
by Board Certified Plastic Surgeons

Stem Cells from Fat - Plastic Surgery’s New Frontier

There is no doubt that the most exciting frontier in medicine now is the use of stem cells. Stem cells have the power to restore beauty, heal damaged tissues, and the potential to treat and cure some diseases.

Embryonic stem cells vs. fat stem cells

Up until recently the media has largely focused on the more controversial embryonic stem cells. These are stem cells derived from embryos. The potential uses of these cells to cure and treat diseases remain vast, but the controversial source of the cells poses ethical questions which have delayed medical progress.

During the past decade, researchers have discovered that stem cells can also be extracted from your own fat tissue. These adult stem cells have the same potential as embryonic stem cells, except for the ability to differentiate into sperm or ova. Unlike embryonal stem cells, stem cells extracted from your own fat are abundant, easily available, and pose no ethical or political controversy.

Cosmetic enhancements vs. therapies to treat diseases

Due to FDA regulations, stem cell therapies to treat diseases are not yet available in the U.S. unless you are part of a clinical trial. In this capacity they are considered to be ‘drug therapy’ and subject to very strict regulation. Therefore, patients not enrolled in these trials are currently traveling outside of the United States to get these therapies.

But using your own (autologous) stem cells to restore a more youthful appearance is available now, from experienced plastic surgeons here is the U.S. There is no need to travel to China, Korea, or Europe to get stem cell enhanced facial rejuvenation or breast augmentation. These therapies do not fall under the FDA’s ‘drug therapy’ classification and are therefore not regulated as such because: 1) the injections are performed in the same operative session as the liposuction procedure to remove the fat; 2) the stem cells have been only minimally manipulated; and 3) the stem cell enhanced fat transfer does not alter the original relevant biologic function of the stem cell. Thus, when the cosmetic enhancement is performed in the same operative session, it is not regulated by ‘drug therapy’ guidelines.

However, if your autologous stem cells are reinjected in a separate or second operative session, it is unclear whether the FDA considers that application to be a drug therapy, even though it is used for the same cosmetic purpose. There is currently an intense legal debate about what constitutes ‘drug therapy.’

Plastic surgeons and fat grafting (fat injections)

Plastic Surgeons have been extracting and reinjecting fat cells into tissues for over a decade. Experienced fat grafting surgeons have known that successful fat grafting is highly dependent on the techniques used for extracting, processing, and reinjection of the fat cells. Surgeons are beginning to understand that fat processing techniques which result in high concentrations of adult stem cells produce not only long lasting results, but also have therapeutic results in injured tissues.

Stem cell enhanced fat injections

how stem cells from your own fat make you look younger

To perform stem cell enhanced fat grafting, fat is first extracted by liposuction using low negative pressure. The fat is then processed. Proper fat processing techniques include centrifugation and decanting of the extracted fat. Long lasting results are only achieved with proper fat processing techniques.

In contrast, surgeons who rinse the tissue decrease stem cell adherence to fat cells, and do not increase the concentration of stem cells. These less concentrated grafts have a smaller percentage of success.

Reinjection of the fat must be performed in very small quantities and distributed through all tissue layers to facilitate reestablishment of blood flow to the fat grafts.

Areas which benefit from stem cell enhanced fat injections

Examples of stem cell enhanced fat transfers which can be performed in the same operative session by plastic surgeons at the present time include:

  1. Facial fat injections - The fat transfer to the face is not just a volume filler. The stem cell enhanced fat can actually rejuvenate your facial tissues and skin. Stem cells assist in increasing blood supply to tissues to make tissues look younger.
  2. Breast Augmentation- Fat injections provide a natural alternative to breast implants
  3. Brazilian Butt Lift- Originally used for buttock enhancement, stem cell enhanced fat transfers are being used in body contouring to create an hourglass figure.
  4. Hand Rejuvenation- As in the face, there is not only a volume enhancement, but aged hand skin is revitalized by the fat transfer.

Other areas of stem cell therapy which are being investigated and currently developed are:

  1. radiotherapy injuries
  2. tissue defects
  3. lumpectomy reconstruction
  4. breast reconstruction after cancer

Stem cells are the new frontier in plastic surgery

Stem cell therapy is a paradigm shift in cosmetic surgery. Instead of the surgeon using his talents to create the illusion of a more youthful body, the surgeon guides your body to rejuvenate itself!!

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Ricardo L Rodriguez, MD
Board Certified Plastic Surgeon
http://www.cosmeticsurg.net

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20 Comments

  • Dr. Ricardo L Rodriguez wrote
    February 27, 2010 at 2:06 pm

    Kerri:
    My best suggestion to you is to go to a University medical center near you where they have a Plastic Surgery training program. Usually these programs have a clinic program to help patients like you.
    Good luck on your search, I am sure you will find Plastic Surgery training program near you.

  • Dr. Ricardo L Rodriguez wrote
    February 27, 2010 at 1:42 pm

    Ann:
    Yes, there is. Already scientists are able to grow fat from a small sample. It takes time and resources to grow, so it is costly, but yes, it can be done now.
    Thanks for reading our blog!

  • Kerri wrote
    February 23, 2010 at 12:47 am

    Hello Doctor, My name is Kerri, I am 28 years old and have had 4 children. My body is very hard on the eyes. I was always able to pull my body back together after my pregnancies until, my last one. I went from 135 lbs. to 247 lbs. My skin hangs and the extra skin on my arms hang about 3 inches down from my muscle. I was wondering if this fat stem cell injection or reconstruction will help keep my skin tight? Even when i lost weight, my skin still hung. I tried everything from tightening and toning work outs to heat wraps and creams, nothing will help. If it can help, is there something i can do to have a procedure done at little to no cost. Maybe a type of market research or some testing. My budget is very low but, my confidence about myself is even lower. I thank you for your time reading my comment.

  • ann wrote
    February 19, 2010 at 2:50 pm

    Is there any possibility in the near future that there will be the ability to grow more of a patients own fat from stem cells so that it would not be necessary to rely on fat that the person already has..as in the case of someone who has had lipo in past and does not want any more significant amount of fat removed. Thank-you.

  • Dr. Ricardo L Rodriguez wrote
    February 5, 2010 at 2:44 pm

    Marko:
    Yes, it works wonderfully for acne scars.
    One of my earliest fat grafting cases was for acne scars, and I was amazed at how good the skin looked. Now we know it was the stem cells in the fat.
    We’d love to hear from you, call Kelly at kelly@cosmetisurg.net

  • Marko wrote
    January 31, 2010 at 4:42 pm

    Hello Dr. Ricardo.

    I am interested to know if this procedure would be helpful for softening acne scars? Thanx

  • Dr. Ricardo L Rodriguez wrote
    December 29, 2009 at 8:21 pm

    Carol:
    You should go to a Physical Medicine and Rehabilitation specialist to see why you are having pain sitting. It may indeed be because of lack of fat, but you need to rule out other possibilities too.
    As for being of a slender build, you’d be surprised how much fat we can find in other areas of your body. If your objective is just to pad some areas, you may have enough.

  • Carol wrote
    December 29, 2009 at 1:09 am

    Dr. Rodriguez:

    I am slender built. Approximately 20 years ago, I had liposuction in my thighs and buttocks and 1000 cc of fat was removed. I feel that too much fat was removed. I am having problems sitting and have pain. I would like to have some fat cells replaced to those areas. Because of my slender built, I don’t have any fat cells in my body to spare. What can I do?

  • Dr. Ricardo L Rodriguez wrote
    December 26, 2009 at 1:15 am

    Sandy:
    Fat grafts, when done well, are permanent.
    I don’t “repeat” fat grafts. If you are interested, contact Kelly at Kelly@cosmeticsurg.net
    Looking forward to hearing from you!

  • Sandy Barber wrote
    December 17, 2009 at 7:20 pm

    How much does it cost for the fat/stem cell transfer to the face.. I have already had a fat transfer to the face and it did not last long.

    Thank You.

  • Dr. Ricardo L Rodriguez wrote
    December 2, 2009 at 8:50 pm

    Nikki:
    Calcifications from fat injections are secondary to poor injection technique. When fat dies, cell membranes disrupt and the cell contents interact with calcium. These calcifications do not turn malignant but some people were concerned that they would be confused with or obscure cancerous calcifications. Experienced mammographers can tell them apart.
    The issue of sagging breasts is a little bit more complex. If the areola is low on the chest wall, or below the fold of the breast, the patient needs a lift.
    Would I recommend it to young women? Yes, but the barrier is price. Implants are relatively cheap compared to fat injections to the breast.
    Hope this helps!

  • Nikki wrote
    December 2, 2009 at 12:31 pm

    I’ve read that fat transfers for breast enhancement cause breast calcifications. If this is true, what’s the likelyhood that cancerous calcifications will form as a result of this procedure? Also, would you recommend this procedure for young women who are interested in this method as an alternative to implants and don’t need reconstruction or want to fix sagging breast due to breastfeeding or age?

  • Dr. Ricardo L Rodriguez wrote
    November 9, 2009 at 5:15 pm

    Laurie:
    Hi!
    Funny you should mention this. I just came back from a medical conference where stem cells were being discussed along with other therapies for “antiaging”.

    PRP is being used for a lot of stuff and it does have its uses. I worked 14 years with platelet derived growth factors (Procuren, Regranex). Procuren is autologous platelet derived growth factors, Regranex (beclapermin) is recombinant platelet derived growth factors. They are, essentially, signaling proteins.
    They can stimulate local tissues, the question is, to do what and how much. Stem cells are better, because they can differentiate into structural as well as functional cells. Fat, when processed correctly, has a high percentage of stem cells. It is, in my opinion, superior to PRP because it has the endogenous building blocks (fat), as well as pluripotent cells to do whatever is necessary.

    By the way, stem cells have may beneficial neurologic effects, but I would never dream of treating nerve related disorders with stem cells, as that is not my area of expertise. Any Doctor with expertise treating orthopedic/musculoskeletal conditions who ventures into treating a totally different area because he has a tool that “works” is, by definition, out of his area of expertise.

    At that convention I mentioned above, a doctor came to me to talk about PRP for esthetic applications. I told him I preferred fat. His astonished answer was, You can inject fat like that? Yes, I can. He followed with Who else uses fat? Well, most plastic surgeons!
    Yet, there are many doctors working outside their area of expertise out there, happily injecting PRP into unsuspecting patients who trust their judgement because they doctors.

  • Laurie Hochheimer wrote
    November 7, 2009 at 9:17 pm

    Dr Rodriguez,
    Sven was just telling me about this new procedure which was started in London by a French Doctor named Dr. Sister. Anyway, it is called Vampire therapy or S3 therapy. I found it to be quite interesting and I thought about you and wondered if you were aware of it. Anyway, below is a comment from a doctor in Utah about it. So, I guess you know where I am going with this, what do you think? Would you consider trying it? I am still looking for something to help my acne scars…that is why Sven mentioned it to me. However, I guess it is great for wrinkles, sports injuries etc. and has been used for a long time to help people with receding gums.

    Which, begs the question of WHY my dentist continues to fill in the spots on my teeth where my gums have receded, and the fillings never last more than a few months. Anyway, getting back to the subject at hand, I know you are busy but let me know what you think (of the physician’s note describing the technique below) if you have the time.

    Thanks, Laurie Hochheimer

    Hi, Christine

    I’m a doctor and have been performing platelet rich plasma injections (the scientific name for stimulated serum) for orthopedic/musculoskeletal conditions for almost 5 years with excellent results. The way it works: At the time of injury platelets congregate at the site of the injury to create a blood clot (everyone knows this) but platelets also release proteins that are directly responsible for tissue healing and regeneration - so basically injecting platelets into an injury that never fully healed such as a tear, chronic tendonitis, (even arthritis), tricks your body into thinking that it has undergone a new injury (but it has not) and this launches your body’s natural healing mechanisms to grow new, healthy, collagen.

    About a year ago I learned of the cosmetic applications so I tried it on my girlfriend (of course) - to date I’ve performed this on about 18 women and 2 men and they have all been THRILLED. The 2 main applications are for filling folds and for rejuvenating aging skin (can be done anywhere on body such as face including eyelids or hands).

    Now - onto a comment on your article. I can totally appreciate that you might be grossed out by PRP into your face if you are squeamish about blood and also if you have strong opinions about society’s pressure on women to look like 22 year old anorexics. However the reality is there are many women (and men) who feel younger than they look and would like their skin to match their vitality and also attention to other aspects of their appearance (hair, clothes, etc). If you look at PRP therapy this way without judgement (and if you can look past the vampire stuff), really, triggering your body’s own ability to regenerate is really a naturopathic approach.
    Additionally, even though I’ve only been doing this for a year, so far the results are lasting and in fact you continue to notice improvement many months out. Anyway, hope this helps.

    Dr Harry Adelson

  • Jaime wrote
    November 2, 2009 at 2:07 am

    Dear Dr. Rodriguez,
    This is to request permission to print your story “Is stem cell facelift a new phenomenon?” that was posted on 14 Apr 2009 on http://www.cosmeticsurg.net/blog/2009/04/14/is-stem-cell-facelift-a-new-phenomenon/.
    Your story will be printed with your photo as author, a short bio about you at the end of the story, and your website address, in Medica Tourism magazine, a monthly magazine in Bangkok, Thailand, which is distributed free to help readers with information about the medical tourism industry.
    I’d be happy to mail you a copy of the magazine.
    Yours truly,

    Jaime Alfredo Cabrera
    Editor, Medica Tourism Magazine
    12-I Ocean Insurance Building
    163 Suriwong Road, Bangkok, Thailand
    Phone: 02-236-5399 Fax: 02-236-5398

  • Dr. Ricardo L Rodriguez wrote
    October 2, 2009 at 10:21 am

    The most exciting research in stem cells is now coming from “Adult Stem Cells” collected from the patients own body. I am particularly interested in fat cells as they are abundant in the body. There are several clinics overseas which are treating Parkinson’s with the patients own stem cells, bu tthe techniques aren’t quite refined yet. I do think that we are only a couple of years away from making significant improvements in treatment of Parkinson’s.
    Check out this link for information from the NIH (National Institute of Health) about clinical trials and stem cells.

  • Suzi Savino wrote
    September 27, 2009 at 7:04 pm

    My sister has Parkinsons. Because so many people are against using stemcells, because they come from infant stemcells. Would it be useful, using adult stem cells, or should I say, successful, with adult cells being used? I would love to hear from you, regarding this process, since, so many people are against using “infant” stem cells. Thanks so much

  • Dr. Ricardo L Rodriguez wrote
    June 20, 2009 at 10:37 am

    In the case of stem cells not manipulated or treated other than in reinjection (which is what I do) there are no reports of “side effects”.
    I suppose that as people try to get more involved with techniques such as getting cells to differentiate into other cell lines there might be unexpected results, but so far, nothing that is raising concerns.

  • Katie wrote
    June 17, 2009 at 9:09 am

    Stem cells have the power to restore beauty, heal damaged tissues, and the potential to treat and cure some diseases. I think it true and the benefits are countless.
    Only concern is what about side effects ?

  • Psychologist wrote
    June 8, 2009 at 8:01 am

    using stem cells from patients’ own body fat.
    Why not? The patients own DNA is already there. It’s compatible.
    Dead baby bodies have their own DNA. Like any organ transplant, they’d be rejected without a life time of medication.

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Dr. Ricardo L Rodriguez
Plastic Surgeon