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
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:
- 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.
- Breast Augmentation- Fat injections provide a natural alternative to breast implants
- Brazilian Butt Lift- Originally used for buttock enhancement, stem cell enhanced fat transfers are being used in body contouring to create an hourglass figure.
- 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:
- radiotherapy injuries
- tissue defects
- lumpectomy reconstruction
- 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!!
by Ricardo L Rodriguez, MD
Board Certified Plastic Surgeon