Stem Cell Face Lift & Cosmetic Applications

The Stem cell face lift is really a term which is not to be taken literally, as it is not a “face lift” in the traditional sense. Face lifts have been done traditionally for facial aging for many years by plastic surgeons. This involves cutting and rearranging the tissues of the face. This surgery may or not be done with what is called the addition of “stem cells” or “fat cells” to the face lifting procedure. Yet before delving further into the procedure on how Dr. Pasquale’s procedure is done at this time, we need to make sure that our patients know some of the basics.

The Stem Cell Face Lift Process

Over the years, Dr. Pasquale has developed his technique for rejuvenating the face with a combination fat transfer and stem cell injection in combination. The stem cells appear to cause certain changes in the complexion and the vascular make up of the facial skin. Asian patients have noted decrease in melasma (brown spots from aging) and lightening of the skin. There also less wrinkles and fine lines and what is described as a youthful glow.

We also believe that collagen is increased, among other neo genesis type changes, which are part of the regenerative process during what we see with normal healing. The reason for this we believe is due to the healing factors which are derived and concentrated from the harvesting and processing of the stromal vascular fraction which contains the stem cells. Simply said its focused.

Harvesting of the cells

Dr. Pasquale uses at this time stem cells found in the fat or sometimes called adipose derived regenerative cells. This he concentrates through mechanical means in the procedure. This is a procedure which is under medical practice not under the FDA. The FDA does not have regulatory authority over physicians practice much as there is no such thing as a FDA approved surgical face lift or FDA approved appendectomy. The FDA only regulates drugs and medical devices, not the procedures used by physicians and surgeons which is medical practice.

Processing the stem cells

Our office operating suite is set up specifically to process these cells with the latest equipment for the safe processing of fat-stem cells used in Dr. Pasquale’s procedure. Our technicians are trained to take these cells and concentrate them to provide maximum benefit to you. Though we are 100% sure that there will be better FDA approved techniques in the future , based on present accepted information we process these cells to provide the highest concentration safely with mechanical means.

Placement of the stem cell concentrate

What we do is concentrate the harvested stem cells which have been mechanically spun down to produce a broth of various healing, growth factors and stem cell mix. This is added to the fat which we believe does two things. First we believe it helps the fat graft take and more fat cells live and adds the regenerative properties of the solution. We do cell counts to help us document the amount of cells in the broth that are viable.

As to the exact mix, how much stem cell and how much healing or growth factors it will contain, this will vary according to each patient and each procedure. This is typical of procedures done surgically unlike a dosage of a drug. The cells that we re inject are the same cells that came out and they are not changed by the process only concentrated. These are viable living cells and factors contained within the broth performing the same function they do before we harvest them. Now we transfer them only to be concentrated at the targeted area.

Placement of the stem cells with fat artistically

This is where the art comes in and Dr. Pasquale uses his artistic judgement to re-volumize the face depending on what will add a more youthful appearance. This may require placement in the temples, or cheek to remove aged hollows of the face.

Its artistic sculpting at its best

This really requires an artistic eye and experience to make the small changes that do not make one appear like they had plastic surgery. This should always appear natural never over done. Dr. Pasquale has perfected this technique over the years. If you are interested in this procedure please contact our office for an evaluation.

The traditional face lift

In the traditional use of the term this is when the plastic surgeon surgically cuts into an inconspicuous area near the ear and removes excess skin pulling it in the appropriate direction to reverse the sagging. There are many techniques for this and each one should be individualized (customized) to the condition of the aged face for each patient. This may involve rearranging some of the deeper muscle layers (smas lift) or other underlying structures and the skin. This is surgery and results can be excellent. It indeed tightens the facial skin and neck but is surgery. For more on surgical facelifts see our Plastic Surgery Web Site of Dr. Pasquale. Here you will find a lot of information about traditional plastic surgery.

Fat Transfer to the Face & Adding Volume

Fat taken from one part of the body and then transferred to the face is another technique which is commonly used. This has been done for many years. Dr. Pasquale has used this technique for over 18 years for facial cosmetic improvement. In the past been this has been mainly for volume replacement for the face before the synthetic fillers were available.

Reverse aging?

As we age many people loose facial fat which gives their cheeks and other areas a hollow aged look. Replacing this lost volume with fat gives excellent results if done correctly and does not give a “fat face” appearance. To some degree each surgeon has his own technique and there is not 100% standardized way to perform this. Many surgeons claim their technique is the best. The important issue is that the surgeons technique uses actual live stem cells, and has a reasonable number. All in all, its good technique when volume replacement is needed. Additional benefits are the well known skin rejuvenation factors which we discuss in skin lightening below.

Skin Lightening

One of the “side effects” we have noticed over time is that we may notice skin become more white and show a decrease in brown spots. This is not due to the fat but most likely due to some of the healing factors along with the stem cells.

Rejuvenating Stem Cells

The latest buzz to the plastic surgery world is the use of stem cells for facial rejuvenation, some tout it as a miracle. Certainly all the stem cell skin cremes are a bit of farce and over state the result. Yet like most claims which appear too good to be true, there is no fountain of youth and stem cells are not the miracle we all look for, at least not yet.

Yet the use of stem cells and the knowledge of what they do is rapidly advancing and is indeed a hot topic with promising results. The term “stem cells” in common vernacular covers a wide range of cells. There are the very controversial use of fetal stem cells harvested from fetal tissue or fetal cord blood. At this time this is not what cosmetic doctors (yet anyway) are using when they talk about such things as the stem cell face lift. This fetal cell usage at this time has ethical and very controversial considerations. Suffice it to say that fetal stem cells are not being used in cosmetic surgery here.

Your fat becomes your beauty!

What cosmetic surgeons are using today are stem cells derived from around the fat or your adult blood ( platelet rich plasma PRP, bone marrow ). These more mature stem cells are everywhere in the body, even the brain has this type of cell. These cells are the cells which repair and regenerate the tissues. How they do this is largely unknown and may involve several factors to “coach” them into doing so. Some feel there are some combination of growth factors which are present which activate the process as well. However, what turns the regenerative process “on” is largely unknown. Yet for now we can call these cells “stem cells” as a descriptive term or as some call them, simply regenerative cells. If taken from around the fat they are called adipose regenerative cells or ADRC’s. All we know for certain is that many claim benefit and Dr. Pasquale has observed this as well in his practice.

What we have observed is that concentrating these type of stem cells and injecting these typically with some fat cells from which they are harvested appears to have some remarkable regenerative properties noted by years of observation. This needs more study. We do see that its not just volume replacement that improves the appearance. This can be improvement we note with the skin appearance post procedure and what has been described as a youthful glow. This may be due to increased blood supply and collagen regeneration or other factors that we simply do not know caused by these cells or yet some unknown mechanism. More dramatically we have noted in breast tissue that has been severely damaged by radiation for breast cancer a true rejuvenation with reversal of the damage occurs. Why this has been observed and happens is elusive. Yet studies are currently underway in the United States and indeed some have been completed in Asia which look very promising indeed.

Politics, Money & Stem Cells

One large political group who lobbies the government and are tying to do the right thing is the American Society of Plastic and Reconstructive Surgeons (ASPRS) they have produced a position paper with a very similar group called the American Society of Aesthetic Surgeons. You can read their joint position paper as well and may help you make up your mind. Their position basically states that many Doctors are producing hype about the “stem cell face lift” for pure marketing purposes, which is really a re branding of simple fat transfer to the face. Further they state that it should be called fat grafting to be ethical. They further state as we have stated that this is not scientifically proven therapy.

Dr. Pasquale does not disagree with that position, however what he does is not simple fat grafting. He uses concentrated stem or regenerative cells mixed with some fat in most instances. This is NOT fat grafting as is known traditionally, so it would be equally wrong to label that as simple traditional Fat Grafting. So some have suggested other names, but at this time this what we call the stem cell face lift to be clear. It is concentrated stem cells derived from your own body. and minimally manipulated and re-injected. This is done in an artistic manner sculpting the face.

What is stem cell facial rejuvenation?

When you hear stem cell based rejuvination procedures and products for cosmetic reasons it becomes rather confusing. You may read about such things as “stem cell face creme” or even “placenta creme”, many cremes claiming to have special healing factors based on stem cells and so on. Stem cells can indeed rejuvinate the skin and most plastic surgeons have known this for years. Yet the majority of skin products, if not all do not work by applying some stem cell formulation topically. It just does not make sense scientifically despite all the hype you read.

Stem cells are living cells, their job along with other cell factors orchestrate healing and these cells become new cell types to replace damaged tissues. They themselves help direct the process or become new tissues in area of the body that is damaged. Their exact role and how they do this is not known 100%, but we do know that they must be alive to do their jobs. This fact cannot be disputed. It is not even reasonable to state that some stem cell creme, that has been sitting around for more than a few hours contains live stem cell. Another scientific fact which should make you question these products is how can a stem cell (which is fairly large in size) even penetrate the skin to do its work? It cant, simple as that a stem cell even if alive cannot penetrate the skin its too big.

Stem cell miracle creams

Now if their are some other ingredients in these cremes which apprear to rejuvinate (usually mositurize) that is up for debate and this may be possible. Yet the stem cell component makes no scientific sense. We assure you that stem cells in externaly applied creme do nothing themselves.

When we talk about stem cell rejuvenation of the skin and face what we are doing is extracting stem cells from your own body and then injecting a concentration of live stem cells (and other factors) into then skin. This is by injection or some form of placement inside the body through a route that works.

References:

1. Tissue Eng Part C Methods. 2013 Jun;19(6):473-8. doi: 10.1089/ten.TEC.2012.0465. Epub 2013 Jan 31. Xenofree enzymatic products for the isolation of human adipose-derived stromal/stem cells. Carvalho PP, Gimble JM, Dias IR, Gomes ME, Reis RL. Source

3B’s Research Group-Biomaterials, Biodegradables and Biomimetics, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, University of Minho, Avepark, Guimarães, Portugal.

2. Blood. 2004 Nov 1;104(9):2728-35. Epub 2004 Jul 8. Suspended cells from trabecular bone by collagenase digestion become virtually identical to mesenchymal stem cells obtained from marrow aspirates. Sakaguchi Y, Sekiya I, Yagishita K, Ichinose S, Shinomiya K, Muneta T. Source Section of Orthopedic Surgery, Division of Bio-Matrix, Graduate School, Tokyo Medical and Dental University, Japan.

3. Yoshimura, et. al, Cell-assisted lipotransfer for cosmetic breast augmentation: Supportive use of adipose-derived stem/stromal cells. Aesthetic Plastic Surgery (2008) 32:48-55