2016 Plastic Surgery Techniques Showcase Regenerative Medicine

Facial Plastic and Reconstructive Surgery

There have been numerous advances in Plastic Surgery over the past 10 years — both socially and medically. Patients wonder what advancements are on the horizon in the realms of Facial Plastic and Reconstructive Surgery? Looks like regenerative medicine may be the next big thing in this constantly evolving field.

Matthew Q. Miller of the University of Virginia, Charlottesville, and fellow coauthors have recently written a review article that considers regenerative medicine techniques in Facial Plastic and Reconstructive Surgery and revealed suggested directions for future studies. The researchers studied stem cells, growth factors as well as synthetic scaffolds. This burgeoning field provides hope to patients suffering crippling disorders of the face and other body parts, in addition to individuals seeking anti-aging remedies.

For instance, “Plastic Surgeons and researchers are developing regenerative medicine-based treatments for people with congenital anomalies of the hands and face, such as microtia, cleft lip and cleft palate; burns; limb and muscle loss; facial aging; facial nerve injuries; breast cancer; and other reconstructive needs,” the Mayo Clinic reported.

“Regenerative medicine is an exciting field with the potential to change standards of care in FPRS [Facial Plastic and Reconstructive Surgery]. This review touches on soft-tissue, cartilaginous and bony regeneration in Facial Plastic Surgery using stem cells, growth factors, PRP [platelet-rich plasma] and/or synthetic scaffolds. Our subspecialty has to continue to clinically investigate these techniques to show whether the new frontiers of regenerative medicine improve outcomes and cost-effectiveness in FPRS while not adding to the risks of treatment,” the review article noted.

As reported by Miller, regenerative medicine focuses on unlocking the regenerative potential of allografts and flaps, which are the foundation of surgical reconstruction.

“Regenerative medicine is a game-changing area of medicine with the potential to fully heal damaged tissues and organs, offering solutions and hope for people who have conditions that today are beyond repair,” the Mayo Clinic stated.

“I am very excited about the possibilities regenerative based medicine opens up, as it will positively affect the standards of care we have for crippling facial disorders and anti-aging treatments.”

— Dr. Slupchynskyj

Scientists anticipate that this new field could be a supplement or replacement for other tactics and procedures that have dangerous side effects or may not be good long-term solutions like Botox.

Recently, a similar study regarding Botox has been published. It provides evidence that injected Botulinum Toxin, can actually jump between neurons and hit areas it wasn’t intended to treat — adding legitimacy to a fear that began when the product first hit the market.

In 2009, the U.S. Food and Drug Administration added a warning to Botox’s prescribing information “to highlight that Botulinum Toxin may spread from the area of injection to produce symptoms consistent with botulism.”

Source: Miller MQ et al. The next frontier in Facial Plastic, Reconstructive Surgery. JAMA Facial Plast Surg. 2016.

Hundreds of U.S. Clinics Offering Illegitimate Stem Cell “Therapies”

A new study reveals hundreds of clinics throughout the United States are promoting unsanctioned stem cell treatments for conditions such as aging skin and spinal cord injuries.

In an online search, researchers were able to pinpoint approximately 570 clinics providing unauthorized stem cell “therapies.” They tend to be concentrated in a handful of states — including Arizona, California, Colorado, Florida, New York and Texas — but are scattered across many other states as well.

“The clinics usually market stem cell procedures for orthopedic conditions, such as Arthritis and injured ligaments and tendons. This does exhibit medical applications, but is still considered experimental,” medical experts said.

In other instances, with little or no substantial proof, clinics hawked Stem Cell “Facelifts” and therapies for serious conditions such as Chronic Lung Disease, Parkinson’s Disease and Multiple Sclerosis.

If these pricey stem cell treatments are unproven and unapproved by federal regulators, how can these clinics exist?

“I ask myself that question all the time,” said Leigh Turner, a Bioethicist who worked on the study.

Turner, an associate professor at the University of Minnesota’s Center for Bioethics, said attention used to focus on “Stem Cell Tourism” — where people travel to countries such as China, India and Mexico to get unproven treatments.

“I think there’s a misperception that everything here [in the U.S.] is regulated,” Turner remarked. “But these clinics are operating here, and on a relatively large scale.”

Stem cells are basic cells with the potential to mature into various types of body tissue. Medical researchers have been studying the possibility of using stem cells to repair damaged tissue in a range of chronic ills — with minimal success to date.

But the general public has heard about the ‘promise’ of stem cells for years, and it can be easy to be taken in by clinics’ marketing tactics,” Turner stated.

Websites can, for instance, link to published medical studies that make their therapies appear genuine, Turner said. “These businesses can be quite savvy,” he said. “I think it’s asking too much to just tell consumers to be wary. We need to be asking, why should these clinics be allowed to do this?”

Arthur Caplan, a Bioethicist who did not participate in the study, mentioned some explanations for the growth of stem cell clinics.

“The businesses are usually not engaging in interstate commerce, which helps them ‘fly under the radar’,” noted Caplan, who directs the division of medical ethics at NYU Langone Medical Center in New York City.

“Plus,” he said, “there’s a regulatory gray area when it comes to so-called ‘autologous’ stem cell therapy, which refers to treatments that use a person’s own stem cells.”

“If you have cells from your own body reinjected, it isn’t clear that you’re getting a ‘new biologic’,” Caplan explained.

Out of the businesses Turner’s team found, most marketed autologous therapies, usually using stem cells from people’s body fat or bone marrow. But about one-fifth of the businesses claimed to use stem cells from umbilical cord blood or amniotic or placental tissue.

“The issue goes beyond people wasting their money or having their ‘hopes dashed’,” Turner said. “It’s known some have been seriously harmed.”

He mentioned two elderly patients in Florida who died following an unapproved stem cell procedure.

The U.S. Food and Drug Administration has taken steps against specific businesses. Last year, it sent a warning letter to a network of clinics that operate in California, Florida and New York. According to the FDA, the clinics illegally use stem cells from people’s fat tissue to treat conditions such as Parkinson’s, MS, Amyotrophic Lateral Sclerosis (ALS) and Autism.

“Many of these claims are outrageous,” Caplan said. “These clinics are preying on vulnerable people.”

His advice to consumers: “Be wary of any procedure that comes with celebrity endorsements or patient testimonials.”

The FDA has published draft guidelines for stem cell use. A public hearing is scheduled for later this year.

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