Stem Cell Facelift Facts

Oleh Slupchynskyj, MD, Board Certified Facial Plastic Surgeon

As we age, skin cells divide more slowly, causing layers of skin become thinner and lose their elasticity. The skin is not the only part of the face vulnerable to swift passage of time and the unrelenting pull of gravity. The muscles and tissues deep within the facial structures also begin to weaken, shirking in size, causing unsightly fine lines and wrinkles to appear.  Our own bodies may provide the ingredients needed to repair some of these tissues, and reverse the ravages of time. Using stem cell technology, we may now have the technology needed to harness those healing capabilities.

A Stem Cell Facelift entails the transfer of adult stem cells from a donor site on the patient’s body to the areas of the face in need of rejuvenation. The procedure is minimally-invasive and can be performed under Local Anesthesia (General Anesthesia is not required). Small needles are used both to harvest the fat tissue and stem cells from the donor site and to deliver the revitalized stem cells to the facial structures, minimizing scarring and post-procedure downtime. Immediately after the procedure, most patients will experience mild swelling and will notice that their skin seems red or pink as if sunburned. These symptoms will subside within a week after the procedure.

Once the fat tissues and adult stem cells have been removed from the donor site, typically the lower abdomen or upper thigh area, the cells are purified with a gentle blotting technique. These cells are not cleansed in a centrifuge as with a traditional fat transfer procedure, due to the danger of damage that the centrifuge poses to the stem cells.  Once the cells have been purified, special growth factors are added to them in the form of micro-hyaluronic acid beads believed to maximize the survival of stem cells. Theoretically, once embedded into the facial structures, these beads will transport growth factor to the stem cells over a period of three months, awakening the stem cells and stimulating them to transform into new facial tissue.

According to a study in the April issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS), two different Fat Grafting techniques–injection of fat cells versus fat-derived stem cells–have similar effects in reversing the cellular-level signs of aging skin.

Given that the facial rejuvenation results are the same, the simpler approach using fat cells plus the “stromal vascular fraction” offers numerous advantages over the more time-consuming stem cell fat technique. Dr. Gino Rigotti of Clinica San Francesco, Verona, Italy, directed a research team consisting of Luiz Charles-de-Sá and Natale Ferreira Gontijo-de-Amorim from Clinica Performa, Rio de Janeiro; and Andrea Sbarbati, Donatella Benati, and Paolo Bernardi from the Anatomy and Histology Institute, University of Verona.

Facial Rejuvenation: Fat Grafts vs. Stem Cells

The experimental study compared the two methods to Fat Grafting for regeneration of the facial skin. In these procedures, a small amount of the patient’s own fat is obtained by liposuction from another part of the body, such as the abdomen. After processing, the fat is grafted (transplanted) to the treated area, such as the face.

The study featured six middle-aged patients who were candidates for Facelift Surgery. All underwent Fat Grafting to a small area in front of the ear.

One group of patients received fat-derived stem cells. Isolated and grown from the patients’ fat, these specialized cells have the potential to develop into several different types of tissue. The other group underwent injection of fat cells along with the stromal vascular fraction (SVF)–a robust mixture of cell types, including stem cells.

Before and three months after Fat Grafting, samples of skin from the treated area were obtained for in-depth examination, including electron microscopy for ultrastructural-level detail.

After injection of fat cells plus SVF, the skin samples demonstrated minimal degeneration of the skin’s elastic fiber network, or “elastosis”–a key characteristic of aging skin. These findings were confirmed by ultrastructural examination, which demonstrated the reabsorption of the elastosis and the development of relatively “young” elastic fibers.

In patients undergoing stem cell injection, the skin changes were fundamentally identical. “This result seems to suggest that the effect of a fat graft is, at least in part, due to its stem cell component,” Dr Rigotti and coauthors write.

The researchers also discovered “suggestive” evidence that the rejuvenating effects of Fat Grafting are related to new formation of microscopic blood vessels. Further studies are needed to confirm this hypothesis, however. Dr. Rigotti comments, “In any case, this is the first study presenting clinical evidence showing skin rejuvenation after Fat Grafting and highlighting the anatomical and structural changes that are the basis of this rejuvenation.”

Both Fat Grafting approaches “appear very promising for facial anti-aging surgical techniques,” the researchers conclude. Given the similar results, the researchers believe that fat cells plus SVF are preferable to stem cell injection. That’s because the fat processing step is less expensive and faster–avoiding the need for stem cell expansion means the fat cells can be harvested, processed, and injected on the same day.

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