Q: Dr. Eppley, I have read a lot recently about stem cells and their potential rejuvenative properties. It seems logical that if our body is full of them that they can be used to treat a lot of problems including the negative effects of aging. I see some plastic surgeons offer a stem cell facelift. Does this really work and, if not, how come some doctors do it?
A: The use of adult stem cells for their potential cosmetic and anti-aging effects is very controversial at present. While our fat is a large reservoir of stem cells (300X to 500X more than bone marrow), that does not necessarily mean that they work as we would like or hope. The popularity of stem cells is largely because of the ability to harvest fat through liposuction as a source for stem cells,. It is fairly easy to ‘recycle’ the liposuctioned fat and put it back into the patient as an injection with the assumption that tissues of the face can be rejuvenated, Numerous anectodal claims are made about such injections as creating youthfulness, adding permanent volume and improving the appearance of the skin. This has led to a number of touted procedures carrying such names as the stem cell facelifts. Despite their appeal, there is no medical evidence by published clinical studies that proves that it actually works.
Most of the time, such stem cell injections are really nothing more than fat injections that unavoidably contain some stem cells. It is the fat that creates any volumetric or lifting effect and not the stem cells that it may contain. While such ‘stem cell’ injections are unlikely to be harmful, they have not been proven to have anti-aging effects. But the hope that they might, and the lack of any adverse effects, provides plenty of motivation for marketing hype.
Dr. Barry Eppley
Q: Dr. Eppley, I am interested in getting a facelift but want a result that really lasts…like the rest of my life. I know that skin and muscle from the neck and jawline have to be lifted and removed and I am fine with that even though it scares me a little bit. But I don’t want to go through that if it doesn’t last a really long time. I have been reading about how stem cells are being used now and some doctors are doing a Stem Cell Facelift. This seems to make a lot of sense because one is not only getting rid of the loose skin but adding something that injects youth back in and can grow new collagen and skin. Is this a procedure that you perform as I am really interested to have it done?
A: The reality is that the use of stem cells in any cosmetic procedure, including a facelift, is both unproven but also illegal. (unapproved by the FDA) Stem cells harvested from patients have recently come under heavy scrutiny by the FDA and such potential cosmetic treatments are now regulated and restricted only to approved clinical trial settings. The widespread marketing of such procedures as Stem Cell Facelifts is now over and you will not hear much about them anymore. Their previous marketing and use was based on the appeal of stem cells and was both unproven and in some cases unsafe. Nobody knows what stem cells will do when transplanted into the body. This is illustrated by a recent report in Scientific American where a women injected with stem cells for wrinkles around the eyes developed bone in her eyelids. This demonstates that the effects of stem cells are not really understood and should be more carefully studied, as they are being done for many other medical condition treatments.
For now you will have to consider a traditional facelift procedure that has long been proven to be both safe and effective with results that last on average 10 to 12 years for many patients.
Dr. Barry Eppley
The discovery that fat is one of the most generous sources of stem cells in the body has generated excitement in plastic surgery as much as it has within mainstream medicine. With the theoretical potential to someday provide more effective treatments to diverse medical problems such as neurologic diseases, cardiovascular problems, and even tissue regeneration in reconstructive surgery, the research activity on this ‘wonder’ cell’ is nothing short of feverish.
Who would have thought that the very thing so many of us struggle to get rid of may someday be the key to new medical treatments? That’s like finding an outfit in the back of the closet that not only still fits but is back in style. (OK, that is beyond the common definition of a miracle.) Since fat can be easily extracted through liposuction, and it contains a high concentration of stem cells, whole new cosmetic uses are being derived for what is known as stem cell-derived fat grafting (SCFG). Fat is being injected all over the body by plastic surgeons, mainly because it is easy to do and perfectly safe. Injected fat has many body uses from body contouring to facial rejuvenation. For the body, buttock augmentation and breast reconstruction (lumpectomy defects) are being widely done. Fat-transplant breast augmentations are being approached more cautiously, but even this use is gaining momentum. Another excellent use for our own ‘fat’ is for hand rejuvenation- using the injected fat to fill hollows between the extensor tendons and to camouflage prominent veins.The face, however, is the most common target for fat and its stem cells. As we age, we lose fat in our faces, and it produces a deflated look. This facial deflation is one of the reasons that we begin to look older and our skin appears to slide from our faces and into our necks. This has led to younger people getting fat injections at an early age and fat injections being used as part of a facelift procedure for more advanced degrees of facial aging.
But, with every bit of hope comes a little or a lot of hype. In the most contemporary spin on fat grafting to the face, right out of Beverly Hills, comes the Stem Cell Face Lift. The theory is that stem cell-rich fat grafts combined with skin tightening makes for a better facelift result. Proponents espouse the theory that the stem cells provide a regenerative effect on the skin, also resulting in smaller pore size and less wrinkling and pigmentation.
Is this actual science or science fiction? Stem cell researchers would most certainly tell us that how such cells behave isn’t so simple. While moving them from one place to another in the body seems as though it should work…that doesn’t necessarily make it so. Conversely, a Stem Cell Facelift is a perfectly natural procedure that has no harmful effects, an almost organic procedure if you will. It uses the patient’s own tissues and may exemplify the appealing concept of ‘heal thyself’. It may even be considered a green procedure, a bit of body recycling if you will.
The use of stem cells in a cosmetic procedure may one day be the key to the proverbial fountain of youth. But for now, it more likely represents a common occurrence that has been used by overzealous cosmetic providers for years. Extrapolating a bit of science into a marketing phenomenon for patient recruitment. It may in fact generate some ‘green’ – but it’s not magic.
Dr. Barry Eppley
Q: I feel like I am ready for a facelift and want to get the best result that I can. In doing my research on the internet, I have come across several recent articles on a procedure called the Stem Cell Facelift. In reading them, they make it seem like it is the best way to go with the best results. But I don’t understand what stem cells have to do with a facelift. Do they help lift the droopy skin or do they make what is already there better. I would like to go to a doctor that does them but I am also worried about whether this is so new that maybe it doesn’t really work that well or it is just some sort of a scam. What is your opinion?
A: The concept of the Stem Cell Facelift is based on two simultaneous techniques, a traditional facelift to lift and tighten loose neck and jowl skin and fat/stem cell injections to add facial volume. The injections are not responsible for any type of skin lifting. They add volume to areas of fat absorption that have happened with age and are purported to help make the skin look better. (which remains far from proven) They may be done together but the fat and the stem cells they contain can not make for any tightening effect on the skin
Is this facelift concept hype or hope. At this point, a little of both in my opinion. The concept is very appealing and the technique uses all natural products from each patient, thus there are no risks involved in doing it. Conversely, whether this facelift approach is better than the traditional proven methods has yet to be adequately studied over the long-term. It may well prove to be an improved method with better results but at this point the promotion of it is ahead of the actual science.
Dr. Barry Eppley