Q: Dr. Eppley, do you do stem cell facelifts and what do you think of them? Do they really work?
A: Stem cells and their many potential uses are one of the hottest topics in all of medicine today. Much research is going into whether they have healing benefits for many diseases. It is no surprise that their appeal has reached plastic surgery as well, particularly given that fat and its extraction by liposuction is the best method to obtain them. And many people have more than an adequate store of donor fat. Fat has been shown to contain up to 500X more stem cells than bone marrow and plastic surgeons are employing many innovative ways to apply them to both reconstructive and cosmetic procedures.
Stem cells and facelifts seem like an odd combination given that facial aging hardly seems like a disease problem. But some plastic surgeons have been using them for the purposes of an enhanced healing and skin rejuvenation effect.There are two types of so-called stem cell facelifts. Those that use stem cells or stem cell -enhanced fat injections as an adjunct to a more traditional facelift procedure. Then there are those that use the stem cells or stem cell-enhanced fat as the primary method of doing the facelift, which is really known as facial volume enhancement creating some lifting effect by skin expansion. To date, either approach remains appealing in theory rather than a proven science in facial rejuvenation efforts.
Dr. Barry Eppley
The large number of stem cells in fat has led to a new wave of treatments in plastic surgery that hopes to harness the potential of this ‘wonder’ cell. Since a stem cell can turn into any type of cell if properly stimulated, it is not hard to see why any treatment attached to it is being hyped as a rejuvenative or regenerative therapy. These R words translate to anti-aging or make me look younger.
Given the ease from which fat can be extracted through liposuction, fat is being reprocessed and injected all over the body by plastic surgeons mainly because it is easy to do and perfectly safe. You might say it is the ultimate form of recycling, a green procedure if you will that is most certainly organic. Injected fat can be used from body contouring to facial rejuvenation. For the body, buttock augmentation and breast reconstruction (lumpectomy defects) are being widely done. Breast augmentation using fat instead of implants is being approached more cautiously. The other good body use is in the aging hands, using injected fat to make the hand look more plump and have a less bony appearance.The face, however, is the most common area for fat injections. Research has now shown that we loss fat in our face as we age. This facial deflation is one of the reasons that we look old and contributes to skin sagging. 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. For the aging gaunt-looking face (or even a younger gaunt face), fat injections can be a good complement to traditional skin removal and tightening procedures.
In the most contemporary spin of fat grafting to the face comes the Stem Cell Face Lift. The concept is that stem cell-rich fat grafts combined with skin tightening makes for a better facelift result. Proponents claim that the stem cells provide a regenerative effect that makes the fat take better and helps the quality of the overlying skin as well. By mixing the fat with a little of your own blood, a theoretical youthful elixir is created.
Is the Stem Cell Facelift actual science or more science fiction? Is it hype or hope? At this point I would say a little of science and a lot of hype. The real scientists of stem cells would most certainly tell us that it just isn’t that simple. While stem cells have been extensively studied, how to make them work is far less clear. Conversely, the hopeful part of stem cells in facial rejuvenation is that it exemplifies the concept of ‘heal thyself’. Our tissues have a remarkable ability to heal themselves from injuries throughout our entire lives. It just seems that we should be able to use that to our advantage at some point.
One of the benefits of fat grafting to the face, whether the stem cells really make a contribution or not, is that it adds volume. And with our current appreciation of what happens as most faces age, becoming a little more cheeky might not be a bad thing.
Dr. Barry Eppley