The Stem Cell Revolution

The law of unintended consequences applies to President George W. Bush when he banned embryonic stem cell research.  The unintended consequence was the search for adult stem cells and the knowledge that there is an almost limitless amount of adult stem cells located in fat or adipose tissue.  This fact places plastic surgeons at the epicenter of the stem cell revolution.  Who better than a board certified plastic surgeon is in a position to obtain the necessary fat (liposuction) which is then processed to obtain adipose tissue derived stem cells?

These adipose derived stem cells can be utilized for a myriad of cosmetic and reconstructive procedures.  For our purposes, these all-purpose stem cells are the basis of all of our facial and skin rejuvenation procedures.  It is a well-documented fact that stem cells, when reintroduced into the face, causes any fat which is re-injected, to “take” better and as a secondary benefit the stem cells release a number of “growth factors” that improve  skin by reducing the visible signs of aging.

It is important to realize that you cannot share your stem cells with anyone else nor can you use stem cells from another person. The fat must be processed immediately and re-injected with the stem cells during the same operation as it is difficult to store adipose tissue for further use.  We have developed a “stem cell lab” within the confines of our sterile operating room.  The lab equipment costs little and only requires basic laboratory experience (such as the experience obtained with a B.S. in Chemistry).

Every medical breakthrough goes through stages.  First, there is disbelief followed by hyperbole.  The hyperbole stage is manifest by over hyping the benefits and the beginning of named procedures such as the “Stem Cell Lift” which basically does not exist.  Realistically, stem cells do not tighten skin or “lift” anything.  They are a great addition to volume enhancement by increasing the take of fat grafts and clearly stem cells cause your skin to rejuvenate by erasing age spots, increase skin thickness, and improve fine lines and wrinkles.  Most patients who have had our stem cell rejuvenation describe their skin as smoother and typically glowing.  Stem cell augmented fat transfer has become a staple in our rejuvenation procedures and at a minimal charge to the patient.

Read more about top facelift surgeon Dr. Paul Howard and view facelift before/after photos.

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Stem Cells, Fat Grafting, & Facelifts

The facelift operation as practiced by Board Certified Plastic Surgeons continues to relentlessly evolve as surgical science and cell biology uncover new applications which can be utilized to improve our already outstanding results.  Responding to the wishes of our patients, operations have tended to become less invasive and shorter in duration with less swelling, bruising, and a much shorter down-time.  The short scar facelift has seen a resurgence with new and original methods of dealing with the SMAS, such as our progressive, multiple vector SMAS plication.  The blending of the improved mid-facelift with the lower eyelids and less invasive neck surgery when possible had been our idea of a modern facelift.  Due to the teachings of Sydney Coleman in New York City, we added structured fat grafting to our lips much improving the perioral area and enhancing the cheeks and what has been architecturally described as the facial “ogee.”  I believe fat grafting as now practiced was a huge step forward in facial rejuvenation completely replacing foreign body fillers such a Juvederm® and Restylane®.  In some circles, the efficacy of fat grafting is still questioned even as the evidence of graft takes in the 80-95% range are routinely described.  Over the last couple of years, the basic science of cell biology has given us new information on adipose biology and the nature of adult adipose derived stem cells.  The term “stem cell” occupies front page position in almost every modern women magazines.  Until recently, it has been unclear how this new information could be applied to Plastic Surgical science.

The evolution of stem cell biology including the fact that we could isolate stem cells from our own body fat seemed almost too good to be true.  Rather than throwing away the fat we obtain with liposuction, we can now take this fat, process it in the office, obtain stem cells, and then utilize the stem cells for improving fat graft take even further as well as adding growth factors to the fat grafts that have a beneficial effect on aging skin.  Body contouring with liposuction complimenting facial rejuvenation is truly a “scots” efficiency as Dr. Ralph Millard would say.  The beneficial effect of growth factors on healing and facial skin aging has been known for several years, but exactly how to utilize this knowledge never progressed after the discovery of its use as “fibrin glue.”  More recently, we have added platelet rich plasma (PRP) obtained by drawing blood at the onset of the surgical procedure, processing the blood to get PRP which adds large quantities of growth factors when added to fat and fat stem cells used for facial contouring and rejuvenation.  All of these biologic enhancements to fat grafting are obtained from the patient and therefore are autologous with no problem with rejection such as that which occurs with foreign body fillers.

To summarize our current facelift techniques, incisions are of the “short scar” variety, the SMAS is handled with progressive tension suturing in multiple vectors, micro-drains are used for 24 hours to reduce bruising, the glabella, cheeks, lips, chin, and perioral areas are enhanced by fat grafting augmented with stem cells and PRP.  Cost controls include doing the procedure in the office with local anesthetics and mild sedation.  The sum of these procedures we like to call the “Howard Lift” for lack of a more descriptive term.

Read more about top facelift surgeon Dr. Paul Howard in Birmingham, Alabama.