Thoughts on a Stem Cell Facelift?

Hello Doctors, What are your thoughts on a stem cell facelift? Is the stem cell facelift just a gimmick, or does it actually work? I know if something sounds too good to be true, it usually is! I appreciate your thoughts on this. 

LaurenKnows

F, 53, New York

Hi LaurenKnows, 

Yours is an interesting and excellent question. Stem cells, as you know, are cells that harken back to our days as a developing fetus in the womb. They are considered primitive cells that have not yet evolved into the specialized cells that populate our bodies and have the hypothetical potential to change into just about any type of cell. If you think about it, we start as two cells, a sperm and an egg, and from those two we derive all the different cells in our bodies- muscle cells, nerves cells, skin cell, heart cells, etc. There are two types of stem cells: fetal and adult. The use of fetal stem cells is highly controversial since, to obtain them, we have to kill a living embryo. Adult stem cells are not regarded as having the unlimited potential of fetal stem cells but their use does not raise the troubling moral questions of the former. We can derive adult stems cells in various ways. We can draw blood and spin it down in a centrifuge isolating the cellular portion, which contains some stem cells. We can also harvest fat, which contains some adult stem cells, from an individual and inject it where it is needed. The latter is becoming more and more mainstream. Fat grafting, as it is called has been shown to benefit areas damaged by radiation in women who have had breast reconstruction following cancer. It is also becoming popular for restoring volume to a face that has become thinned due to the natural loss of facial fat with aging. In both cases, fat grafting seems to have a benefit beyond just restoring volume. In irradiated areas it seems to decrease the fibrous scarring and make skin more supple. In the face, it seems to have a rejuvenating effect on the skin. Both of these are thought to be the result of the action of stem cells that are transferred with the fat grafts. Does it? At this time there is no proof from careful research. 

The new buzz word in facial rejuvenation is "volume". A traditional, surgical face lift just tightens up loose skin. If the face is thin to begin with, it will be tight after a face lift but still thin. Injecting fat, rather than performing a face lift, may be a better option in such patients. There are limits to what fat can do, however, and fat grafts will never supplant a face lift. The term "stem cell face lift" is fluid and what this means may depend on who you ask. For some it means injecting just stem cells, not fat, into the face for their rejuvenating effect. These are typically derived, as I indicated above, by drawing blood and centrifuging it, then injecting the cellular portion. It is not a volume enhancing procedure but rather relies on the salutary effect of these stem cells. For others, it means fat grafting, sometimes with additives to the fat tissue to somehow enhance the effect of the stem cells. There is a problem with this approach, however. 

Those who perform these procedures promote them as though we have a good understanding of what stem cells do and how to control their effects. In point of fact, we don't. We really don't know how they work, how long the results will last, and we do not know the long term effects of these procedures because they simply have not been around that long. One real concern is what happens to these stem cells that are manipulated in this fashion over the years. Any cell that can undergo changes to differentiate into  other types of cells also has the potential to undergo changes that might lead to cancer. The bottom line is, we just don't know enough about stem cells at this time to be able to confidently say that we can anticipate or control what happens with them. Stem cells are not a "magic bullet" to repair or reverse all the effects of aging. There are genetic factors, environmental factors, and lifestyle factors all of which influence how we age and how we respond to various treatments, including stem cells. 

From what I have seen, a stem cell "facelift" will cost you the same as a full surgical facelift. There are risks as well. One of these is that you could spend all of the money, go through the procedure, and three months down the road look in the mirror and have nothing to show for it. No procedure is foolproof or 100% successful in medicine. 

Because stem cell harvesting and injection does not require the skills of a trained surgeon, literally any physician can learn to perform this. I guarantee you will see all sorts of non-surgeon physicians jumping on the bandwagon to offer stem cell facelifts because they will be seen as a money maker in this era of diminishing insurance payments and increasing government regulation of medical practices. I feel that we need to proceed slowly and methodically in the commercial use of stem cells but, if history is any indication, this will become one of the most hyped and heavily marketed procedures very quickly, long before we really enough about it to declare it safe and effective. Before undergoing a stem cell face lift, you would be well advised to investigate this thoroughly and check out the credentials of the doctor doing it. To non-surgeons, who have no other tool in their armamentarium, every person will be a candidate for a stem cell face lift. The applicable adage here is: when your only tool is a hammer, everything looks like a nail. One resource to learn more is  https://www.plasticsurgery.org/news/press-releases/beware-of-pitches-for-stem-cells-in-cosmetic-surgery

Dr. Richard Bosshardt has 1 Facelift before & after:

Facelift before image performed by Dr. Richard BosshardtFacelift after image performed by Dr. Richard Bosshardt

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