From hair-rejuvenation treatments to PRP “vampire” facials, stem cells are having a moment within the cosmetic treatment world. However, with their rise in popularity, it’s important for people to understand how stem cells relate to facial rejuvenation. New York plastic surgeon John Kang, MD, of John Kang’s Facial Plastic Clinic in New York City, offers a popular treatment known as “stem cell lipo-transfer” that’s designed to restore volume loss in the face, and he’s often asked how stem cells play a role in this procedure. Below, he fills NewBeauty in on what his stem cell lipo-transfer procedure entails, while also debunking myths about stem cell therapies.
NewBeauty: What exactly is “stem cell lipo-transfer”?
Dr. Kang: With all the hype about stem cell therapy out in the media, patients ask all the time whether we perform “stem cell therapy.” The answer is simply “no.” However, we advise our patients that every time we perform lipo-transfer, they receive the added benefit from the patient’s own “adipocyte derived stem cells” that coexists in their fat matrix. This is the reason why the quality of your skin is always brighter and appear better hydrated after the lipo-transfer procedure. In other words, the unloved fat pouch on your belly, flank, and thigh area could very well be your own source of anti-aging when it comes to reversing the signs of aging on your skin.
Over the years, we’ve become more aware of the importance of 3-D rejuvenation of the face, lipo-transfer has been proven to be best surgical option for addressing the volume loss and deflation part of the aging process. As a result, most patients have come to understand how important fat transfer has become for volume replacement and 3-D recontouring of the face. However, what most patients are not aware of are the additional benefits from the adipocyte derived stem cells which coexist in the fat matrix.
NewBeauty: What are these additional benefits?
Dr. Kang: The droplets of fat that are transferred back into your tissue consist of more than just mature fat cells. The fat matrix also contains “stromal vascular” cells. At a cellular level, the stromal vascular cell fraction (SVF) contain many important cells including: adipocyte-derived stem cells (ASC), pre-adipocyte, endothelial cells, pericytes, macrophages, and fibroblasts.
All these cells within SVF are an amazing array of cells involved in the building blocks of your tissue matrix. In fact, as more studies come out, it is becoming clear that it is the pre-adipocytes (young fat cell), which survive the trauma of fat harvest from the donor site then survive the transfer process into the new host site. While I can discuss more about pre-adipocyte, today I want to share with you what we understand so far about adipocyte-derived stem cells (ASC). This is a heavily researched area and we still have so much to learn about ASC, but here’s some of the basic information I want to share.
The unloved fat pouch on your belly, flank, and thigh area could very well be your own source of anti-aging.Dr. Kang
Did you know that every gram (just shy of 1-cc) of fat contains 1 to 2 million cells, of which roughly 1 to 10 percent is considered stem cells, depending on which published study you are quoting from? To be conservative at 1 percent, that still means that with each one 1-cc of fat you are transferring to the face, roughly 10,000 to 20,000 cells are adipocyte-derived stem cells. In 30-cc of fat, which is a typical amount in a lipo-transfer procedure, conservatively you are introducing 300,000 to 600,000 stem cells that would not have otherwise entered to enrich your skin. These stem cells can release growth factors to help stabilize the degeneration of your elastin fibers as well as develop “young” elastin fibers, and also help with formation of new microscopic blood vessels all working toward improving the quality of your aging skin—almost helping to slow down or maybe even reverse some of the aging changes to your skin.
NewBeauty: This seems similar to PRP therapies. Is that the case?
Dr. Kang: This concept is very close to using platelet-rich plasma to rejuvenate the skin. The key difference is that PRP is an infusion of growth factors concentrated from your blood, which will dissipate with time, while the adipocyte stem cells continue to produce the growth factors and help produce new vessels to sustain life to the newly transferred fat cells and rejuvenate the overlying skin. A good analogy is if the PRP is the egg, the adipocyte stem cell is the chicken that keeps on laying the egg.
NewBeauty: Is there anything our readers should be aware of when researching stem cell treatments?
Dr. Kang: One very important caveat is that some business-minded practitioners claim they can modulate the stem cells to produce better results. They are calling themselves “Stem Cell Centers” and charging exorbitant prices and making false advertising claims, deliberately misleading the public. As a result, FDA has come down on these centers and practitioners with stern warning to stop making false claims. I want to make it very clear that lipo-transfer alone can do wonders in providing a “volume-lift” and as an added bonus, the abundance of adipocyte derived stem cells can help to rejuvenate the overlying skin. However, all of these benefits are inclusive in the lipo-transfer procedure and at this juncture, unless the FDA changes its position, you needn’t pay extra for gimmicky “stem cell” procedures.
Historically, many surgeons have also struggled with the concept of converting lipo-transfer from surgical case (under general anesthesia or deep sedation) into simple office procedure (under local anesthetic with just mild oral sedation), which makes this procedure much less cumbersome for both the surgeons and patients. As a result, there is a trend for most surgeons to provide this surgery as an in-office procedure.
NewBeauty: How does your practice’s approach differ from others?
Dr. Kang: Because I have been performing this procedure for over 20 years using an atraumatic, micro technique, all under local anesthesia, the fat can be easily harvested from the donor site, carefully processed, and transferred back into the face, usually all under an hour. As a result, repeated sessions are simply in-and-out procedures with many patients choosing to have it done on a Friday afternoon, rest over the weekend, and return back to work the following Monday. With every session, new fat is always harvested, so repeated sessions using frozen fat is a concept foreign to me for many reasons. With exception of few, most patients have nearly no bruising and only mild to moderate swelling, allowing them to return back to work in matter of days. However, I want to emphasize that just like any surgical procedure complete resolution of all the swelling will be in weeks, depending on the amount of fat transferred.
Due to this relatively easy protocol we have created, many of our patients undergo repeated sessions of lipo-transfers. They are no longer in need for the large volume restoration, but in small amounts for continued regenerative gain of their skin from the adipocyte-derived stem cells in the stromal vascular cell fraction of the fat matrix—it’s your very own Fountain of Youth.