Plastic Surgery Experience
Regenerative medicine is a new branch of medicine that involves replenishing, engineering or generating human cells, tissue or organs to restore normal function. In modern plastic surgery and other branches of medicine, professionals are always discussing the benefits of PRP (platelet-rich plasma) and stem cells.
PRP (Platelet-Rich Plasma)
PRP is a natural product derived from your own blood. It is obtained by separating the red blood cells from the platelets and plasma by centrifugation. This results in a clear, pale yellow fluid. This fluid is centrifuged a second time concentrating the platelets, nutrients and growth factors resulting in platelet “rich” plasma. 50cc of blood will yield approximately 7cc of platelet rich plasma. In plastic surgery, PRP can be used topically, injected under the skin or mixed with other tissue, the most common being fat.
PRP used topically or immediately under the skin can promote collagen growth, improve skin tone, tightness and texture resulting in softening wrinkles and sun damage. The most common use of PRP at the Pearl-Ereso Plastic Surgery Center in Mountain View is to enhance the viability and longevity of structural facial fat grafts predominantly used to restore volume and structure to the aging face. PRP is added to processed fat immediately prior to placement in almost all areas of the face. This can be a standalone procedure or be combined with face and neck lift, eyelid or brow surgery. The addition of the growth factors found in PRP appears to provide more rapid healing, less inflammation and more survival of the fat placed giving longer lasting results. PRP-enriched fat is particularly helpful under the eyes and around the mouth. It can also be used with processed fat to soften the appearance of sun damaged hands with prominent veins and tendons!
“High quality PRP added to processed fat has clinically improved my results observed after placing structural fat grafts in all areas of the face.” – Dr. Pearl
PRP is being intensely studied all over the world. It has been shown to improve wound healing and has been used for many years to treat musculoskeletal injuries and arthritis, particularly in the knee and back. Partial muscle tears appear to heal more rapidly when PRP is injected directly into the injured tissue. Chronic wounds treated with PRP appear to heal more quickly. New uses for PRP are being reported worldwide on a regular basis!
Stem cells are usually considered to be a unique population of cells that have the ability to renew themselves and differentiate into different types of cells. They can be divided into embryonic and adult stem cells. Embryonic stem cells have the greatest regenerative potential and can develop into virtually any adult cell type. Adult stem cells have been found in almost every type of tissue, but it remains very difficult to make these differentiate into specialized cells, tissue or organs once they are removed from the body. There is amazing research working on how to successfully culture all types of specialized tissue from these stem cells.
For practical purposes adult mesenchymal stem cells are primarily derived from fat and bone marrow. Stem cells developed from fat and bone marrow are the most common sources of adult stem cells used in medicine today. They are being used for soft tissue augmentation, wound healing, bone, cartilage and skin formation. Bone marrow transplants have revolutionized the treatment of myeloma and other malignancies of the bone, blood and lymph tissues. Research in this area continues to work on standardization of successful methods to produce reproducible excellent regeneration of healthy tissue.
In plastic surgery today, we are most interested in the use of adipose derived stem cells (ADSC). ADSCs have many outstanding characteristics such as being loaded with growth factors, anti-inflammatory factors and the ability to generate new blood vessels which greatly aids in the wound healing process as well as providing the potential for the rapid and long-lasting growth and repair of tissues. The other outstanding characteristic of ADSCs is that they come from fat which provides a plentiful source for cells! Using centrifugation and enzyme techniques they are relatively easy to isolate. Studies in Japan, the United States and Europe have shown increased viability and longevity of structural fat grafts that have concentrated ADSCs added to the processed fat.
The problem with concentrating ADSCs is that it is time consuming, expensive and requires some sophisticated equipment and personnel. This makes this process difficult in the common accredited outpatient surgical center. At this time there is also some controversy with the FDA regarding manipulating the fat with enzymes and then adding it back to the processed fat to be used for grafting. For these reasons enzymatically derived ADSCs are not commonly used by us. Mechanically refining fat by emulsification is much easier to perform and although not as effective as enzymatically treated fat, is commonly performed at the Pearl Ereso Plastic Surgery Center. Currently fat is being divided into milli, micro and nano fat depending on the size of the fat particles. Nano fat actually has very few fat particles and is mostly liquid filled with growth factors that can be placed in many areas with a fine needle and syringe!
These are all very exciting developments in plastic surgery. It is important to understand that at this time almost none of these procedures are FDA approved and many unproven claims are being made by all types of practitioners in medicine. Our advice is to read what you can, remain inquisitive, but always be skeptical, especially if amazing claims are being made!
Please call us at Pearl-Ereso Plastic Surgery Center in Silicon Valley and the Bay Area to obtain more information!
Pearl - Ereso Plastic Surgery Experience