Stem Cells Could Replace Plastic Surgery

Silicone breast implants and botox could one day be things of the past thanks to promising new techniques that would allow doctors to work plastic surgery miracles using only a patient's own stem cells.

Traditionally, plastic and reconstructive surgery has relied heavily on fillers. Bags full of saline or silicone are used to plump up breasts. Chunks of fat are taken from one area of the body and grafted into another. These techniques, which like other body enhancement procedures have soared in popularity in recent years, can work successfully but they also have drawbacks.

Dr. J. Peter Rubin, assistant professor of plastic and reconstructive surgery at the University of Pittsburgh School of Medicine, said using fillers requires invasive surgery and the results may not look ideally natural. In the case of fat grafts, they also might not last as long as a patient would like, as fat transferred whole to a new part of the body has a tendency to break down as time goes on.

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Stem cells are cells that have the ability to make more of themselves and to differentiate into special types of cells, like skin or other tissue types. Some stem cells, called pluripotent or multipotent, are capable of turning into many different kinds of cells and growing wide varieties of tissues ranging from bone to neurons to organs and muscle. While embryonic stem cells are the most well-known type (and the type that raises controversy), not all pluri- and multi-potent cells come from embryos.

In order to do this, he said, researchers would separate out multi- or pluripotent adult stem cells and grow them in a petri dish. Depending on how they're grown and what materials they're grown in, the stem cells can be coaxed into taking on different specialties, such as fat or cartilage. Those cells would then be injected into the patient, where they would continue to grow and divide, creating a small amount of natural tissue. No surgery required.

Turns out, fat is an ample source of multi- and pluripotent stem cells. Science has known for decades that fat tissue is home to a large population of immature cells that have the ability to grow into new fat cells. Rubin said that around 2000 and 2001, researchers began to realize that these "pre-fat cells" were actually stem cells that could become not just fat, but cartilage, bone, and even neurons and heart muscle. And, unlike other tissues rich in stem cells, such as bone marrow, fat tissue is easy to extract. All you need is liposuction.

Tom Baker, director of investor relations for Cytori, a San Diego-based company that makes machines for processing fat stem cells in the operating room, described how it works: First, a doctor liposuctions fat from a patient. Half that fat gets set aside, while the other half is processed to pull out a mixture of cells rich in stem cells. That mixture is then injected back into the reserved fat, which is grafted into place inside the patient.

A Japanese study and a Cytori-funded study presented at the San Antonio Breast Cancer Symposium in December 2007 have shown that the supercharged grafts, unlike normal fat grafts, maintain a more natural shape and don't wither away. The difference is extremely important to patients. The Japanese study, for instance, was conducted on women who'd lost part of a breast to cancer and wanted the reconstructive surgery to look as normal as possible.