Are Stem Cells the New Plastic Surgery Frontier?

Alexander E. Spacher

They may not only have the power to cure diseases but also enhance your looks. Is now the time to try out the technology?

While the controversy about embryonic stem cell research in curing diseases such as Parkinson’s, Alzheimer’s or diabetes continues, another debate is taking place, this one about the use of adult stem cells in cosmetic procedures—specifically, taking fat stem cells and using them to maintain and repair that tissue.

Harvesting unwanted fat from the waist, stomach, hips or thighs to add volume to the face is nothing new, but Beverly Hills dermatologist Nathan Newman, M.D., who calls himself the innovator of the stem-cell facelift, relies on a syringe instead of a scalpel. According to Dr. Newman, liposuction damages the stem cells, but his low-suction method preserves them. He then concentrates the stem cells before injecting the “enriched” fat to sculpt the face. “I try not to cut anymore,” he says. “I can restore a youthful look without doing that.”

Los Angeles–based plastic surgeon Richard Ellenbogen, M.D., performs the incision-based facelift but uses an LED light to activate the stem cells after separating them from the fat. The technique, he says, produces long-lasting results mainly for three reasons: He extracts the robust fat from the back of the waist, removes the tissue’s fatty acids and injects the fat into individual layers of the face. “The results are anecdotal,” Dr. Ellenbogen says, “and we need years and years of more research. But it’s like chicken soup: It won’t hurt, and it might help.”

Not so fast, counters Charlotte, North Carolina, plastic surgeon Felmont Eaves, M.D. “In the coming century, stem cells will have a huge impact on our ability to regenerate tissue,” he says. “But treating the cells with growth factors and laser lights and saying this will rejuvenate you is based on theory. They can’t show a single human study. From my standpoint, it’s snake oil.” The jury’s still out for Minneapolis– and St. Paul–based plastic surgeon Joseph Gryskiewicz, M.D., who is also the chairman of the Emerging Trends Task Force at the American Society for Aesthetic Plastic Surgery. “Manipulating fat to derive stem cells is like getting the cream at the top of the milk,” he says. “Is it okay? We don’t know.” Machines used to isolate fat stem cells, which spin the fat to separate the layers—most stem cells are located at the bottom—are not cleared by the FDA (neither Dr. Newman nor Dr. Ellenbogen uses these devices). “Do the machines do what they say they’re doing? You can’t tell,” says Dr. Gryskiewicz.

Although such procedures are, for the most part, unlikely to be harmful—except if used in the breasts, where they could potentially stimulate tumor growth—the bottom line is there isn’t enough evidence that any of this is effective, says J. Peter Rubin, M.D., chief of plastic surgery at the University of Pittsburgh, where he developed a research program in the biology of fat-derived stem cells, funded by the National Institutes of Health and the Department of Defense. “There is very little published human data to show that injecting stem cells under the skin makes any difference—that it makes your skin look better or improves the outcome of plastic surgery,” he says. “We have to separate the hype and marketing from the evidence we have to back it up.”