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Stem Cells Offer New Hope In Plastic Surgery

Stem cells technology is on the verge of revolutionizing reconstructive and aesthetic surgery.

By Dr Sanjay Saraf

Stem Cells Promise Better and safer Plastic Surgery

Stem cells have created a lot of interest and attention over the past few years, mostly for their potential in treating conditions like leukemias, spinal cord injuries, diabetes, Alzheimer’s disease and Parkinson’s disease etc. Successful trials have already been made to repopulate heart muscle after a heart attack to replace bone loss in the skull and articular cartilage reconstruction. Recently, adult stem cell research started exploring the potential use of a patient’s own stem cells for tissue replacement and rejuvenation in plastic surgery.

The stem cells are basically the mesenchymal cells that can differentiate themselves into many different cell types under appropriate conditions; such as skin, nerve, fat or muscle. This ability to become other types of tissues makes them particularly attractive in plastic surgery where the surgeons are always striving to restore what has been lost or damaged by age, disease or trauma.

There are basically two types of stem cells, embryonic and adult. The embryonic stem cells are controversial because whether obtained from any source, they always involve the destruction of a living human embryo. Adult stem cells, on the other hand, are obtained from the patients bone marrow or from other sources such as umbilical cord blood , placenta or even lipoaspirate .

Presently,there is a lot of concern about the materials used in currently available breast implants, which are marred by the tendency to form contracture and propensity to rupture and leak.The materials being used in facial plastic surgery too, are less than ideal.The various allogenic materials used in facial cosmetic surgery tends to lose its size and shape over time. Numerous studies have shown that even conventional soft tissue reconstruction after breast cancer surgery and facial soft tissue reconstruction following cancer or trauma surgeries can lose 40 percent to 60 percent of their volume over time.

This new technique is expected to revolutionize various aspects in reconstructive and aesthetic surgery. Reconstructive surgery could greatly benefit from stem-cell generated natural implants that do not shrink or lose their shape.In head & neck cancers and breast cancers where large area needs to be excised and reconstructed,with stem cell technique it will be possible to take stem cells from the patient, grow them in vitro, and then used them for reconstruction. Stem cells also offers the possibility of prefabrication of flaps ,reconstruction of cartilaginous frame-work of ear, articular condyle reconstruction, vascularized bone flaps , cranial bone defect and renewable source of replacement cells and tissues to cover raw areas following massive burns. The advantage of stem cell-based method in aesthetic surgery is that, when used for wrinkle removal and breast augmentation , the implants will retain their size and shape better than any other allogenic implant. These implants from stem cells have the potential to provide a safer alternative to silicone or saline implants – which can rupture and also interfere with breast cancer detection. They could also be aesthetically superior, keeping their shape and size for longer than synthetic implants, which typically shrink 40 percent to 60 percent over many years.

A study at the University of Illinois suggests that silicone breast implants could be replaced by tissue grown from a person’s own stem cells within a decade.About 150,000 gallons of liposuction fat is discarded yearly.Even one pint of such fat or one pound of whole fat removed in a tummy tuck, for example, can yield up to 200 million stem cells by stem cell technology.Natural implants thus created from a patient’s own cells could radically improve operations for soft tissue reconstruction, breast and lip enlargement and wrinkle removal. When this tissue is implanted it will essentially become part of the patient’s own body tissue and there will be no risk of tissue rejection with the implants retaining their size and shape better than synthetics.

But, still we have a long way to go and more, longer term studies will be needed as many questions remain unanswered. However, the present approach represents a giant leap in tissue engineering technology and it seems that the time is not far when the stem cell-derived tissue would offer a better as well safer way forward for plastic and aesthetic surgery.

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