Facial Fat Graft with or without Stem Cells?

I would like to even out some irregularities (dents, PS called them "tissue deficits") and give just a tiny bit of volume to my cheeks with facial fat grafts. The PS I visited said that I do not need a lot of volume and that he has to proceed carefully in order not to do any harm, but also clearly noticed the irregularities. He offers fat grafting without and with stem cells, the later being exactly double the price. Are stem cells really worth the price? Will frozen fat be good enough later on?

Doctor Answers 4

Fat Transfer

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Fat grafting and or facial resurfacing are options.  Stem cell research for this is still new so I would wait on this for a year or so. Thank you for your question and good luck with everything.

Danville Plastic Surgeon
4.9 out of 5 stars 26 reviews

Fat Grafting and stem cells

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many plastic surgeons who perform structural fat grafting report that patients often describe a variety of improvements in their facial skin following fat grafting surgery. This observation has led to the use of fat grafting in reconstructive surgery, for instance in the management of chronic wounds such as those seen in some patients following radiation treatment for cancer. Fat grafting into the tissues below a chronic, non-healing wound has been shown to stimulate successful wound healing in a number of studies.
So what is responsible for this effect? Many of us suspect that it is produced by 'stem cells' which are known to be present in abundance in human adipose (fatty) tissue. Stem cells are very dynamic human cells which have the capacity to be transformed into any number of cell types (fat, muscle, skin, fascia, etc), and which are capable of producing a variety of proteins which promote the repair of damaged cells and tissues.
Much of the evidence has been anecdotal, i.e. the personal observations of physicians made while treating patients in their usual clinical practice, outside the setting of a specific scientific study. A great deal of basic science research is now being done to specifically determine cause and effect, and it is certain that over the next few years we will gain a much clearer understanding of the healing properties of fatty tissue and stem cells.
Be aware that the term 'stem cell' is increasingly being used in what I feel may be an irresponsible manner - as a marketing gimmick to attract patients to a particular practice or surgeon. Nobody has an exclusive claim or right to the use of stem cells, and as yet no one has demonstrated an objective, quantitative method for measuring any 'stem cell effect' in facial rejuvenation surgery, if it is truly present. I believe that this effect exists, but it currently is not objectively and reproducibly measurable and therefore should not be used to 'sell' surgery.

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 123 reviews

Facial fat grafts do not need stem cells for successful result

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The use of adipose-derived stem cells (which come from your own fat collected by doing liposuction) is still debated and there is no consensus on whether they are particularly helpful when added to fat grafts. If you don't need high volumes of fat to achieve the desired result, it would probably work well without stem cell enhancement.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 59 reviews

Fat graft

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The surgeon you consulted may have something the rest of us do not. Isolating the stem cells from the fat is very difficult and expensive. One company has been doing the research and has a machine to isolate the stem cells(CYTORI).

In an office setting or hospital the aspirated fat contains stem cells if you do the harvesting right, and the surgeon can not take out the stem cells or add stem cells.

Some surgeons with experience in this field feel that when fat is centrifuged at 3000RPM, the lower 1/3 of the fat contains most of the stem cells. Still in research.

Samir Shureih, MD
Baltimore Plastic Surgeon

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