Are stem cells also a ticket to a younger face?

Perhaps no medical discovery in the world has been hyped as a magic cure-all bullet as much as stem cells. Often credited with unheard of regenerative powers, they are believed to offer a potential cure for a plethora of conditions, from heart disease and orthopaedic problems to paralysis. Not to be left out, some in the world of aesthetic treatments have also found in stem cells a new panacea in the form of facials and even facelifts, but experts advise caution. Stem cell facials, for instance, have gained much currency as a powerful way to get a younger appearance by stimulating the growth of new tissue. Media mogul Kim Kardashian made the headlines a few years ago when she had a vegan stem cell facial, where a serum of plant stem cells is applied onto the skin, according to US Magazine.

But in a more worrying sign that the industry may be pushing acceptable boundaries, several aesthetic clinics have started offering stem cell facelifts that, similar to standard fat grafting, involve injecting the patient’s stem cells into the face for additional volume. One problem, experts say, is that it’s not clear to what extent stem cells are effective in rejuvenating the skin, if at all, while unanswered questions about potential risks abound.

To provide prospective patients with some valuable guidance, Global Health and Travel talked to Dr J. Peter Rubin, Director of the Adipose Stem Cell Center and Professor of Plastic Surgery at the University of Pittsburgh in the US. Dr Rubin is a plastic surgeon with considerable experience in stem cell research and trials. Currently, he is researching the use of stem cells in restoring damaged tissue after trauma or amputation. 


Q: You served as chair of the task force of the American Society for Aesthetic Plastic Surgery and the American Society of Plastic Surgeons on the efficacy of stem cell treatments. Can you explain why the task force was created and the results of your review?

A: There are many instances in which aesthetic procedures involving stem cells are widely advertised on the Internet. Many patients and doctors wanted to know if there’s any validity to these procedures as well as the position of our plastic surgery societies. Therefore, in 2011 we did a detailed literature review looking at the scientific evidence behind stem cell treatments for facial and skin rejuvenation. We found that there is very little scientific evidence to support many of the treatments that are being done. Most of the studies we have seen, and there is not a large number of them, are case reports by practitioners saying: I have treated some patients with stem cells and I think they look better or the patients themselves think they look better. These reports are very weak because they focus on individual cases that were successful, without telling us anything about the other patients who were treated or about any risks. Anecdotal reports are the mainstay of evidence that for-profit clinics use to promote their treatments.


Q: You also conducted a survey among board-certified plastic surgeons on the ethics of stem cell treatments. What is the main sentiment about these procedures in the plastic surgery community?

A: The survey revealed that a majority of board-certified plastic surgeons in the US do not feel it is ethical and appropriate to advertise stem cell treatments for aesthetic purposes because the evidence behind them is too thin. A majority of plastic surgeons also feel that we don’t have enough information about the risks and benefits associated with these procedures to properly inform patients. 


Q: Despite the lack of strong scientific evidence, stem cell facelifts are carried out in many clinics around the world and don’t seem associated with serious risks. What do you make of it?

A: One thing to consider is that a lot of people advertise stem cell treatments that do not really involve stem cells but simple fat injections - a standard approach to facial rejuvenation that has already proven to be safe. Others may do a good facelift and inject stem cells along with fat, charging a lot more money compared to a standard fat grafting for the face and attributing the good results to the stem cells. Additionally, there is no question that stem cells, especially adipose (fat) stem cells, are potent releasers of growth factors that stimulate tissue regeneration. So, the rationale to support stem cell facelifts is there, but the devil is in the details. What is the best way to administer these cells for effectiveness? What is the best dose to use? What is the best timing for treatment? Although there’s a rationale, you still have to develop the specific treatment and its methodology in a way that has shown to work because there are many variables. If you ask what a stem cell facelift is, I don’t know how to answer because there’s no clear definition. Stem cell treatments may be combined with other procedures that we already know are very effective. Therefore, it is very difficult for patients to discern whether stem cell treatments make a difference.


Q: Do you recommend against undergoing stem cell treatments?

A: No. I am suggesting that any patient who is considering that should speak with the practitioner offering these treatments and ask the right questions: Do you have any evidence that this works? Are there any clinical studies? Since not all the studies are published, some surgeons may have proof that their technique works. If surgeons just have anecdotal evidence to back up their stem cell treatments, patients should be very cautious. Bottom line is that patients should be properly informed so they can make decisions about their healthcare.


Q: Do you believe that stem cells will end up being a game changer in regenerative medicine?

A: The field of stem cells has very strong potential to help many people in very different areas. Currently, I am conducting studies on stem cells for regenerating tissues after trauma and seeing very promising results. For example, we are using stem cells in patients who have had amputations, and our preliminary results suggest that the procedure is able to decrease pain and inflammation as well as stimulate tissue regeneration. I am one of those who believe the field is very promising for regenerative medicine, but we need solid evidence to justify any treatments that we offer. We also have to be crystal clear with the patients about the risks and benefits that come with those treatments.




This story was originally published in the Global Health and Travel issue of October 2017