ASAPS Annual Meeting Reflection: What’s Hot

Written by Joseph Gryskiewicz, MD, PSEN Aesthetic Assistant Editor

Plastic surgery advanes are occurring faster than an “unstoppable” freight train. Probably the hottest of the hot topics is fat……no, not fat removal, as much as fat injection. Adult stem cells (ASC’s) are being studied as a potential way to enhance the survival and results from lipo transfer. Dr. Kataro Yishimura, of Japan, is using the stem cells of fat taken from the hips or tummy for breast augmentations. He will be presenting over 500 breast augmentations done solely by transfering the patient’s own fat cells. As Dr.Robert Singeraptly warns elsewhere in this insert, there is little data to support stem cells as the progenitor for growth. Is this even approved by the FDA? Should it be? Does injected fat cause calcifications which could impair accurate readings of future mammograms in these patients? Could this hide early breast cancer? Worse yet, could the transferred stem cells soup up cancer ready cells igniting a malignancy? There are more questions than answers at this point. A national registry through our reasearch socities hopes to answer these questions as time goes on. To take this a step further to the face, one could ask if there is even such a thing as a “stem cell” facelift? More science and less market hype needs to be added to the stem cell test tube mix. Several European centers are injecting tissue fillers rather than fat for breast augmenation…….I wouldn’t jump on that band wagon either.

Let’s talk about removing fat. Melting your fat by “freezing” your subq tissue is referred to as cryolipolysis [pronounced any way you prefer]. This method has promise for some selected localized areas such as love handles. Using external laser light to reduce fat is a cruel hoax in my opinion. Laser assisted liposuction doesn’t seem to me to be any better than regular liposuction, although some feel they have proven otherwise in “tight” clinical studies. Many surgeons believe traditional liposuction is still the gold standard.

If you like the idea of transfering your own tissue for enhancement, take a look at the “Vampire Lift.” Your own blood is spun in a centrifuge, the plasma rich growth factors are harvested and injected into your face for rejuvenation. Yes, it works; works well because long term clinical studies both here and in Japan have demonstrated durable tissue filling. Now we need a multicenter randomized clinical trial to pound the final nail into the coffin to silence the unbelievers.

On that same note of tissue fillers, safer, “non-sharp” needles have just been introduced in the U.S. for tissue filler injections to prevent the rare occurance of skin loss. Hand rejuvenation using tissue fillers is rapidly catching on. Advanced laser techniques are now availble to treat filler complications such as painful, persistent lumps.

Brigadier General W. Bryan Gamble, plastic surgeon and Commander Dwight David Eisenhower Army Medical Center will in the future describe various advances spawned by recent military conflicts. War Stories: Military Technology and Surgery Complications and Solutions will be reviewed. He will merge into the very latest on tissue regeneration which can help replace lost tissue and the latest in burn therapy which is saving many more soldiers’ lives.

Aesthetic surgery to sculpt and shape the male and female genitalia is becoming more accepted bit-by-bit. Be sure you find someone with lots of experience. Buttock augmentation is one of the last frontiers but is only done by specific individuals world wide.