What You Need to Know About Stem Cells

plastic surgery dr paul howardResearchers and even medical students have known about stem cells for decades. They are the multi-potential cells in embryos that can become any cell in the body; brain, muscle, heart, etc. Years later an adult version of the stem cell was identified, not quite as basic as the embryonic stem cells, but able to become many other types of cells.

Once identified, we could grow them outside the body and stimulate them to become more advanced cells such as those composing cartilage, muscle, bone and even heart tissue.

More recently it was discovered that the bodies’ main repository of adult stem cells is in our fat (adipose) tissue. These adult stem cells can also be harvested from the bone marrow in much smaller quantities and with significantly greater pain.

This discovery was great for plastic surgeons as we are the primary surgeons who harvest fat for cosmetic reasons by suction-assisted lipectomy (liposuction). With this technique, liters of fat can be harvested at one time to be processed to release the adult adipose-derived stem cells from the fat.

There are methods that currently exist to multiply the number of stem cells from thousands to hundreds of millions, but this must be done in a laboratory and is controlled by the FDA.

These stem cells once multiplied and stimulated in the lab can become a medical treatment by replacing injured or worn out cells in the heart, joints and maybe even other organs such as the liver and kidney.

For the present, we can use a person’s own stem cells (not Aunt Thelma’s) to replace soft tissues if injured using your very own fat cells which already are charged with stem cells. Fat grafting to the face as part of a facial rejuvenation procedure has been around a decade or so in my practice. The addition of extra stem cells to the facial fat grafting we do with facelifts gives a remarkable improvement in skin tone and texture due to the rejuvenating qualities of stem cells.

The limit to stem cells is that they only work for you because you and your stem cells have the same DNA. Therefore, one can harvest and freeze your fat with your stem cells for future use but no one can “borrow” your stem cells.

Another limitation to stem cell medicine is that you cannot rub stem cells on your skin like sun block. The stem cells only work inside your body where they can interact with other cells. It naturally follows that if you cannot use Aunt Thelma’s stem cells, stem cells from other DNA sources like plants and trees have no effect on humans but are probably great for other plants and trees.

Just the words “stem cells” have become a cultural phenomenon. I’ve read recently where stem cells can reconstruct a breast and even make a small breast larger. Of course, none of that is true but fat grafting, with or without stem cells, is commonly used to reconstruct soft tissue defects of the face, breast and buttocks. The stem cells are there just to improve the amount of fat that survives with grafting and provide no volume on their own.

Advertisers who use the words “stem cells” to describe their latest, greatest fountain of youth product are taking advantage of the hyperbole of public perception which is totally different from the public facts regarding stem cells.

Gynecomastia by Dr. Paul Howard

Gynecomastia is a deformity that usually manifests in teenage boys where there is massive hormone stimulation of the nascent breast tissue causing enlargement associated with pain and a very disturbing physical deformity.  Gynecomastia tends to run in families therefor there is some genetic component and usually becomes manifest in the early teenage years when male hormones are active.  It is usually associated with mild to moderate torso obesity.  The deformity is worsened by weight as there usually an aspect of the deformity that is fat tissue in addition to tender breast tissue.  It is that fat portion of the deformity that has caused insurance carriers to demand weight loss as well as hormonal studies to document and treat the disease.  There are insurance carriers who specify in their contracts that they explicitly do not cover gynecomastia resection under any circumstance.

The treatment of gynecomastia in adolescents should include, if necessary, an attempt at weight loss followed by surgical resection, usually tumescent liposuction technology.  Unfortunately, if surgery is performed in the early to mid-teenage years there is a possibility of recurrence, usually beneath the nipple/areolar complex, as it is virtually impossible to remove the breast tissue in its entirely.  Additionally, any upper fluctuation in weight will also give the appearance of a recurrence.

Gynecomastia in adult males is usually due to excessive marijuana smoking and/or abuse of anabolic steroids or large doses of testosterone.  Most men who fit this profile are body builders with a reasonable low body fat. Those with higher body fat percentages also have a fatty component to the deformity.  Most body builders who “stack” their anabolics also take an anti-estrogen drug trying to prevent the painful breast enlargement.  Surgical removal for pain relief and cosmetic chest improvement usually requires direct excision.  These men usually have hypertrophic and highly vascular chests causing common hematoma formation post-operatively.  Again, recurrence can be common if the patient continues to use steroids.

Gynecomastia, especially the teenage version, occurs at a very unsettled age when there may be extreme body dysmorphism.  Children this age can be unpleasantly negative at a time when undressing for the gym or going to the swimming pool can be a traumatic event.  These psychological issues are reason enough to operate early even if a re-do becomes necessary.

Call today to schedule your consultation with Dr. Howard 205-877-PAUL