Nearly 130,000 face lifts and more than 31,000 brow lifts were performed in the U.S. in 2014, making them one of the most popular cosmetic surgeries among both women and men. [1] Face lifts and brow lifts are both performed to correct signs of aging, including wrinkles, creases and folds, and loose, lax skin. Injectable procedures including both dermal fillers and neuromuscular agents like Botox® were significantly more popular: About 5.5 million injectable procedures were performed on both women and men during 2014. [1]

Although face lift procedures to treat the aging face are nothing new, in recent years, the interest in procedures to combat the visible effects of aging has grown significantly as the U.S. population has shifted to an older demographic. Increased demand has translated into more research into novel techniques that are potentially safer and more effective. Because of their ability to support cell renewal and replenishment at the cellular level, stem cells have been the focus of many studies and clinical research efforts.

The primary factors that cause facial aging can be divided into two major groups [2]:

  • Extrinsic factors include causes that act on your skin to cause age-related changes, such as sun exposure, air pollution, inadequate nutrition, alcohol abuse and smoking. Facial changes characteristic of extrinsic aging include wrinkles, hyperpgimentation, hypopigmentation and thick, scaly patches called actinic keratoses.
  • Intrinsic factors are based on heredity. Facial changes characteristic of intrinsic aging include thinning skin and harsh expression lines.

Additional damage can occur from the production and release of free radicals, but the effects are random and therefore less predictable than extrinsic or intrinsic factors. [3]

Extrinsic and intrinsic factors and free radicals can all act on the underlying components of skin, including collagen, elastin and hyaluronic acid, all of which play critical roles in helping skin stay resilient and maintaining other characteristics associated with young skin.

INDICATIONS LEADING TO FACE LIFT

Many signs of aging in the skin and facial features occur as a result of a loss of the skin’s natural volume and elasticity. In young, healthy skin, collagen and elastin work together to provide an elastic, resilient structure that enables skin to bounce back and appear firm. Hyaluronic acid, a natural sugar, helps skin stay firm by retaining nutrients and water to moisturize and nourish skin. Young skin replenishes collagen, elastin and hyaluronic acid at a fast pace. But as the body ages, replacement is less rapid. [4] The cellular processes that help promote production of collagen, elastin and hyaluronic acid begin to slow, and skin begins to become thin and inelastic. The cumulative effects of extrinsic factors like UV exposure from the sun and airborne pollutants begin to become evident.

What results is loose, lax skin, fine lines and wrinkles. As the skin loses its ability to hold moisture and natural fatty deposits begin to break down, a loss of volume leads to a “hollowed out” appearance, typically most noticeable in the cheeks.

TRADITIONAL MANAGEMENT

Facial signs of aging including wrinkles, lines, creases and loose, sagging skin have typically been treated in one of five ways [5]:

  • Using invasive surgical approaches (face lift, brow lift, blepharoplasty, etc.) to remove excess skin and fat
  • Minimally invasive techniques using injectable fillers or neuromuscular agents such as Botox to temporarily correct wrinkles and lines
  • Chemical peels which rely on combinations of chemicals to produce a “controlled injury” that stimulates the production of new skin
  • Noninvasive techniques such as laser therapy and radiofrequency treatments to tone and tighten skin and temporarily reduce the appearance of lines and wrinkles
  • Topical agents such as retinoids to help decrease the signs associated with photoaging

Although some of these techniques may help stimulate production of natural collagen, the effect on the development of skin tissue components is secondary.

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STEM CELL THERAPY FOR FACE LIFTS

Stem cells are of special interest to medical researchers because of their unique ability to differentiate into other cells. The potential to repair and replace tissues using a person’s own cells has opened up a whole new field of medical research and affected nearly every medical specialty and subspecialty. Since their discovery more than three decades ago, stem cells have been explored as options to manage cancer and repair or even replace damaged organs. But it wasn’t until 2011 that the Food and Drug Administration (FDA) approved the use of stem cells for the management of wrinkles – in this case, specifically nasolabial folds, the creases that extend from the nose to the corners of the mouth. [6]

The stem cells used for cosmetic management are multipotent mesenchymal cells, which means they have the ability to turn into many other types of cells in the skin. When injected into the skin, these stem cells have the ability to interact with damaged cells, replenishing and replacing them with healthy cells.

In face lift procedures, stem cells are combined with a person’s fat tissue and injected under the skin to help fill in wrinkles and creases. While the fatty tissue provides immediate results by “plumping up” the skin and helping skin look smoother, the stem cells go to work ferreting out damaged areas and providing a support network for the fat graft. Although the specific mechanisms by which stem cells injections work to achieve cosmetic results aren’t clearly understood, some researchers believe the cells may help promote development of new blood vessels that provide transplanted fat with additional nutrients needed to maintain cellular health, or they may communicate with other fat or blood vessel cells and “instruct” them to multiply. [7]

Although fat transfer is a common technique for filling in lines and wrinkles with a person’s own tissue, the addition of stem cells is relatively recent and holds significant potential for more predictable results and stable resorption rates, which means patients may ultimately enjoy results that last far longer than other types of cosmetic filler injections. [7] Because the stem cells used in the face lift procedure are derived from the patient’s own tissue, the risk of rejection is also eliminated.

Suggested Reading:

  1. Cosmetic Surgery National Data Bank STATISTICS. 2015:203-205. Available at: Surgery.org.
  2. Department of Dermatovenerology, Split Clinical Hospital Center, Soltanska 1, 21 000 Split, Croatia. Acta dermatovenerologica Alpina, Panonica, et Adriatica 07/2008; 17(2):47-54. Source: PubMed
  3. Emerit, I, Chance, B. Free Radicals and Aging. Basel: Birkhäuser Basel; 1992.
  • Waller, JM, Maibach, HI. Age and skin structure and function, a quantitative approach (II): protein, glycosaminoglycan, water, and lipid content and structure. Skin Research and Technology. 2006;12(3):145-154. doi:10.1111/j.0909-752X.2006.00146.x.
  1. Ganceviciene R, Liakou AI, Theodoridis A, Makrantonaki E, Zouboulis CC. Skin anti-aging strategies. Dermato-endocrinology. 2012;4(3):308-319. doi:10.4161/derm.22804.
  2. June 21, 2011 Approval Letter – Laviv. FDA. 2015. Available at: http://www.fda.gov/biologicsbloodvaccines/cellulargenetherapyproducts/approvedproducts/ucm260486.htm. Accessed April 16, 2015.
  3. J Plast Surg Hand Surg. 2012 Apr;46(2):59-68. doi: 10.3109/2000656X.2012.668326.

Adipose-Derived Stem Cells as a Tool in Cell-Based Therapies.

Bajek A, Gurtowska N, Olkowska J, Kazmierski L, Maj M, Drewa T.

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Expanded Stem CellsStromal-Vascular Fraction, and Platelet-Rich Plasma Enriched Fat: Comparing Results of Different Facial Rejuvenation Approaches in a Clinical Trial.

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Cell-based therapies of liver diseases: age-related challenges.

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Biogerontology. 2016 Apr;17(2):297-304. doi: 10.1007/s10522-015-9623-7. Review.

Aging of Stem and Progenitor Cells: Mechanisms, Impact on Therapeutic Potential, and Rejuvenation.

Nurkovic J, Volarevic V, Lako M, Armstrong L, Arsenijevic N, Stojkovic M.

Rejuvenation Res. 2016 Feb;19(1):3-12. doi: 10.1089/rej.2015.1676. Review.

Adipose stem cells and skin repair.

Jeong JH.

Curr Stem Cell Res Ther. 2010 Jun;5(2):137-40. Review.

Mesenchymal stem cell differentiation and roles in regenerative medicine.

Hwang NS, Zhang C, Hwang YS, Varghese S.

Wiley Interdiscip Rev Syst Biol Med. 2009 Jul-Aug;1(1):97-106. doi: 10.1002/wsbm.26. Review

A comprehensive review on mesenchymal stem cell growth and senescence.

Ksiazek K.

Rejuvenation Res. 2009 Apr;12(2):105-16. doi: 10.1089/rej.2009.0830. Review.

Disclaimer:
Actual results may vary. The statements are not intended to imply that the results would be the same or similar for each patient. Each patient is unique and no particular result or outcome can be predicted or guaranteed. The statements in this website have not been evaluated by the Food and Drug Administration. Some of these procedures may be considered experimental. These procedures are not intended to diagnose, treat, cure or prevent any disease. The use of stem cells is not approved by the Food and Drug Administration to combat aging or to prevent, treat, cure or mitigate any disease or medical condition mentioned, cited or described in this website. The science of treatment with stem cells is in its early stages and stem cell treatments are not considered to be the standard of care for any medical condition, ailment, illness or disease. There could be significant and unknown risks associated with stem cell treatments, as long-term studies have not been performed.