Stem cells are known to regenerate tissue and repair damage.  The controversial part is that stem cells with the most potential for serious medical treatment are embryonic in nature, and that poses ethical problems.  But now, clinicians are testing the results of using a person’s own fat-derived stem cells in various cosmetic treatments to reconstruct and rebuild lost tissue in less invasive ways. Injecting adult stem cells into the face can make pores become smaller, and make general skin tone fuller brighter and fuller.  Fat grafting, which has always been problematic because of uneven reabsorption issues, becomes less problematic when stem cells are added.  It seems to cause the fat to stay in place longer and even generate new cells. Who knew? Fat could be the gift that keeps on giving!

Plastic surgeons have high hopes for stems cells, too.  The Stem Cell Facelift is a new procedure being tested in the European Union and Japan, where physicians inject the patient’s own stem cells into the wound of the facelift.  Reports claim that with the addition of the cells, healing is quicker and the results of the facelift continue to improve as the new cells keep regenerating.  For breast reconstruction, using fat that has been enhanced with stem cells may replace the need for silicone or saline implants.

Don’t get too excited – the FDA has yet to weigh in on this and much more research has yet to be done in the U.S.  Of course, that hasn’t stopped the cosmetic companies from capitalizing on the concept.   Never mind that real stem cells could never be put into products because they would die immediately.  Several anti-aging creams are targeting stem cells in the skin for repair, using plant stem cells – specifically from apples – as ingredients and producing conditions “around existing stem cells” that would cause them to grow.  You can bet there will be more products, and soon.

The most unusual product we’ve seen is C’ELLE, a $500 system for capturing your own stem cells from menstrual blood and sending them to the company for preservation of up to a year ($99 for each subsequent year.)   Someone isn’t all that keen about this idea, though. “The C’ELLE service is not currently available to New York state residents.”

Do we have something to thank Andrew Cuomo for again?

• MakeMeHeal.com published a fairly extensive review of the Stem Cell Facelift.
• Stem cells basics, including the use of adult cells, can be found on the National Institute for Health website.
• How the fat-derived cells are harvested is no small matter, as this doctor explains.

I exaggerate of course, but hand rejuvenation is a new specialty among esthetic professionals for good reason.  While the skin of the face and neck may get all the attention in the fight against aging, the condition of our hands are, as my husband pointed out – a dead giveaway.  No matter how fat your butt is, older hands lose their fatty tissue and look bony and wrinkled.   Hands are often the first thing damaged by the sun, which results in freckles and age spots.  Because they are always in water and being wiped off, skin on your hands is often dry and itchy.  Even the veins stick out more as we age.  Remember the hands of the Wicked Witch of the East?

You get my point.  If hands are your issue, you are not alone.

The solutions for regaining youthful hands are many.  Product-wise, Retin-A and glycolic acid can be applied to the hands topically, which cause age spots to fade over time, just like they do on the face.  Chemical peels and microdermabrasion are also prescribed for faster results, but will definitely keep you from doing dishes for a few days while your hands heal.  Retin-A products usually run about $60-$100 a tube; the skin resurfacing procedures cost $200-$500.

Processes like laser skin resurfacing for the hands are very popular in medical spas using Fraxel, Thermage, Refirme or IPL, which can remove spots and broken capillaries.  For larger blood vessels, physicians use the same technique they use for spider veins – sclerotherapy – during which a chemical is injected into the veins that causes them to shrink. Dermatologists are even using injectable fillers to temporarily plump bony hands.  Depending on the services you receive, expect to pay $1,500 to $5,000 for these types of treatments.

If you are VERY serious about your hands, you can also go in for soft tissue augmentation where fat cells are taken from other parts of your body and transplanted to your hands. Hand rejuvenation procedures like those usually take place under outpatient anesthesia and are upwards of $1,500-$5,000 as well.

Doctors can bundle the procedures to save you money, but hands down, cosmetic hand rejuvenation could turn into some serious ‘high fives’.

Say you want a fuller face.  A surgeon sucks out a little fat via needle and syringe or cannula from your belly or hips, then injects it into your cheeks or lips, smoothing wrinkles and restoring a youthful plumpness.  Since the cells were yours to begin with, there’s no chance of allergic reaction or rejection.  Sounds like stealing from the rich and giving to the poor, doesn’t it?

Still, fat grafting is the lowest rated procedure at RealSelf.com, primarily because of its unpredictability.  Fat is living tissue and has to be kept alive to properly plump its new location.  Fat grafting involves harvesting, processing and re-injecting, and some of the fat cells are going to die during the process. The question is, just what percentage will become useless.  As one plastic surgeon on RealSelf put it, it is highly dependent on technique.  Another variable is that the fat could be reabsorbed into your body, and the so-called experts can’t seem to agree whether the results are permanent.

Additionally, if you want to kick up a little controversy, get a few plastic surgeons together and ask about fat transfer for breast augmentation. In 2007, the American Society for Aesthetic Plastic Surgery and the American Society of Plastic Surgeons came out against the procedure for breast enlargement, because there is little or no data that shows it is better or safer than using silicone or saline implants.  Some doctors also argue that if the transferred fat dies, it can leave behind scar tissue or calcifications. It can also hamper cancer screenings, and it remains a hot-button issue..

From people who have had it done, however, especially in their cheeks and hands, fat grafting usually wins high praise.  Some recent studies show that because the fat is rich in mature stem cells, fat grafts to your face and cheeks may improve your complexion.  It is outpatient surgery, requiring a day or two of downtime to allow the harvest sites to heal.    The cost of the procedure varies widely, not only by region and surgeon, but also depending on where you having the injections (lips will be less than butts).

For more information, PlasticSurgery.com is a good resource.

Platysmaplasty (neck lift): A surgical procedure to remove loose, baggy skin in the neck area and tighten the neck muscle

People seeking to remedy the effects of aging such as a fleshy neck, jowls or turkey wattle can consider two types of neck lifts: Cervicoplasty — or a skin-only procedure — and Platysmaplasty, during which skin is removed and the neck muscle, or platysma, is removed or altered. The procedure can be done on its own or in conjunction with a face lift (rhytidectomy). During platysmaplasty surgery, incisions are made under the chin and/or behind the ears to access the neck muscle (platysma) and manipulate or remove it. Permanent stitches may be used to hold the tissue in place. In some cases, the surgeon may be able to make smaller incisions and use an endoscope for a less invasive procedure. This is a newer option and may not always be available.

This surgery takes two to three hours, possibly longer if other procedures are done at the same time. Most people can return to work or regular activities in 10-14 days, and to sports or other excessive physical activity in three weeks. The incision will be bandaged and your head and neck will be fitted with a compression garment for several days after the surgery to hold the sutures in place, but also to improve circulation, minimize swelling and promote healing. Swelling and bruising of the lower face and neck will last several days after surgery, and sensations of burning, tingling and numbness are typical for several weeks post-op. You will also have to avoid turning your head and stretching your neck for awhile. Costs for this type of neck lift range from $3,000 to $8,000, but can go significantly higher when combined with other procedures. The results of the surgery are reported to last 5-10 years, having about the same duration as a face lift.

• The Realself.com satisfaction rate for this surgery isn’t particularly high.
• A step-by-step accounting of the surgery can be found here.
• Dr. Michael Walker talks about the difference between the surgery for men and women.

In an article published in Reconstructive and Plastic Surgery, a number of patients who had forehead lifts not only looked younger but also received the added benefit of an end to those debilitating headaches from Hell.

The link was first reported in that journal in December of 2004 and revisited again last summer.  In the most recent study, the 49 patients having a forehead lift – or brow lift – more than half (57 percent) also reported an end to their migraines.

There are reportedly 30 million migraine sufferers in America, and according to relieve-migraine-headache.com, 25 percent of women and 8 percent of men experience migraines in their lifetime.

The brow lift procedure severs the nerves and muscles in the forehead which may be migraine triggers.  Some patients in the most recent study were injected first in the forehead with Botox, which temporarily paralyzes the muscles and nerves.  If the recipient not only reaped the rewards of a fresher, wrinkle-free forehead, but also stopped having migraines, they also had a brow lift. The doctors who did the procedures would like to see further trials done, but the results are promising.

And while we jest, we are well aware that migraines are no laughing matter and would love to see this as a reasonable and relatively simple solution to a problem that afflicts so many.

That said, who do we talk to about a clinical trial to see if a butt lift will eliminate lower back pain?

• WebMD, which knows EVERYTHING medical, weighs in.
• Everything you want to know about migraines is here.
• Of course, plastic surgeons think this is VERY good news.

So, if you’re an outtie, let’s face it. You’re now longing to be part of the innie crowd.

With umbilicoplasty, or the nicer-sounding belly button renewal or lift, your belly can be born again.  Whether you’ve had an outie all your life, or your belly button is starting to protrude after babies or the skin above your navel is starting to droop over it, this relatively simple surgery (in terms of time, recovery and cost) can reset your middle ground.

If you think about it, the belly button is just a fairly large scar that we all have.  After we’re born and the umbilical chord is cut and tied, some heal as innies, some as outies.  Like everything else on our bodies, they tend to change over time, be it from child birth, drastic weight gain or loss or just gravity.  For some, it becomes a real hot-button issue.  Women want to look good in a bikini or have that attractive spot to pierce; men with good abs don’t want a knot sticking out of a well toned mid-section.

Umbilicoplasty is different from a tummy tuck, focusing solely on the navel.  It is often done in conjunction with that surgery to make sure the belly button matches the newly flattened tummy.  If an umbilical hernia is causing the belly button to protrude, surgery to fix the hernia would precede the belly button lift.  When done on its own, umbilicoplasty takes about an hour with local anesthesia.  The incisions are usually hidden within the navel itself and downtime is about one day.  The surgical costs will likely range from $500-$2,000.

• Here’s a really wierd site about belly buttons.
• Did you ever wonder if Adam and Eve had belly buttons?  This Christian site has the answer.
• American Health and Beauty always has good information.

The technical term is ptotic breasts, according to WebMD.com,  and in this case, women aren’t looking for implants, they are looking for a breast lift, or mastopexy – a procedure that removes excess skin in order to lift up sagging or drooping breasts.  Whereas breast augmentation increases your cup size, the breast lift brings them back up toward your chest and away from your knees.

The problem is simple:  there is too much skin, the tissue is too low and the nipple is pointing southward. To get them back where they should be, a plastic surgeon removes the excess tissue and skin, sutures them into a new new position and moves the nipple up to its new location. There are two types of breast lifts: the concentric (doughnut) lift that is used with smaller, less droopy breasts; and the more common anchor-shaped lift. There are different techniques, too, and the surgery can even be done without moving the nipple in milder cases.

The two biggest drawbacks of the surgery are scarring, and losing sensation in the nipple for some period of time.  Scars usually run from the nipple down, in an inverted “T”,  so are not dramatic, but definitely noticeable.  When the nipple areolar complex is severed and moved, it will be sore and then numb for some period of time, depending on individual healing time.

The breast lift was the seventh most popular cosmetic surgery in 2009 and 19th most sought procedure overall, according to American Society for Aesthetic Plastic Surgery. It is sometimes done in conjunction with breast augmentation surgery. Lift surgery alone is done on an outpatient basis and takes from 1-3 hours. Gauze is removed after a couple of days and stitches are removed after about two weeks.  A surgical bra is worn for support, sometimes for several months after the surgery. Bruising, swelling and pain should be gone after 4-6 weeks, but it can take up to a year to completely recover.

Lastly, this surgery will not keep breasts perky as long as implants. Age, weight changes and additional will stretch them out again. Cost for the procedure averages $7,000-$9,000, depending on where you live and the extent of the surgery.

• iEnhance.com offers a list of 13 questions to ask a prospective surgeon before undergoing this procedure. If you’re not good at talking with a doctor, print the list and take it with you.

• Before and after pictures on LocateADoc.com give an idea of the results and also of the scarring you will see afterward.

• This short, minimally graphic video of a surgery by Greek surgeon Dr. Nodas Kapositas is a great example the process.  It shows just enough of the actual surgery to give an understanding without being difficult to watch. Bonus: funky music!

Brow lift: A surgical procedure in which the skin of the forehead and eyebrows is tightened to eliminate sagging eyebrows or correct frown lines in the forehead.

Also called a forehead lift, this procedure wipes your worries away – or at least those pesky worry lines that aging and stress tend to grant to many of us. Ranking 22^nd among all cosmetic procedures, the brow lift has only been around since 1995. There are several different types of procedures:

• “Coronal” involves making an incision at or just past the hair line and removing excess skin and possibly some muscle from the forehead area. A plus is that the surgery may result in a lower hairline, however, there could also be noticeable scarring.
• A newer approach is endoscopic surgery, which involves several smaller incisions as opposed to one longer incision. This surgery adds some time to the one- to two-hour procedure, but is less invasive and there is a smaller chance of temporary scalp numbness.
• A subcutaneous lift involves incisions made at the hairline and scarring may be visible.
• A temporal brow lift, sometimes called a lateral lift, involves pulling the skin horizontally rather than vertically, and sometimes results in an exotic, cat-like look, but may also eliminate crow’s feet or wrinkles around the eyes.

Brow lift surgery is sometimes combined with bletharoplasty (eye lift). Sutures are removed in 7-10 days. The average recovery time is two weeks, and the after-effects are swelling and numbness, which can also affect the eyes and cheeks. The cost for this procedure varies widely, anywhere from $3,000 to $8,000, depending on the type of procedure and area of the country you’re in.

RESOURCES:

• Here is a straightforward look that explains the different types and subtypes of this procedure.
• How about a video of an endoscopic surgery?  First pictures, then surgery footage.  It isn’t bloody – sort of like cutting up a chicken – but it’s probably not for the faint of heart. 

It gets worse.

Noses play a central role in many people’s self esteem. It is the focal point of our faces, second only to the eyes.  But you have to get beyond the nose to even get to the eyes, and if yours is larger than life or crooked as a creek, it is going to draw attention and probably affect the outcome of your psychological growth.  So the person gets a little obsessed – big deal?  But hypochondriacs, they say?  Well, if your nose is the size of Wyoming or the shape of a left-hand turn sign, a simple cold is going to be much, much worse, don’t you think?  And if you’re already obsessed with the damned thing and it doesn’t work right…well, you know what I mean.

But as I said, it gets worse.  As LookinGood went nosing around for more information on this peculiar psychological phenomena, we discovered that one of the side effects of rhinoplasty – aside from the pain and expense – is depression.  No one knows why nose job patients experience uneasiness or a slump after surgery.  Some say it’s the side effects of anesthesia, but I’ve never heard of a person getting depressed after an appendectomy, have you?  Others say it’s because of sleep deprivation – patients have to sleep sitting up for a couple weeks after surgery. A recent report from Pharmacology & Physiology in Anesthetic Practice, has a physiological explanation:  “Disrupting the sensitive receptors … which moisten and control the temperature of the air which you breathe … can lead to minor disorientation and depression for several weeks and sometimes months after rhinoplasty.”

Whatever the reason, it just seems plain unfair.  And at the risk of pointing out the obvious – why the hell did they name it “rhino”- plasty, anyway?  Conjures up the image of circus animals, for heaven’s sake!

All plastic surgery comes with some price, but this seems a bit much, I think.

So I say to to those people suffering the snide remarks and self-consciousness about their schnozzes; the mental anguish of making a decision about plastic surgery, along with the depression that might come as an after-effect, just remember these important words:

“It’s not the size of a nose that’s important. It’s what’s in it that matters.” (Steve Martin)  I hope that helps.

We all know that our faces change as we age, with “change” just being a nicer word than “sag.”  A new study led by physicians at the University of Rochester Medical Center, however, suggests that changing bone structure is as big a contributor to the problem as aging skin.

And this, my friends, is bad news for our boys.  Their future facelifts may not just be skin deep, but cut right to the bone.

That’s what Dr. Oscar Ramirez is banking on, anyway, touting his Mandibular Matrix Implant System.  It sounds like something from a Keanu Reeves science fiction movie, but really it’s just fancy words for implants to the entire lower jaw (a.k.a. the mandible).

The idea is to give men, and sometimes women, a stronger jaw line, enhancing the shape of the face and making it look younger.  Mandibular implants aren’t new, though as with most cosmetic procedures, advancements are always being made.  Dr. Barry Eppley, at exploreplasticsurgery.com, notes that creating a strong jaw is not simple.

The mandible has three sections, the chin, the body (side), and the jaw angle. Because this is an area unique to each individual, implants have to be custom-made in advance, or carved during surgery.  They can be done in one, two or three pieces. They are inserted through incisions at the bottom of the chin or sometimes through the mouth.  They are held in place with sutures and screws.   Often, a neck and/or jowl lift should be done at the same time.

Ramirez’s system “is composed of an articulated wraparound geniomandibular chin implant and a wraparound gonial angle implant,” according to the website, and appears to be two overlapping plastic pieces attached to each side of the face.  The accompanying picture looks like a skeleton wearing a heavy-duty chin strap.

And of course, this is considered cosmetic, which means no insurance.  The cost could range from $4,000-$10K.

This is some seriously facial engineering, here folks.  Really manly kinda stuff.  Women might be accused of taking our facelifts too lightly, but leave it to the guys to do it big.  No nip/tuck here, this is structural demolition and reconstruction.