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.

Let’s get the snorts and guffaws over with: Cosmetic tattooing, or micro-pigmentation, does involve someone sticking inked needles into your face. And, in the spirit of full disclosure, this will be a pro-permanent makeup article.  I immediately went home and had it done.  But I am getting ahead of myself.

The process has many names, but it is the same technique that produced pin-up girls on the forearms of WWII veterans, skulls on the biceps of bikers, and little butterflies on the shoulder of your underage daughter – electric needles are used to inject permanent dye into the skin.  Cosmetic tattooing is used to help with reconstructive surgery, simulate facial hair lost through chemotherapy or alopecia, cover scars or, in my case, address laziness.  I like to wake up with makeup.

Micro-pigmentation uses extremely small pigment granules for coloring on the face or other sensitive areas of the body, because it is for esthetic enhancement rather than art.  Estheticians apply permanent eyeliner, lip liner and full lip color, eyebrow enhancement, beauty marks, areola recreation, as well as scar camouflage.  The dyes used for makeup are different than the ones used for a Grateful Dead logo and the procedure is relatively quick and mostly painless. Depending on the size of the area, it takes around 40 minutes to an hour, and two sessions are needed with a couple weeks in between treatments.  There is mild discomfort, but most specialists use a topical anesthetic to numb the skin.  The cost varies – anywhere from $300-$500 for eyebrows, up to $2,000 for areola work and it is likely that the work will fade after a few years, especially if you spend a lot of time in the sun.

The bad news is that while there are lots of different colors and pigments, “none, including the hair dye henna, are actually approved by the FDA for skin injection,” says WebMD.com.  Risks include infections, inadequate sterilization of the needles, allergic reactions, scarring, and bleeding of the dye into surrounding skin.  The American Association of Blood Banks requires a one-year wait between getting a tattoo and donating blood because of the risk of hepatitis or HIV contamination.  Most states now heavily regulate and inspect tattoo parlors, but consumers should be sure to do their research, check references and above all, make sure the environment is clean.

Having said all that, the results can be fabulous (I told you this was a PRO article.) Tattooed eyebrows, when done correctly, are indistinguishable from real ones.  Faded lips have new color and scars disappear.  I have worn thin eyeliner since I was 12 years old, but sight problems were making it more and more difficult to apply well.  Two sessions and two years later I have positively no complaints and awaken, like the women on my trip, suspiciously well made up.  Now if I could just tattoo out the wrinkles…

Ultrasound is the treatment you might have used at the physical therapist’s office after that sports injury, your doctor’s office when the gallstones flared up or that the OB/GYN used when you were pregnant to show you the baby’s heartbeat and determine whether it was a boy or a girl.

Ulthera’s DeepSEE technology combines the ultrasound imaging and therapy, channeling that energy into your forehead. The company says its device is different from other in-office aesthetic devices because it allows doctors to see below the skin’s surface and guide the ultrasound energy to specific places at varying levels without surgery.  We can feel our brow furrowing just thinking about it, but some heavy hitters were testing the technology, including Northwestern University’s Feinberg School of Medicine, Harvard Medical School and Wellman Center for Photomedicine at Massachusetts General Hospital, the University of California at San Diego and Massachusetts Eye and Ear Infirmary.  Those are pretty good credentials, if they get them.

According to Ulthera’s press release, it works like this: “Focused ultrasound energy triggers the body’s natural healing response, resulting in new and improved collagen support and gradual firming, tightening and actual lifting of skin tissue over time.”

“We use imaging to anticipate where the energy will be placed, and then we deliver small amounts of very productive energy to targeted planes of tissue. This precision contributes to both safety and effectiveness, and because this is accomplished without damaging the superficial layers of skin, patients experience no down time,” said principal investigator Murad Alam, M.D., Associate Professor of Dermatology and Otolaryngology and Surgery, and chief of the Section of Cutaneous and Aesthetic Surgery at Northwestern.

After one treatment, research documented gradual improvement over 30, 60 and 90 days.    Patients reported less hooding (drooping of eyelids) and a more “open” look around the eyes.  Because it is non-invasive, there’s no downtime and like Domino’s Pizza, it usually takes 30 minutes or less.  In Canada, Europe and Asia, clinicians are using Ulthera on the lower face and neck as well.

We couldn’t find any cost estimates for this process, but we can guarantee it will be cheaper than the surgery it could eventually replace. Brow or forehead lift surgery, the 22^nd most performed procedure in 2008, was going for $3,000-$8,000.

And if it turns out it doesn’t wipe away the worry, maybe the DeepSEE technology can show us where those little voices in our heads are coming from.

Well, this one that we found, Follicular Unit Extraction (FUE), is just that: another hole (or more accurately, series of holes) in your head. The hairs to be transplanted are extracted from the back and sides of the head using a tiny (.8 mm), circular punch that leaves little to no scarring. The hairs are then transplanted to the desired spot on the head. The description of the “punch” makes us think of a really, really little biscuit-cutter or something made by Ronco and sold during an infomercial.

The Foundation for Hair Restoration and Plastic Surgery touts this as a “breakthrough procedure,” and it could be, but it’s not exactly new. It started emerging in 2002, with recent advancements in the extraction “punch” that have made it smaller and less invasive.

They also call FUE “incisionless,” which we find hard to believe because a) pulling out tiny circular pieces of scalp sure sounds like there’s cutting involved even if the surgeon isn’t using a scalpel; and b) the extracted follicles are implanted in tiny incisions in the other part of the scalp.

One of the pros of FUE is supposed to be that because the scarring is minimal, men can wear their hair shorter or have a buzz cut.

Topping the list of cons is that it takes a long time – sometimes two or more sessions that can last up to 9 hours. And the best cost estimate we’ve found is $4 per graft. During some of those marathon sessions, as many as 1,200 grafts are being done. You do the math.

As with any plastic surgery, do your homework. Most of the information out there says this procedure isn’t right for everyone. And though more surgeons are offering FUE, that doesn’t mean they all have the experience to do it well. You know you need a bad hair transplant like you need …. well, you get the idea.

• True & Dorin, The Hair Loss Doctors, explain and offer the procedure here.
• Hair Loss Learning Center cautions about the hype on FUE.
• Want to see how it works?  The HairNetwork offers a video on YouTube.

I don’t know whether to attribute it to the new products I’ve been trying, stress, hormones or diet.  When I get stressed, I don’t eat right. And hell, at 43, much like at 16, I have absolutely no clue what these hormones are doing.

Of course, with all this playing out all too obviously across my face, I appreciated the timing of Paula Begoun’s recently released report on acne.  Apparently, I am not alone.  Acne affects an estimated 95 percent of the population, regardless of skin color or type.  The report says that yes, my breakouts are probably due to all of the above, and tells me how to fight the flaw, and not let the flaw win.

It is most interesting to note, however, that every natural instinct we have for eradicating those complexion killers is just wrong, wrong, wrong.  And contrary to popular belief, none of it makes them disappear any faster.  You can’t squeeze them or scrub them gone.  The report discourages harsh skin care products.  Astringents like witch hazel won’t dry up that little geyser any quicker, and in fact, if the skin gets dried out, it can’t heal.  Dry skin is also a breeding ground for the bacteria that grow pimples.  Who knew?  Similarly, don’t use products, such as bar soap on your face or waxy styling products on hair that will touch your forehead. These will leave a residue that will clog pores and clogged pores are part of what started this whole mess in the first place.

If acne is a serious issue for you, you need to get Begoun’s report (anyone who is serious about skin care at all should be on her mailing list), because treatment is very individual, depending on your skin type and lifestyle.  Her extensive recommendations include products with salicylic acid or benzoyl peroxide, but she encourages a regular, gentle cleansing routine as the best approach.  Alternatives such as Tea Tree Oil treatments or the use of sulphur are discussed and the report is a must-have before making a decision with your dermatologist about prescription methods.  All the latest on new treatments such as Dapsone, updates on the use of antibiotics, vitamin supplements and other topicals are covered in her report.

Fortunately, my face cleared up in a few weeks, so I was able to give up re-living my pizza face years.  Now if I could find a routine to clear up my social life as easily…

Laser skin resurfacing is a popular way of rejuvenating wrinkled or scarred skin, but the first step in the procedure has to be understanding all the words being tossed around. Ablative. Non-ablative. Fractional. Erbium. CO2. Oy.

According to the American Society of Aesthetic Plastic Surgery, more than 500,000 laser resurfacing treatments were done in 2009, and nearly 73 percent were non-ablative, such as Fraxel Restore.  Non-ablative resurfacing means the laser heats the layers of skin below the surface to stimulate collagen and promote new cell turnover.  (Trade names include Fraxel Restore, Laser Genesis, Lux 1540.)

Ablative skin rejuvenation procedures “remove” that top layer of skin, burning it away so it is replaced with fresh new skin.  Another term often used is “vaporize.” If it sounds painful and drastic, it is.  It can take three weeks for the oozing and crusting to subside, and three months for the redness to go away.  (Laser names include Fraxel Repair, Active FX, SmartXide DOT)

Lasers involved will either be CO2 – carbon dioxide – based or erbium-based.  According to WebMD.com, CO2 lasers have been used for many years to treat a variety of skin issues.  This type of laser penetrates more deeply than erbium lasers, and the heat can also affect the surrounding area.  The erbium lasers are recommended for people with darker skin tones because they don’t penetrate as deeply and there is less chance of burning surrounding tissue.

The procedure now referred to as the gold standard is fractional ablative laser resurfacing, which is described as “(drilling) tiny holes deep into the skin” in this WebMD.com video.  Doctors have found that by making a number of smaller penetrations with a CO2 laser over an area of scarred or wrinkled facial tissue, the number of treatments and amount of down time are greatly reduced.

Often, non-ablative laser treatments require several appointments.  Patients opting for fractional ablative resurfacing report results after one treatment.  There is a lower risk of infection and little or no crusting and oozing afterward.  According to RealSelf.com reviewers, though, it is still a painful treatment.  And the cost for any laser facial skin resurfacing ranges from $500 to $5,000.

• Here’s another good explanation of ablative, non-ablative, fractional comparison. 

We’ve seen it already this summer.  June brides who tried something new to look special on their big day, only the special look they ended up with was especially a bummer.  So for the rest of you summer brides, (and this goes for mothers and grooms as well) before you say “I do,” there are some don’ts that you should keep in mind:

Of course you want your skin to be bright and glowing, but don’t schedule a facial treatment close to the big day.  If you’re considering a facial or any sort of peel, you have to make sure you give your skin plenty of time to recover, a minimum of a week.  Facials draw out impurities and can lead to breakouts, and if it has been over a year since you had one, or maybe you’ve never had one at all, you must expect some type of skin reaction.  And depending on the level of the peel, the new skin it unveils will be red for several days to 2 weeks.  Make sure there’s time to heal before you walk down the aisle.

Give the same consideration to any facial waxing.  If you’ve never waxed before, just prior to your wedding is not the time to start – at least not with regard to your face.  I regularly wax my chin and eyebrows … and I regularly break out a couple of days later.  Plan accordingly.

Even if your color theme includes orange, it doesn’t apply to your skin unless you are one of Willie Wonka’s Oompa Loompas.  Don’t go overboard tanning, especially if you’re wearing white (and/or strapless).  Fake tans — spray-on or otherwise acquired — are not fixable and they will still be very obviously fake decades later, regardless of how good your photographer is.  Spend the money to try a couple different techniques a month before the wedding, then choose.

Most importantly, don’t go crazy with your makeup, and if you are using a professional, have a makeup rehearsal weeks before the event.  You want to be a blushing bride because you’re excited and glowing, not because you’re over-painted.  Too often, we see brides who go for the extra eyeliner or lipstick or blush because they think the pictures will look better. If you’re taking the stage at the community theater or running off to join the circus, you can make an argument for changing the way you wear your makeup.  But you’re getting married because somebody loves the way you look every day.  “Something blue” should not be your eye shadow.  If you don’t normally wear blush or magenta lipstick, don’t do it for your wedding.  Whether you hire a professional, put your face in the hands of a friend or do it yourself, accentuate the positive.  Enhance what you have, don’t hide it under layers of cosmetics.

When it comes to your wedding day, if you only remember one thing, remember that those pictures you shelled out thousands for are going to be passed down through generations.  Make sure they look like you.

• More don’ts can be found on TheKnot.com.
• Sacremento Magazine has a good list of Do’s.
• WebMD.com features “The Perfect Bridal Beauty Guide.”

“If you’re going to get a bikini wax,” she said, “you might as well get a Brazilian.”

That first rrrrr-iiii-ppppp of the wax-removal material was, let’s say, a wake-up call.  My idea of a Brazilian and the actuality of it were two entirely different things and in my brain that realization was apparently on a 30-second delay.  After the initial “Oh … my … god,” it was all pretty funny, I couldn’t really do anything but roll with it (visualize stopping half-way through – not an option).

A recent article from WebMD was geared toward people contemplating a bikini wax or Brazilian, full of things to keep in mind.  Usually a pretty thorough researcher, I was kind of naïve when it came to waxing anything other than my face, but I can honestly say that if I knew then what I know now, I’d still do it, I’d just make sure the esthetician and I are on the same page.  If you want a bikini wax, it’s kind of like edging the lawn.  The Brazilian is roto-tilling the whole garden.

That summer, my legs never looked better.  They were smooth and soft and sleek for weeks.  There weren’t any “strays” poking their coarse little heads out.  I could wear as much or as little as I wanted without a second thought.  And while I was, um, startled by the process at first, I can’t say it was really painful for me, which was especially surprising because of the extreme sensitivity of my face when it comes to waxing.  There was some initial discomfort, but it wore off quickly.

I’d do it again in a heartbeat, but there have been awkward days at the beach – standing waist-deep in body-numbing water for hours because of a really unfortunate 5 o’clock shadow or grasping for something inflatable or damp with which to cover myself because my garden had not recently been weeded – when I wonder why I didn’t make that waxing appointment.

There are alternatives to waxing, of course.  The most obvious is shaving, because most of us do that already.  It’s just a matter of kicking it up a notch.  Gillette, Schick and even Noxema offer bikini-area trimmers.  And while you can’t use it for extremely personal places, I do like the Smooth Away for my upper thighs.

In terms of results, though, none of those comes close to waxing.  Just remember:  If you want a so-called “landing strip” or “racing stripe,” you have to let the waxer know.  Otherwise, it’s quite an eye-opener.