An update on plastic surgery societies position statement on stem cells and fat grafting

by Alexey Bersenev on August 14, 2011 · 0 comments

in adipose, consensus

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The official ASAPS/ASPS position statement on stem cells and fat grafting was officially published in Aesthetic Surgery Journal last week with excellent commentary attached to it. I love this commentary and I can’t resist my wish to share some excerpts here and keep you updated.

First of all, some of ASAPS/ASPS concerns, which led to official statement:

  • Claims that skin quality can be improved from stem cell treatments, and that outcomes from fat grafting can be improved with stem cell therapy.
  • Widespread marketing, evidenced by a Google web search using the search terms “stem cell facelift” yielding 197,000 results and “stem cell breast augmentation yielding 302,000 results, respectively.
  • Instructional courses, some “for profit,” that have emerged which are designed to teach methods of stem cell extraction for aesthetic procedures.
  • Claims of purifying or activating stem cells through techniques that have not been fully verified and tested for safety and efficacy in current, peer-reviewed medical journals, or claims of improved outcomes as a result of these therapies.

The commentary:

Stem cells have captured the attention and imagination of the public, appearing to be a “magic bullet,” sexy and omnipotent, capable of curing health concerns from cancer and cardiac disease to warts and wrinkles. While the scientific enthusiasm for the potential therapeutic impact of stem cells seems justified, the great hope currently placed on stem cell therapies makes the public vulnerable to emotional manipulation, deceptive marketing, or even outright fraud.

The authors explained stem cell bias through level of evidence:

While the stem cell future may be bright, there is currently scant peer-reviewed evidence to substantiate marketing claims for stem cell aesthetic procedures. What little information is present is mostly of lower levels of evidence (LOE).

The resulting evidence-based plastic surgery culture promises to transform both our practices and the process by which we assess – and subsequently accept or reject – innovations such as stem cells. At the same time, if we can effectively communicate the evidence message to the public, we can make significant progress in realigning a dysfunctional plastic surgery marketplace. Currently, this marketplace is characterized by unsubstantiated (or even fraudulent) claims being made far too often and with apparent impunity.

The current rash of stem cell “therapies” seems to demonstrate a high risk for this kind of bias. Although the marketed “stem cell” treatments may vary significantly, in most cases they involve a combination of fat-grafting procedures and some variant of stem cell “activation” and/or “concentration.” Because marketers for stem cells claims clinical superiority over fat grafting alone, the question is not a lower-level issue: “Can this stem cell procedure be done?” Claiming superiority, the marketers have raised the evidence stakes to a high-level question: “Are fat grafts with stem cell enhancement more effective than fat grafts alone?”

As an attempt to answer the last question, I’d like to link to clinical study which compared simple fat transfer versus adipose-derived stem cell–enriched lipografts. The authors of this study, at least use correct terms. It worth to look at.

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