dear all
all this science of stem cell fybroblasts has been around for some time, we have seen isolagen failure, now new product vavelta is available (embryonic stem cells), new products are to become available soon (Juvista for scarless healing after scar revision surgery). i am anyway still not at all convinced that all this would really work on large broad depressions. it will certainly improve skin quality and texture but i am remaining firm believer that scars have to be lifted by filler or implant to be kept lifted. I absolutely love the idea of dermal pocket grafting. your own deepithelised skin graft works as a implant, its autologous very long lasting, it will become if taken part of your own tissue. i am sure it will bring some of fresh fybroblasts in as well as theres some fat tissue left on the acctual graft. unfortunately this seems to be largely overlooked procedure in UK. its available by few docs in states and in Australia,here in UK doctors keep using short acting and altogether unsuitable fat transfer. i think one of reasons is you need dermabrader to take the epithel off before you harvest the graft. dermabrasion has disapeared from UK and Europe and therefore graft cannot be properly prepared. as for the most effective lifting agent i think silicone remains the best in terms of natural looks and longevity, but of course one has to live with synthetic substance in face. i cannot help but hope that some dermatologist here will finally wake up and start utilizing dermal pocket grafting.
thank you for warm welcome. i am very happy you have repaired some of my inaccurate descriptions. i was writing that post very fast and i wasnt paying enough attention to the "niceties"in text. i am very well aware of the diference btw adipocyte, fibroblast and stem cell, its anyway my believe that any stem cells we want to inject have to primarily turn into fibroblasts if any collagen production has to be achieved. back to basic as with regards to fat transfer: there are number of renewed dermatologists in united states who consider fat not suitable as such, after you inject it however careful you are fat stars to live its own life in your skin, it can die very fast, it can remain and it can turn bulky big and unsightly.this is very difficult to predict and therefore you never know how you going to end up. there were number of people on different posts with less then satisfactory experience. its my believe that it would have been better to use dermal graft as transporter of either progenitor fibroblasts of stem cells, graft would have filled defect and cells would have effectively improve quality of skin. as for silicone i fully understand your concerns towards safety of this, if you anyway have severe tissue and volume loss and it affects your life to the extend of social suicide, its a good and lasting procedure. there are number of very succesful stories of people who had this done years ago and didnt have any problem at all. at the end of the day is everybodys choice dependent on many factors. thank you in any case for this great post and for all your inteligent comments.
Hi askin77,
First and foremost, welcome to the forum.
I am under the impression that you did not read the entire thread, because you seem to be confusing a few terms that have already been discussed at length. For one, you incorrectly equate fibroblasts and stem cells. You then seem to imply that the methodology discussed here would be ineffectual by tying it to what you perceive as the failures of fibroblast based products, traditional adipose transplantation and standalone PRP. All in all this does suggest a lack of familiarity with this thread's central discussion. Therefore I kindly ask that you read it beginning to end in order to inform yourself about the nature of the topic and relevant details herein.
I will address some of your specific comments below.
askin77: "[...] stem cells fibroblasts have been around for some time [...]"
Response: Technically speaking, fibroblasts are not exactly stem cells. Fibroblasts synthesize connective tissue, glycoproteins, etc (useful for wound healing), but they are generally considered to be near terminally differentiated. Their ability to undergo morphological changes under normal circumstances is very limited. True stem cells on the other hand are much more potent and can rather easily differentiate into fibroblasts and other cell types. That's what makes them effective when they are properly utilized.
Stem cells can be ranked in terms of their potency. Omnipotent stem cells are by far the least differentiated, and therefore the most potent stem cells capable of creating an entire organism. Pluripotent are next in rank, followed by multipotent cell types found in adults. An example of the latter is adipose derived mesenchymal stem cells that are capable of differentiating into cell types found in and around subcutaneous fat. That's why they can be useful when dealing with atrophic acne scars, which are essentially visible on the skin surface due to missing tissue normally found at the dermal and hypodermal levels.
askin77: "I absolutely love the idea of dermal pocket grafting. your own deepithelised skin graft works as a implant, its autologous very long lasting, it will become if taken part of your own tissue."
Response: I also like the idea of dermal grafting.
When done right it works, just like the methodology I currently employ. When transplanted, adipose derived mesenchymal stem cells can differentiate into various other cell types found at the site of injection/transfer/transplantation. They take their differentiation cues from the surrounding tissue and, in the case of how I use them, from a temporary autologous scaffold composed of blood and extracellular matrix particulates. This, done in combination with an instigated localized inflammation from subcision and needling, can make them rather effective in elevating/flattening skin depressions.
askin77: "[...] doctors keep using short acting and altogether unsuitable fat transfer."
Response: Fat grafting is short lasting only when done improperly. If it is handled incorrectly during the extraction, processing and transfer phases a large a majority of adipose and imbedded stem cells will die, making it next to impossible for most of the transplanted tissue to integrate itself into the transplantation site. Thus the body reabsorbs it over a few months time. On the other hand, when this procedure is done properly, the added tissue can last and even grow for decades to come. Just ask Jaden, who posted about her experience yesterday. (note: I presume Jaden is a female, pardon me if I my presumption is incorrect.) I should also mention that if one can increase the number of stem cells in the transplanted tissue, long term results should be even more apparent. Either way, I only use adipose tissue when I specifically contour the shape of the face and/or fill in large areas of atrophied tissue.
askin77: "as for the most effective lifting agent i think silicone remains the best in terms of natural looks and longevity [...]"
Response: Silicone is in my opinion quite dangerous when used as a lifting agent. One must always face the short, medium or long-term possibility of an immunological reaction to this foreign substance, however "inert" it may be. Localized and systemic effects can never be ruled out. Thus I have stayed away from it.
askin77: "little update on PRP on www.my-cells.net: it will last about 12 months then you need to have top up. for 6. 500 pounds."
Response: We are all at mercy of the natural aging process. Any benefit we get from a procedure will over time be counteracted by the unforgiving winds of time. Nonetheless, PRP in conjunction with subcision, needling and adipose derived mesenchymal stem cells can be an effective weapon in our battles with the realities borne out from our scars, injuries and mortality. The comprehensive procedure I discuss in this forum can benefit us long-term, potentially doing so well into our golden years.
I hope you do not see my reply to your posts as rude and therefore demeaning in any way, form or fashion. I simply want to clarify certain terms and procedures brought up in your original post so that the consequential discussion remain maximally objective.
Once again, welcome to this forum.
BRD
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