Understanding Stem Cells in plastic surgery
There has been a lot of mention of stem cells in the media both positive and negative. Their potential has been heralded as the next wave of medical advance than can dramatically change the health of humans. In plastic surgery, stem cells have been advocated for many different procedures. There has also been a lot of negative publicity about patients getting stem cells and having major complications. Most often these treatments have been given by doctors and companies aiming to profit from desperate patients looking for a cure or treatment for a difficult disease.
First off, one thing needs to be said. Stem cells, their potential and risks are not fully understood. There is a lot of research being done in the plastic surgery world concerning stem cells but the truth is that we really don’t know a lot about stem cells. This article serves to help patients to learn the basics about stem cell, therapy with stem cells and the cautious nature of stem cell treatment.
What are stem cells?
Most cells in the body have a form and function. When we were small embryos in our mother’s belly we were originally a bunch of cells .Some of these cells developed into our brain. Others developed into skin, bones, the heart, muscles and so on. Cells that haven’t developed into a specific type of cell with function are called stem cells. The term for this is pluripotent. (“Pluri” means many and “potent” means potential i.e “many potentials”).
What are the types of stem cells?
The two main types of stem cells are embryonic and adult. Embryonic are those that are found in an embryo or fetus. They develop into different cells as a fetus grows based on many factors. These factors are being studied by scientists currently and are not fully understood. Adult stem cells are found in grown-ups. Adult stem cells tend to develop into cells in the area where they are found. For example bone marrow stem cells grow into different blood cells. Skin stem cells grow into adult skin cells and so on.
What are the potential of stem cells?
The potential of stem cells is that they can be transferred to an area of the body or organ that is damaged for regeneration. This can be the skin ,the eye, the brain. The theoretical potential is endless. Stem cells injected into the heart can help the heart regenerate. Stem cells injected into the skin can help the skin grow and regenerate.
What are the uses of stem cells in plastic surgery?
Stem cells have been used in fat grafting, scarring reduction and other treatments. One note, Platelet rich plasma or PRP which has been used in vampire facelifts has nothing to do with stem cells. These treatments are extremely experimental. We do not know the potential or damage they may cause in the short or long term just yet.
What are the limitations right now of stem cells?
The main limitation of stem cells is that we really don’t know how to make a stem cell turn into a specific target cell. For example, if we inject stem cells into the lung how do we make sure it grows into lung cells? How do we also know that these cells will grow into the particular organ part we want? If we inject stem cells into the eyelid, how do we determine if the stem cells become eyelashes, skin, muscle or fat?
What are the risks of stem cells?
The most common risk of stem cell treatment is failure meaning we get injected with stem cells and it does nothing. The cells die and don’t develop into anything. The worst risk is cancer. Yes, cancer. Stem cells are undifferentiated cells and can develop into anything. Anything includes cancer cells. In fact a tumor called a teratoma develops from stem cells in an embryo go haywire and develop into many different cell types in a place they shouldn’t below. (Ball of hair and teeth in the chest of a baby). Other risks include stroke, loss of vision and unwanted damage from the cells.
The best analogy would be like introducing a scientifically engineered virus into a population to “kill the flu” so mankind never has to deal with the flu again. Many viruses go out and kill the flu but some turn into a deadly virus that kills mankind. Stem cells are the same. We don’t have enough scientific knowledge to control 100% what a stem cell will turn into yet.
If these risks exist and things are unkown why are there so many companies touting stem cells are a “wonder treatment”?
There is one reason for this….money. In a world of 7.4 billion people, there are many people with terminal diseases that have the financial resources to pay for stem cell treatment. If a patient has ALS or Graves disease and someone tells them “there is a chance if I inject stem cells into your spine, eye socket, skin or heart, I can cure you. By the way it’ll cost you 20 grand”. There are enough people who will say “Yes I will take that chance and shell out the 20 grand”. The people doing this are making a lot of money. A lot. The medical culture is such that untested treatments are frowned upon. If you look carefully at these practitioners of only stem cell therapy they are usually not “the giants” in their field. Some in Colorado have even lost their license in a normal field for medical malpractice or drug use and now are searching other streams of revenue. I would emphasize that phrase "stream of revenue". It would be advised to not seek experiemental treatment in stem cells from a doctor who has not personally published atleast 5 papers in their field concerning the use of stem cells.
The most common analogous term that is like “stem cell” in medicine is the word “laser”. Laser is a buzzword that elicits feelings of technology, cutting edge treatment and better results. This is not based on data but marketing, media and common misconceptions. Patients often associate “laser” with something better and it is used in many fields to recruit patients and make them feel more comfortable with a procedure. A laser is not always better but patients often think it is. The same thing is preyed on with stem cells. Using stem cells in medical marketing gives patients confidence, trust and hope. Though it is not right, it is done and done commonly.
Like the patients in the media recently blinded, the stem cells by companies often injected are from fat cells. Those cells and how they differentiate are not fully understood and the risks of these treatments have not been studied. In the 80s, companies used antibiotic injections to treat non infectious diseases such as cancer or lupus for exorbitant charges. Patients often did not get better and lost hundreds of thousands of dollars for the hope of treatment of a terminal or damaging disease. Caution is warranted for stem cell treatment today unless it is at the NIH, university setting or public clinical setting.
A place online offered stem cell treatment and I am not sure what to do?
The simplest best advice would be to talk to your regular doctor. They would know if there is any utility in have an experimental treatment with stem cells. If you have ALS and have only 6 months to live, it may be worth to give it a shot. If you have graves disease and the stem cell treatment can give you cancer or a stroke, it may not be worth it. Discuss with your real doctor the treatment options. Do not rely on the doctor who is going to get paid thousands of dollars to give you a shot. The three patients who went blind from an intraocular stem cell injection did jut that and went blind.
What are the take home points?
First, stem cell treatment does have a lot of potential.
Second, stem cells are not magic. I will repeat stem cells are not magic.
Third, stem cell treatment is in a very early experimental stage and we do not know how to they work or how to control them.
Fourth we do not know very well the risks of stem cell treatment
Fifth, their are a lot of predators in the world who prey on desperate patients...so be very careful