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The current popularity of injectable treatments is based on placing synthetically-derived compounds and drugs into and under our skin. At best, these are well tolerated agents that create their effect and then are gone after a relatively short period of time. The future of injectable cosmetic treatments will likely be somewhat different. And we are getting a glimpse of that potential paradigm shift right now.

Spurred by the discovery in the 1990s that fat contains a rich supply of cells similar to the stem cells found in bone marrow , developments and techniques to use stem cells from fat for injectable cosmetic and reconstructive procedures is being worked on around the world. A stem cell is a cell from which other types of cells develop and they lie in a resting state amidst many of our tissues. Fat has proven to be a rich source of stem cell populations. The theory behind this new injectable approach is that fat may be processed or handled in a way that allows the stem cells to create a blood supply for the transplant that helps the fat survive after injection. Or perhaps have the stem cells convert after injection into fat cells to replace those regular fat cells which did not survive the transfer process. During a single operation, fat is obtained by liposuction from the stomach or thigh for example and then processed using a special technique.. The ‘treated’ fat is then injected into the desired area. Because the patient is the donor, there is no risk of tissue rejection. This concept is being used in other parts of the world right now for breast augmentation and small breast reconstructions. I currently use a similar approach for my fat injections for cosmetic facial improvements and for those patients who desire buttock augmentation with fat grafts rather than a synthetic implant.

Botox® and synthetic injectable fillers are here to stay and will be the backbone of office and non-invasive cosmetic treatments of the face for years to come. The use of one’s own fat remains theoretically appealing, however, and current research suggests that it will ultimately have a slice in the injectable ‘pie’ in the near future. Because it involves more effort and costs, it role will always be more limited than off-the-shelf products. But its rich source of stem cells and its lack of any rejection issues makes fat a filler material worth working on.

Dr. Barry Eppley

Indianapolis, Indiana

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