Regenerative Medicine Procedures for Aesthetic Physicians

264 Pages·2019·10.085 MB·English

by  Hernán Pinto, Joan Fontdevila

Matthew P. Lungren
Michael R.B. Evans
Editors
Regenerative Medicine
Clinical Medicine
Procedures for Aesthetic
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Regenerative Medicine Procedures for
Aesthetic Physicians
Hernán Pinto • Joan Fontdevila
Editors
Regenerative Medicine
Procedures for Aesthetic
Physicians
Editors
Hernán Pinto Joan Fontdevila
Aging Research Institute (i2e3) Department of Plastic Surgery
Aesthetic Specialties & Aging Research Hospital Clínic de Barcelona
Institute (i2e3) Barcelona, Spain
Barcelona, Spain
ISBN 978-3-030-15457-8 ISBN 978-3-030-15458-5 (eBook)
https://doi.org/10.1007/978-3-030-15458-5
© Springer Nature Switzerland AG 2019
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Preface
Adipose tissue grafts have been the last great evolution of plastic surgery
after perforator flaps. In its first applications, we observed fascinating
changes, such as the improvement in the texture of the tissues, skin coloration
and vascularization – changes that went beyond the simple increase in vol-
ume. Later, we would know that this is due to the regenerative properties that
our own tissues can have and, properly done, can be expressed where they are
applied in the pursuit of the best natural aesthetic improvement.
In this book, we wanted to integrate in a single work the current knowl-
edge on the biological bases of the different treatments with regenerative
effects, the technical foundations and the perspective of the results that can be
obtained (and those that can’t). And our will has been that it had the features
we expect for a book for our own consultation: concise, clear and practical.
In this way, we want it to be a handbook of consultation for all those pro-
fessionals interested in the fascinating world of regenerative medicine, which
will surely bring many new indications as we know better their potential.
Barcelona, Spain Joan Fontdevila
v
Preface
Regenerative procedures are one the most appealing and high-potential ways
of treating our patients in modern medicine. The fact of being able to regener-
ate up to some extent a damaged structure enhances the possibilities of the
physiological healing process way beyond its original duty. Any regenerating
strategy implies full functional and structural restoration which is something
non-acquirable by reparation.
This book presents the state of the art in regenerative procedures currently
applied by aesthetic physicians, plastic surgeons and dermatologists. It is
divided into two parts, the first of which provides a detailed introduction to
aesthetic medicine and the aging process. The second part, in turn, addresses
the current status of techniques and technologies with regard to autologous
grafts, covering fat transfer, blood grafts, skin grafts and stem cells. The book
examines the surgical applications of these grafts, as well as potential side
effects and limitations.
With this text, we want to promote and support an evidence-based behav-
iour, provide the state of the art of the regenerative procedures already applied
by aesthetic physicians and set the basis of a “regenerative approach” to
beauty, tissue damage, cell restoration and aging.
Barcelona, Spain Hernán Pinto
vii
Contents
Part I A pproaches: Introduction
Regenerative Medicine Techniques: Clinical Applications
in Aesthetic Procedures � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 3
Hernán Pinto
Aesthetic Medicine: Trends, Patients’ Needs � � � � � � � � � � � � � � � � � � � � � � 9
Paloma Tejero
The Molecular Physiology of Ageing: New Targets
for Regenerative Medicine � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 15
Salvador Macip and Mohammad Althubiti
Part II Approaches: The Process of Aging
Beauty and Aging � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 33
Eva Guisantes
Reducing the Damage: Metabolism Behaviour Aesthetic
Medicine � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 45
Jesus A. F. Tresguerres
Fat Harvesting: The Latest Scientific Evidence on Cell Viability � � � � � 63
Jesus Benito-Ruiz
Part III A pproaches: Strategies to Reduce the Clinical Impact
of Aging
Graft Processing and Enrichment Strategies � � � � � � � � � � � � � � � � � � � � � 71
Jordi Descarrega and Juan Cruz
Variants of Fat Grafting: From Structural Fat Grafting to
Microfat, Sharp-Needle Intradermal Fat (SNIF), Nanofat,
Emulsion, SNIE, FAMI, and SEEFI � � � � � � � � � � � � � � � � � � � � � � � � � � � � 81
José M. Serra-Mestre and José M. Serra-Renom
Fat Graft Application � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 87
Mauricio Raigosa and Tai-Sik Yoon
ix
x Contents
Part IV R egenerative Medicine Procedures for Aesthetic
Physicians—State of the Art: Fat Transfer, Lipo-Filling
Lipofilling in Reconstructive Surgery: Indications, Outcomes,
and Complications � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 97
Joan Fontdevila
Lipofilling in Aesthetic Surgery: Indications, Outcomes,
and Complications � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 109
Joan Fontdevila and Ariel Marshall
Enriched Plasmas: Concepts and Processing � � � � � � � � � � � � � � � � � � � � 125
Paloma Tejero, Lucía Jáñez, and Victoria Sunkel
Was It Gold What Shone? Platelet-Rich Plasma Applications,
Outcomes and Security Considerations � � � � � � � � � � � � � � � � � � � � � � � � 139
Lucía Jáñez, Paloma Tejero, and Marina Battistella
Autologous Conditioned Serum as an Antiaging Tool � � � � � � � � � � � � � 159
Hernán Pinto
Part V Regenerative Medicine Procedures for Aesthetic
Physicians: Skin Grafts
Skin Cell Cultures and Skin Engineering � � � � � � � � � � � � � � � � � � � � � � � 171
Lucía Jáñez
Techniques and Processing � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 203
Letizia Trovato, Riccardo D’Aquino, and Antonio Graziano
Injection/Application of Micrografts � � � � � � � � � � � � � � � � � � � � � � � � � � 215
Letizia Trovato, Antonio Graziano, and Riccardo D’Aquino
Techniques and Processing Methods to Isolate Stem Cells
and Stromal Vascular Fraction Cells � � � � � � � � � � � � � � � � � � � � � � � � � � 223
Severiano Dos-Anjos and José Miguel Catalán
Part VI R egenerative Medicine Procedures for Aesthetic
Physicians: Stem Cells
Regenerative Medicine Procedures for Aesthetic Physicians � � � � � � � 237
Martinez-Redondo Diana, Gartzia Itxaso, and Castro Begoña
Stem Cell Research in Aesthetic Medicine � � � � � � � � � � � � � � � � � � � � � � 245
Pablo Sutelman
Part VII Regulation and Conclusions
Regulation � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 261
Herrero Jone and Castro Begoña
General Conclusions: The Current Status of the Regenerative
Medicine in the Aesthetics Applications � � � � � � � � � � � � � � � � � � � � � � � � 265
Joan Fontdevila and Hernán Pinto
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 269
Part I
Approaches: Introduction
Regenerative Medicine
Techniques: Clinical Applications
in Aesthetic Procedures
Hernán Pinto
Compared to lower vertebrates, the human body tion’s quality of life and increase their ‘health span’
has a limited regenerative capacity. To face this is putting a certain amount of pressure to the old
fact, intervening in this limited ability of tissues promise of regenerative medicine to succeed.
and organs to self-heal has been an old promise Organs and tissues are also susceptible to be dam-
of regenerative medicine. Since first reports aged by disease, trauma or congenital defects.
appeared about the possibility of expanding Thus, virtually every medical and surgical specialty
organ failure and tissue damage repair beyond will soon be looking towards newly emerging
allogenic transplantation and the use of animal- regenerative medicine techniques. Cosmetic and
derived products, efforts have been made to aesthetic medicine will not be an exception, and in
deploy regenerative principles into practice [1]. the coming years it is forecasted that the biggest
At the interface between life sciences and engi- advances in cosmetic medicine and plastic surgery
neering, regenerative medicine has been regarded will be derived from the application of regenerative
as a therapeutic revolution [2], but being it or not, medicine techniques [3].
it is indeed a novel biomedical field that requires The chance to reverse ageing effects on body
the contribution of multiple disciplines and a functions is one of the reasons-to-be of aesthetic
holistic view of human biology. It observes and medicine. It is known that one of the major fea-
enhances the properties of living cells, through tures of ageing is a decline in the regenerative
the exogenous addition of growth factors, often vigour of many organs and somatic tissues.
in combination with biocompatible scaffolds, to Ageing is accompanied by a progressive decline
boost the tissue’s regenerative capacity [3]. in stem cell function, resulting in less effective
tissue maintenance and regeneration [4]. Thus,
restoring beauty through regenerative medicine
Regenerative Medicine to Reverse techniques will mirror a fully recovered, although
Tissue Decline limited by the idiosyncrasies of mammal species,
regenerative capacity of younger tissues.
The increasingly ageing population in first-world
countries and the increasing demands to medicine
for building strategies to improve elderly popula- Preventing the Translational Gap
To achieve its aims, a shift in the traditional
H. Pinto (*) approach where clinicians work far from basic
i2e3 Biomedical Research Institute, Barcelona, Spain
scientists becomes almost mandatory. In this
e-mail: [email protected]
© Springer Nature Switzerland AG 2019 3
H. Pinto, J. Fontdevila (eds.), Regenerative Medicine Procedures for Aesthetic Physicians,
https://doi.org/10.1007/978-3-030-15458-5_1