Once the graft takes (4 to 6 months), results will last for many years. The majority of patients will have good volume correction for 7 to 10 years. There are several caveats to the longevity of stem cells therapy-

• Duration of treatment is variable
• This depends on your DNA & genetics
• Fast metabolisers & active patients may absorb fat faster than others
• As one ages, volume loss continues. This procedure does not stop the clock
• Deep volumizing fat holds shape & structure longer
• Superficial nano fat (without adipose tissue) has a shorter lifespan
• Adipose tissue, in general has a longer volume correction compared to fillers

Stem cell survival is dependent on many factors including the way it is harvested, but also individual factors. Good candidates for stem cell transfer include-

• Patients with a healthy BMI
• Patients with a stable BMI (Stable weight)
• Non-smokers
• Age 20 to 70
• Patients with adequate sun protection
• Healthy, with no diabetic predisposition

1 to 3, depending on your metabolism, amount of atrophy, as well as individual factors such as exercise, diet & expectations. The biggest drawback of stem cell transfer & fat transfer is the variability of adipose tissue resorption. Fat transplantation itself has a retention rate of 50-60%. Stem cell differentiation is dependent on many factors including harvesting, preparation & re-injection techniques.

The vast majority of my operations are combined with laser resurfacing & or deep chemical peels. Lasers, peels & energy devices work by stimulating your own immune system to produce collagen; this is known as collagen induction therapy or neocollagenesis. The combination of fat stem cells & collagen stimulation modalities gives synergetic effects.

No. The majority of stem cell transfers are conducted under light sedation. I use tumescent analgesia in the donor area, coupled with blocks on the recipient site. Most operations take between 40 to 80 minutes to perform.

Skin rejuvenation is easy to understand. There are only 2 ways to predictably rejuvenate skin (in terms of improving skin texture, tone & volume).

Firstly, procedures directed at innate collagen stimulation. These are designed to get your immune system to produce collagen & renew skin cells. Methods include lasers, energy devices & chemical peels. Fat transfer & Adipose Stem Cells fall into this category.

Secondly, dermal fillers. This solution is aimed at replacing volume loss. If your immune system cannot regenerate or replenish deficits, you may require a helping hand. Dermal filler gives a good one to one (or more) correction that is predictable. Fat transfer & grafting have variable rates of resorption however they are more cost effective (esp. If large volumes required). Fat also lasts longer (once past the initial phase) & has no issues of allergies or reactions.

Apples are great sources of nutrients. Nothing better than a freshly baked apple pie. The marketing geniuses of several companies have marketed special apple products (fruit not Apple iPhones), as rejuvenation supplements rich in stem cells. If you are inclined to believe that fruit cells can differentiate into adipose or collagen then you can try this out. The bottom line is that fruit stem cells are safe, they are cost effective & are digested in your stomach & small intestine. If you find this therapy effective, by all means, give it a go. Besides, you can try to grow apple trees if you have any stems left over.

If you are inclined towards natural therapies, a homeopathic – naturopathic practitioner can assist you. I do not practice natural remedies.

If you have a deficit in volume secondary to acne, you only have 3 choices to ‘fill the hole’. (Obviously the aim of treatment is to get your own immune system to stimulate collagen. RFM, lasers, peels & microneedling are sensible options)

1. Dermal fillers: These work by acting as a spacer. They can stimulate collagen. They last 2-5 years. The amount of collagen stimulation is not predictable.
2. Dermal grafting: These grafts also act as a spacer. They last for many years, they also cause iatrogenic scars as I have to cut & suture each graft.
3. Fat & stems. My harvesting & processing techniques together with my injecting techniques are standardised as per literature. This treatment has a variable rate of resorption.

If you are inclined to try a ‘natural & long lasting’ solution for your acne scars, & can clearly understand the variable rates of absorption, consider fat transfer & stem cell therapy. I do believe that this realm of dermatology is still very new, & there will be more advances in the next two decades.

Actual side effects are rare. These include prolonged bruising, bleeding, as well as lumps & oil cysts. Overcorrection (uneven fat distribution & absorption) is due to variable survival rates in the recipient site.

Under correction is NOT a side effect as this treatment has a variable rate of uptake, as a guide 50-65% of the volume injected stays viable.

Treatment cost will vary depending on the procedure. Skin rejuvenation is not covered under Medicare, however subcision & laser resurfacing may be partially covered by Medicare for the treatment of severe acne scars.

Lots. Why can’t we just inject marrow stem cells, or develop human to human stem cells for skin rejuvenation? Well here is the answer. For BMT or bone marrow transplants, an oncologist will prescribe chemotherapy to wipe out your bone marrow prior to the transplant. This chemo period is normally for 2 weeks. This is designed to reduce your immune system’s fight for the graft. A suitable bone marrow- donor’s stems is then injected (based upon HLA typing & compatibility). These stem cells are injected through a special catheter from the front part of the chest (this line is the same line for chemotherapy).

Once stems are injected we wait for 2-3 weeks. During this time you will be on an antiviral, anti-fungal and 2 types of antibiotics, given through a central line. Blood tests are conducted 2-3 times a day, with frequent blood cultures when you spike a temperature. Most patients stay in an oncology ward for 3 weeks until they are discharged.

If you survive this phase of bone marrow transplantation, you have till day 100 until your acute graft vs host becomes chronic. Immunosuppressives will be weaned off at 6-12 months. 

You then need to deal with the second phase of stem cell transplants, namely chronic graft vs host. Apart from the usual GI side effects, skin changes include PIH, or darkening of skin (very common), white spots (hypopigmentation), poikilodermatous changes, xerosis or dryness, as well as a dozen more common skin changes.

As you can see, stem cell therapy is so much more involved than buying stem cells from apples grown in Indonesia.