Some time ago Macrolane was presented in the media as a new method of breast augmentation without using silicone. Since breast augmentations without silicon are one of my specialties, I wish to make a few additional comments:

Since silicone implants have a number of serious drawbacks, alternatives are always welcome. In the case of using Macrolane for the enlargement, hyaluronic acid is injected into the breast. Hyaluronic acid has been used for years in cosmetic medicine for injection into lips, but has – as is also often cited – the disadvantage that it is completely metabolized after only one to one and a half years. Therefore, regular re-applications are required if the result is to be preserved.

In the case of breast enlargement, the hyaluronic acid is injected in to the breast tissue through small incisions underneath the breast in ‘nut-sized’ depots. This means that by every re-application, additional incisions must be made, which of course leave some visible scars, and the ‘nut-sized’ depots can be felt in the breasts as hard lumps.

Concerning the cost of the procedure: the manufacturer of Macrolane, Qmed, charges doctors EUR 350 for 10 ml of the Macrolane material. Therefore it is easy to calculate that the price of a relatively standard 200 ml per side enlargement will be some EUR 14,000 plus surgeon’s fees.

Instead of silicone and hyaluronic acid, it is now possible to perform breast augmentations using stem cell-enriched autologous fat. Several clinical studies from Japan and the U.S. have now confirmed that stem cell-enriched autologous fat provides an ideal, durable and non-hazardous filler material for breast reconstruction after surgery, as well as for cosmetic breast augmentation.

This process is expensive, but yields the best possible results. Firstly breasts enlarged using the autologous stem cell method look completely natural in any position and in motion and also feel natural, because the injected stem cells form real living fat tissue. Lastly, this method leaves no visible scars.

Heinrich, MD

Some time ago, when we first started offering cosmetic interventions with autologous stem cells such as breast augmentation with stem cells, I predicted that in the near future stem cells could also be used for regeneration. And that anti-aging medicine and the treatment of chronic diseases would benefit alike. I promised you that I would keep you informed of new developments in this exciting field. And now that is what has happened: as one of the first centers in Europe to do so, we are able to offer you regenerative therapies with autologous stem cells from fat tissue!

Autologous (the body’s own) stem cells hardly age at all and have the capability of regenerating and rejuvenating the body’s organs and tissues. This has been known for years, and these findings are used in anti-aging therapy as well as for the treatment of degenerative and chronic diseases as well as in aesthetic surgery. Fatty tissue is the most important “autologous storehouse” of these precious cells; the density of stem cells in fatty tissue is much higher than in bone marrow, for example.

Regenerative stem cell therapy requires the suctioning of a small amount of fat. Next after having undergone suitable preparation the stem cells are isolated and then injected. Owing to the large quantity of stem cells in fatty tissue, unlike stem cells obtained from bone marrow or from the blood in the umbilical cord, stem cells obtained from fatty tissue do not need to be propagated artificially in the laboratory! Once the stem cells have been harvested and isolated, they can either be injected systemically or locally into a specific organ or tissue, as has been indicated. The stem cells can also be frozen and stored for future use.

The intervention is performed as an outpatient procedure under local anesthesia and takes around 2 hours. The amount of fat suctioned depends on the desired dose of stem cells. Generally a small quantity of fat suffices for obtaining the required dose of stem cells, which is done by means of a complex laboratory procedure. In the normal case of intravenous administration, the stem cells find the way to those building sites in the body where their regenerative and curative effect is needed on their own.

As a general rule the therapeutic effect manifests itself a few weeks after the application. The rejuvenating and regenerative effect of stem cells leads to noticeable and measurable improvements in looks, vitality, and organ functions, which can assume the nature of an overall rejuvenation.

This stem cell therapy can be administered either alone or in combination with Hormonal Regeneration® (a bioidentical hormone replacement therapy) and is one of the most promising contributions from cosmetic medicine to anti-aging medicine and medicine in general!

In the past we used to throw away the liposuctioned fat. Nowadays, however, we realize that it truly contains something akin to the elixir of life.

Heinrich, MD

Do you remember the media hype about Courtney Love’s stem cell facelift? Obviously she denied it, and because a stem cell facelift leaves no scars, we will never really know whether she took this royal road to facial rejuvenation or not.

Exactly how is a facelift with autologous stem cells performed? Well, I’m not going to reveal all of the secrets to you here, but I will let you in on the essentials.

Our faces and bodies age because the biological quality and elasticity of the skin deteriorate and the subcutaneous tissue, the muscles, and all other bodily structures atrophy. We are all familiar with the signs of aging: the skin tissue loses tone and “freshness,” wrinkles become more evident and permanent, etc.

Unlike a normal facelift, in which the flaccid skin is excised to create an artificial firmness, a stem cell facelift is performed solely by injections. We extract the stem cells from fat, which we suction from any problem zone using microcannulas. In contrast to a breast augmentation with stem cells, a relatively small amount of fat is used for a stem cell facelift.

After the stem cells are isolated by means of a special multistep laboratory procedure, they are injected into the facial tissue either in pure form or mixed with an autologous fat matrix according to a special technique. To do so, we use either very fine hypodermic needles or thin cannulas. The injection technique is critical to the success of the procedure and is chosen according to the nature of the aging/flaccidity of the face.

After the procedure, the face will be swollen to varying degrees (depending on the injection technique). It takes a few weeks for the effect to occur. The hands and neckline can also be noticeably rejuvenated with this method. The treatments can be combined, for instance, with a facial liposculpture. In this procedure, the fat pads in the cheek or neck and chin zone (e.g., double chin) are reshaped by liposuction using special facial microcannulas.

The stem cell facelift brings about a noticeable rejuvenation and toning of your face, without leaving scars. You decide whether to tell your girlfriends that you took the royal road to fantastic looks, or whether you – like Courtney Love – wish to keep it a secret, as is indeed the right of every woman.

Heinrich, MD

Recently I received the following e-mail from a prospective patient from Canada. I post it here because of the important issues concerning breast augmentation with stem cell-enriched autologous fat (Cell-Assisted Lipotransfer, CAL):

Hi,

I just had a few questions about where and who you have learned this procedure from.

I have been doing fat transfer to the breast since 1995 which is basically the same underlying surgery technique as CAL. My teacher was Pierre Fournier of Paris and a lot of other leading cosmetic surgeons in the U.S., Europe, and South America.

Adopting the new protocols of CAL to the breast was a matter of understanding how fat transfer works as well as the result of my thorough scientific research since 2003, when first information of the possibility of using autologous stem cells from fat reached the cosmetic surgery community. I met with Dr. Yoshimura, who was the first to perform CAL in patients, in Tokyo to exchange experience about CAL to the breast in 2007. The Japanese were pioneering CAL with the help of the Japanese government since 2003.

How long have you been performing this procedure?

We are doing CAL since 2006, being the first doctor in Europe and U.S. to perform CAL. Thus we have treated successfully a lot of patients and have ample experience with this challenging procedure.

I have had this CAL procedure done before in Japan. I am interested in getting it done again because I have lost some fat from the first time.

Sometimes doing a touch up can be a good idea as achieving the planned volume can take two procedures in some patients due to individual breast tissue details. Same applies when fat is lost. Typically not more than 5 % should be lost but individual patients may experience more volume loss sometimes.

Although I do not want to go back to Japan because I live in Canada and there are dents left over from their liposuction the last time so I’m concerned about going back.

Fat harvesting for CAL requires that 1,000 to 2,000 ml of fat are extracted. In case this is done with standard liposuction cannulas the risk of consecutive dents or irregularities after liposuction is considerable, especially in women that do not have ample fat deposits.

In these women microcannulas with diameters of not more than 2 mm need to be adopted. They allow for smooth and scar-free harvesting of big volumes of fat with minimal risk of dents. Aftercare is very easy as one week of compression typically is enough. Using delicate microcannulas we can correct those dents most probably.

Best regards,
DDr. Heinrich

Heinrich, MD

For many years I have been providing especially gentle treatments from the Regenerative Medicine repertoire at the Clinic DDr. Heinrich: along with Hormonal Regeneration®, autologous stem cells from autologous fat for enhancing, rejuvenating, and regenerating the body are particularly worth mentioning.

The biological potential of stem cells contained in fat deposits enables an impressive regeneration of facial and body skin. Other possibilities for this treatment include the so-called stem cell face lift, sustainable body silhouette shaping, and also silicone-free breast augmentation!

The rejuvenating effect of stem cells lies in part in the fact that they produce special tissue hormones (growth factors). The bioidentical synthesis of these hormones in the laboratory and the therapeutic implementation thereof have been possible for some time.

Hence we now offer a new procedure with specially adapted growth factors from skin cells as a simplified alternative to stem cell-assisted fat transfer. To a certain degree, we are able to duplicate the rejuvenating and regenerative effect of stem cell therapy with this new therapy. In the scope of the treatment, we use very short micro needles to introduce the growth factors into the skin. No surgery is involved.

Moreover, it is possible to stimulate thinning hair to more luxurious growth with specially adapted hair follicle growth factors. Whether it will be possible to treat complete baldness with this method, however, remains to be seen.

With a little training, one can even perform this treatment oneself at home.

The future lies in the use of cell-specific growth factors and tissue hormones! It is important to note, however, that an optimum regeneration of organs and tissues cannot be achieved by local measures alone. A thorough regenerative treatment of the whole body is required in all cases, and Hormonal Regeneration® (bioidentical hormonal replacement therapy) is the gold standard for doing so.

Stem cell therapy with autologous stem cells from autologous fat will be an option for rejuvenating organs and the entire body in the not too distant future.

We are thus making great strides towards achieving the benefits of that legendary Golden Age, in which people live for more than 100 years in relative ease, remain attractive and vital, and show hardly any signs of aging. What do you think?

Heinrich, MD

The trend toward gentler, less invasive Cosmetic Surgery methods is increasingly gaining in importance. As a leader in Europe, our surgery in Vienna has been performing breast augmentation using stem cells since the year 2007.

These types of intervention have also recently started to be offered in the United States. In fact, U.S. media is positive, sometimes even euphoric, concerning the potential of stem cell-enriched autologous fat. The results of stem cell therapy are convincing due to their special natural appearances and significantly less invasiveness when compared to traditional methods such as silicone implants and facelifts.

Stem cell therapy utilizing stem cell-enriched autologous fat particularly lends itself, apart from the body shaping (e.g. breast, buttocks, dent correction, etc.), also to treatments for face, cleavage and hand skin rejuvenation.

Patients often ask me whether every woman is suited for breast augmentation using stem cell-enriched autologous fat and what the limits are concerning the increase in size of the breasts.

Apart from women who are very skinny, sufficient fat can be obtained by liposuction using microcannulas for most women to be able to have a breast augmentation performed utilizing stem cells.

To which extent a particular woman’s breasts can be enlarged depends largely on the elasticity of her breast tissue. The more compliant and stretchable the breast tissue is, the more it can absorb stem cell-enriched fat. In particular, we are frequently consulted by women who have lost breast volume following breast feeding.

Thus, in this process, a certain “looseness” of the breast is an advantage if more than 1 cup size should be gained. For breasts having a normal level of firmness, it is usual to achieve an increase of about 1 cup size per surgical intervention. However, for breasts that are very firm, more than one intervention may be necessary to achieve the desired result.

Heinrich, MD

Since 2003, breast augmentation utilizing stem cells from autologous fat has been developed enabling silicon-free breast reconstruction following cancer surgery. Till now though, it was unclear whether this might reactivate the cancer again. However, University of Pittsburgh researchers led by Prof. Albert Donnenberg have now demonstrated that stem cell-enriched autologous fat is safe even in the presence of inactive tumor cells.

Breast augmentation with the body’s own stem cells is suitable for both reconstruction after tumor removal and for cosmetic reasons for women wanting larger breasts or wanting to regain lost breast volume following breastfeeding and weight loss. Our Clinic DDr. Heinrich was the first place in Europe where such aesthetic treatments were performed in 2007.

I have long maintained professional exchanges with international stem cell researchers. For example, I discussed the potential of autologous fat stem cells for aesthetic and therapeutic treatments with Prof. Donnenberg in 2008. Together with my team I further developed breast augmentation using stem cells and optimized both the results and patient tolerance.

The required breast augmentation fat is collected by liposuction using microcannulas and following stem cell-enrichment is injected into the breast using fine needles. Fatty tissue having good blood circulation is then developed that enlarges the breasts permanently. The procedure is performed under local anesthesia or “twilight sleep” and the results are impressive due to their naturalness and freedom of scars.

In our Clinic DDr. Heinrich we also utilize stem cell-enriched autologous fat treatments for face, cleavage and hand skin rejuvenation; as well as for buttocks, hips, thighs and calves “body-forming” and correction of dents arising from liposuction.

Heinrich, MD

Currently, the media reports about the U.S. singer Courtney Love (46) whose face suddenly appeared to be about 10 years younger. It is rumored that she has undergone a stem cell facelift, which uses the body’s own stem cells obtained from autologous fat. While the surveyed surgeons in the United States are just making their first steps utilizing stem cell technology for this application, we in our Clinic DDr. Heinrich have for more than three years been successfully performing to a broad public facelifts without scalpels and breast augmentations using stem cell enriched autologous fat.

For some years now, research has been carried out concerning the biological potential of viable cells such as stem cells and progenitor cells, which are included in each person’s own fat. Based on these findings, we decided early in 2007 to start performing treatments utilizing the body’s own stem cells. The positive results for facelifts and breast augmentations utilizing stem cells has confirmed our beliefs that stem cells rejuvenate the tissue into which they are injected and stem cell enriched autologous fat forms natural living tissue, the majority of which is retained for a long period.

Conventional treatments using the patient’s own fat sucked off from one body part and then injected “untreated” into the face, have been around for decades. However, occasional boosters are necessary because over time much of this fat is broken down again by the body. It also lacks the spectacular rejuvenating effect obtained via stem cell treatments. Surgical facelifts with a scalpel or injections of Botox and hyaluronic acid, which some doctors use for facial “rejuvenation” often lead to unnatural looking results, as well as having a number of other disadvantages. In contrast, the stem cell facelift is convincing by its natural character and durability of the result, as well as by the local rejuvenating effect.

Of crucial importance for the success of interventions utilizing autologous stem cells is the experience in dealing with the collection of autologous fat, its preparation and its implantation in to the treatment region. Over the years, I and my team were able to refine existing treatment techniques to optimize the results and patient tolerance. More and more patients like Courtney Love now benefit from this treatment. In the Clinic DDr. Heinrich, patients are not only in very experienced and competent hands, but they can also combine the treatment with a stay in beautiful Vienna. That’s really wonderful – what do you think about that idea?

Heinrich, MD