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Stem Cells

Stem cells are undifferentiated biological cells that can differentiate into specialized cells (e.g. muscle, fat, blood cells), and divide to produce more stem cells.

There are two broad types of stem cells: embryonic stem cells and adult stem cells. The former can differentiate into any of the more than 200 cell types of the human body to make a whole organism, the latter can differentiate into a few different specialized cell types: Embryonic stem cells and Adipose derived stem cells.

Where the embryonic cells are few and challenging to obtain, adult stem cells are plentiful and easier to obtain and can be accessed through various tissues, including bone marrow, adipose tissue (fat), and blood.

Specifically, adipose tissue is an excellent source from where to extract stem cells. These stem cells are referred to as adipose derived stem/stromal cells or just ASCs.

ASCs are pre-disposed to differentiate into adipocytes (i.e. fat cells), but has the properties to diffenrentiate into other cells (e.g. bone, cartilage, and muscle cells) and stimulate the production of proteins and nutrients for the necessary repair processes when needed.

As adult stem cells (e.g. ASCs) are much easier to access compared to embryonic stem cells, which require extraction from an umuilical cord, they are naturally also much less controversial to use for both research and therapy.

Additionally, when ASCs are obtained from the intended recipient of the cells, also known as autologous stem cells (i.e. the patient’s own cells), the risk of rejection is essentially non-existent as the body recognizes its own cells. Therefore, autologous ASCs are broadly considered a safe treatment solution.

ASCs are found in the stromal vascular fraction (SVF) of the harvested adipose tissue. SVF is the cell pellet that forms when adipose tissue is harvested by liposuction, and the adipocytes are enzymatically digested using collagenase.

SVF is a heterogeneous cell population comprising cells of endothelial, percytic, and hematopoietic origin, and a smaller fraction of adipose stem and precursor cells.

ASCs are found in the stromal vascular fraction (SVF) of the harvested adipose tissue. SVF is the cell pellet that forms when adipose tissue is harvested by liposuction, and the adipocytes are enzymatically digested using collagenase.

SVF is a heterogeneous cell population comprising cells of endothelial, percytic, and hematopoietic origin, and a smaller fraction of adipose stem and precursor cells. SVF – Stromal Vascular Fraction (Wiki)

One can typically harvest 5,000-10,000 ASCs per ml of fat. Although, this may sound like a lot of cells, it may be as little as 0,1% of the total cell population in the tissue. Unfortunately, the small percentage of ASCs available in fat is a major restriction from offering reliable and effective cosmetic treatments on a commercial scale. However, recent research has demonstrated that a subsequent expansion of stem cells in the laboratory is technically feasible to produce a sufficient high number stem cells to offer natural cosmetic treatments reliably and effectively.

The Therapies

The potential of stem cells in medical therapies is no new concept. Since findings in the 1960s, stem cells have received much recognition for their unique repair abilities. They are used today to treat leukemia and related bone/blood cancers through bone marrow transplants. They have also been the study object of many research trials around the world ranging from various heart conditions to different types of arthritis, Parkinson, wound healing, diabetes, and inflammatory bowel diseases to mention a few.

The safety record from all the stem cell trials using autologous ex vivo expanded ASCs have been very encouraging with no unintentional side effects reported. XXXX from Anne..

Despite, all the efforts and potential of stem cells, it has proved difficult to turn the results into commercially viable treatments. The reasons are many and are a mix of technical, practical, regulatory, and financial considerations.

However, recent progress made in this area entail that the world may be on the verge of a medical revolution centered around harnessing the body’s own powerful source of repair material to treat a wide range of ailments, and even body part replacements. With regards to aesthetic treatments harnessing the stem cell beneficial properties, the future is already here as presented by Stemform.

Cosmetic Treatments

In cosmetic treatments, there is much confusion as to what constitute stem cell therapies. The reasons are many and include smart marketing people associating their treatments with the words “stem cells” to benefit from the positive attributes of the very same.

However, labelling a procedure as a stem cell treatment does not automatically make it so, and certainly does not make the results any better than conventional procedures.
Some private clinics and hospitals claim to offer stem cell treatments for breast augmentations, facial filling, skin rejuvenation etc.

It is important to distinguish between the following terms and cosmetic treatments:

Conventional lipofilling: Autologous fat (patient’s own fat) only

Cell-assisted lipofilling: Autologous fat + autologous SVF (patient’s own fat enriched with various cells types found in the stromal vascular fraction

Stem cell enriched lipofilling: Autologous Fat + autologous ex-vivo expanded ASCs (Stemform proprietary technology)

Stem cell filling: Autologous ex-vivo expanded ASCs (Stemform proprietary technology)

Conventional lipofilling is widely known and offered in modern plastic surgery clinics and hospitals. However, the results are highly unreliable with graft retention expected between 20%-50%. In effect, only 20-50% of patients’ expectations are met.

Cell-assisted lipofilling is offered by only a few private clinics and hospitals around the world offer (a.k.a SVF treatments). These treatments are sometimes labelled stem cell treatments for marketing purposes even though stem cells may only comprise 0,1% of the total cell population in the SVF, and even less as a concentration to fat. In cell assisted lipo-transfers, the surgeon harvests more fat than needed to obtain SVF cells, which are then mixed with the autologous fat tissue to form the transplant for breast augmentations, facial filling, or for skin rejuvenation. However, the concentration of SVF cells to fat remains low, and the concentration of ASCs to fat is so low that it is hardly different to what you can find in normal adipose tissue. This is most likely the reason, why most scientists conclude that there is no difference in fat graft survival between fat graft enriched with SVF vs conventional lipofilling.

Stem cell enriched lipofilling and stem cell filling are Stemform’s proprietary innovations (link to Stemform way), which involve significantly expanding the patient’s ASCs in a laboratory (ex vivo) before injecting them alone or as a mix with autologous fat to form the transplant for breast augmentations, facial filling, and/or for skin rejuvenation. The results of this innovative method are remarkable.

The simple conclusion is that ASC numbers / ASC concentration to fat matter.

Numbers matter

One possible mechanism underlying the Stemform innovation is that ASCs — being more resistant to low oxygen tension than mature fat cells — will survive the cosmetic procedures better and, thus, differentiate into new fat cells, start repairing damaged cells, and help secure the supply of proteins and nutrients to the transplant, thereby replacing/preventing the well-known high ratio of hypoxia-induced death of fat cells.

If a great number of mature fat cells die shortly after the procedure, there needs to be enough other cells (i.e. ASCs) to survive for the treatments to be effective.

In other words, boosting the number of ASCs to fat ensures a significantly better survival of the graft, thereby creating a reliable cosmetic filler outcome.

All Stemform cosmetic treatments rely on a minimum of 20 million ASCs per ml fat to ensure a high-quality result. In conventional lipofilling, this number is around 10 thousand ASCs per ml fat. In cell assisted lipofilling, the concentration is only a fraction higher than conventional lipofilling and thus remains in the thousands of ASCs per ml fat. Where graft retention is boosted to >90% (measured by MRI after 4 and 12 months) when using a 20 million ASCs per ml fat concentration, the similar measure drops to 20-50% when relying on conventional lipofilling with 10 thousand ASCs per ml fat.

*SVF isolated from 100 ml condensed fat contains around 1-3 million ASCs along with 97-99% other cells