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Regenerative medicine in facial and plastic reconstructive surgery reviewed

Regenerative medicine techniques and platelet-rich plasma are being studied and used to varying degrees of success, according to a literature review recently published in JAMA Facial Plastic Surgery.

“The field of regenerative medicine aims at enhancing tissue healing and regeneration through the exogenous addition of therapeutic growth factors and cells, often in combination with tissue-compatible scaffolds,” Matthew Q. Miller, MD, of the department of otolaryngology-head and neck surgery, University of Virginia Health System, Charlottesville, Virginia, and colleagues wrote. “Perhaps the biggest advances in facial plastic and reconstructive surgery (FPRS) in the upcoming years will be the result of regenerative medicine techniques.”

Researchers conducted a literature review using PubMed and searching for “regenerative medicine facial plastic surgery,” “stem cells facial plastic surgery,” “scaffolds facial plastic surgery,” and “platelet-rich plasma facial surgery” to retrieve articles dating back to at least 2010 in basic science and clinical journals.

The researchers looked at soft-tissue and bony regeneration strategies, including synthetic scaffolds, constructs that can be implanted with or without cells or growth factors in the regeneration of tissues.

Other regenerative medicine techniques reviewed included the use of stem cells, including adipose-derived stem cells, in the use of cell-assisted lipotranser to help in volume and symmetry in facial augmentation, as well as using centrifuged lipaspirate and platelet-rich plasma in the rejuvenation of the periocular aesthetic unit.

Surgeons have been slower to incorporate growth factors, proteins that are required for survival, proliferation and differentiation of various cell types, into FPRS clinical practice, the researchers wrote. Favorable results have been demonstrated in small case series in the use of the recombinant human bone morphogenetic protein-2.

Studies involving platelet-rich plasma also were reviewed with some showing positive results, but limited objective data.

“Regenerative medicine is an exciting field with the potential to change the standards of care in FPRS,” the researchers wrote. “In the near future, these novel approaches may begin to replace autologous grafting and free tissue transfer in FPRS, the current standards of care.”

“Our subspecialty has to continue to clinically investigate these techniques to show whether the new frontiers of regenerative medicine improve outcomes and cost-effectiveness in FPRS while not adding to the risks of treatment.”  – by Bruce Thiel

Disclosure: Miller reports no relevant financial disclosures. Please see the full study for other researchers’ relevant financial disclosures.