Dr. Sam Lam Plastic Surgery Forum

I read that you do top ups only after a year is this right. I thought I read that top ups have to be done within a few months as the fat isnt good if kept longer than this...
does the fat have stem cells in it to rejuvenate the skin.. how much of the fat should we expect to be retained.

[quote="dr. lam"]RIGHT NOW THAT IS A VOODOO COMMENT. I DON'T THINK WE KNOW BUT THE SKIN LOOKS BETTER AFTER A YEAR. MY BEST GUESS IS THAT IT HAS TO DO WITH LIGHT ON THE SKIN CHANGES BY FILLING OUT HOLES.
SML[/quote]

( I missed you!!)

A few questions onset by reading this post---

Frozen fat cells... I had no idea some doctors did that? Does it mean that some take fat out and part of it is frozen as to be used for touch-ups, some months later? ?!?!

What would happen if someone had a touch up at some months if, according to what I read from you, the final result is only seen about a year after the graft?
Doesn't a person risk to end up overfilled or weird looking if there are touch-ups before a year?
Or is it just a "waste" of fat to do it before a year, but not a problem?

I was interested in what you say is obviously a debatable matter: stem cells in fat cells. I have noticed some docs say that fat transfer can be done with stem cells or not (just looking on the net, not specifically for that matter), others seem to think that all fat transfer implies a transfer of some stem cells.
Does our fat stored in the places from where it tends to be taken for fat grafts contain stem cells? I know it is not a clear matter, but what do you tend to believe?

What areas of the body can the fat be used for the facial fat graft?
I am so slim, I wonder where on earth you'd take enough ccs to fill my cheeks... only place I think I have some extra fat (not the big deal, mind you) is in the abdomen. Do those cells work for the transfer?

Hugssssssssssss

Thank you Sam! so nice to hear from yoU!

All so well explained as usual! :)

BTW, concerning the fat stem cell and fat transfer issue, I found something online that I find interesting and seems from someone who also does not simplify things... what do you think of what was written?

"May 1, 2010
By: Rochelle Nataloni
Cosmetic Surgery Times
****************

Dr. Coleman.............

What's more, he prefers to think of these hard-working cells [color=#408040]as repair cells rather than stem cells. "Fat is not just a storage organ, it is a repair organ. It supplies repair cells that mend bone or skin or whatever part of the body it is called on to help," Dr. Coleman says. "If you put fat under sun-damaged, aging skin, then (apparently) it perceives that there is a problem, and it is directed by messengers or growth factors to repair the aging skin[/color]."

(at first)...he says, he didn't know what was responsible for these effects. "I assumed that maybe there were some hormones that I was transferring with the fat — and I still think that might be a component," he says. "But then about nine years ago, people started talking about the fact that there were many stem cells in fat. So over the last few years I started rethinking what I was doing and I started concentrating the fat with a centrifuge and using only the densest fat for grafts, and I found that the rejuvenation effects including decreased pore size and improved skin texture were even greater."

RELEVANT RESEARCH Dr. Coleman's recent research involving the effects of fat stem cells on radiation damage in animal models supports his anecdotal observations. "Our research shows that you can actually reverse radiation damage with just the placement of fat into an area that's been irradiated," Dr. Coleman says. In the study, which he performed with colleagues at New York University, four weeks after irradiation, mice were fat-grafted with 1.5 cc of lipoaspirate or sham-grafted with sterile saline. Hair growth, skin color and degree of ulceration were analyzed following irradiation.

Irradiated skin was harvested four weeks following grafting for analysis, and results showed that chronic ulceration and fibrotic skin thickening stabilized; alopecia, skin color/texture and ulceration improved in fat-grafted mice compared to sham-treated controls; antibody production significantly decreased in the treated animals; scar-index decreased 4.3-fold in the treated animals; and vascular density of irradiated skin increased in fat-grafted mice compared to controls.

Dr. Coleman says these findings suggest that fat grafting alleviates radiation skin damage by improving vascularity and downregulating the transforming growth factor pathway. This process is likely mediated by progenitor cells (stem cells) and angiogenic adipokines present in processed lipoaspirate/fat. The process probably is responsible for the improvement in skin quality in facial rejuvenation patients as well, Dr. Coleman points out.

Basically, a facelift forms the skin into a different relationship with the face in order to eliminate wrinkles and the signs of aging. Fat grafting is a more physiologic process in that it actually plumps first to make the patient look more like they did, volume-wise, when they were young, and then it repairs the skin," Dr. Coleman says"

What do you think?

Hugsssssssssssss

Dearest, always so helpful!
I only am curious why the centrifugation could not be compatible with some of those cells being or having stem cells... only asking from a strictly medical curiosity .

What makes me happy about hearing that, is from all I heard from now, I realized my dermatologist works the way you do. I told him that I will have fat transfer with YOU but it just makes me trust him more in general.

On a sidenote, the doctor will soon write a book and showed a super high interest in reading your work as a bibliography, as I told him things I learned from reading and hearing your comments over ageing, signs of ageing etc and either he agreed or intuitively was doing some of the things you were doing. He is not as good as you, I bet, but he obviously is on the same page regarding many concepts and wants me to help him with the bibliography of the book he will write, as he wants to read YOU. (And I'd be the librarian to take care of the bibliography, so you would be quoted and it would be clear what YOU said). It will take time for him to write the book, so there is plenty of time, but it would be neat if you let me know by PM or email what are all the books or info accessible so the doctor can order it and read you.
Hugsssssssssssss

THANK YOU! but the doc was actually super interested in other publications as well... your posts on the process of ageing, the issues of symmetry and asymmetry, loss of volume and how filling is sometimes the answer, not pulling the skin, etc.
All he read about you or that I told him you said interested him
THANKS!

[quote="dr. lam"]most of that stuff is in my videos. not as much printed material. sorry about that.[/quote]

It's ok! they are very informative, well recorded, and there is a standard way to make references to videos, with all the info to identify them and make sure the author of the words is recognized. "Biblio"graphies now include rules for the references to internet content, videos, etc.