Objectives: While regenerative medicine has been a popular topic for the last decade, only recently has technology improved to the point where the average practitioner can utilize this in daily practice. "Stem cells" are a selling point in specialties ranging from orthopedics to dentistry, chiropractic medicine, and veterinary specialties. While growth factors and PRP have been available for many years, variable outcomes have hindered popularity. New mechanical processing units which produce nanofat and follicular stem cells are FDA approved.
Introduction: The popularity of nanofat has rapidly increased during the past two years. While there are no adipocytes in nanofat, one cc of the substance contains thousands of progenitor cells. Easily obtainable from human adipose cells, the substance is the end product of a series of "milling" processes. Another type of stem cell produced mechanically are FSCs, follicular stem cells. Nanofat can be used alone or in combination with macrofat, milli fat, and microfat. FSCs are used for reversal of miniaturization of the hair follicle. FSCs don't regenerate hair in bald regions, but do improve density.
Materials / method: Nanofat can be mechanically produced using a cube into which millifat is injected. Three rounds of processing produce a substance which can be injected with a 30 gauge needle. Three follicular plugs of donor hair are taken from the occipital scalp, trimmed, and processed in a small device into tiny particles. Both products can be combined with PRP or growth factors. Injection sites for nanofat can be intradermal, or combined with other fat products, injected subdermal. FSCs are injected into regions with fine or thin hair, but not bald regions. No real down time is needed.
Results: Clinical improvement in areas ranging from muscle thickening to epidermal resurfacing have been seen with the use of injected nanofat. Topically applied nanofat following microneedling has not shown dramatic results due to the rapid death of cells due to dessication. The ability to perform intradermal injections has application as a filler replacement. FSCs injected in regions where hair is thin and short has shown great promise, especially in younger patients. Low down time and affordability is noted in filler applications, hair restoration, resurfacing, and treatment of striae.
Conclusion: A new avenue of regenerative medicine is available for the aesthetic practitioner. While this does involve harvest of either fat or hair follicles, the mechanical processing of donor tissue averages about $500 euros per disposable. No centrifuge is needed. Nanofat can be used by itself or in combination for intradermal filling, or for enhancing fat grafting. "Resurfacing" or dermal regeneration improves over time. Follicular stem cells, also processed with a milling type device, can be injected in areas of miniaturization of the hair follicle is present, reducing the need for hair transplants.
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