EXTON, Pa., June 22, 2011 – Fibrocell Science, Inc. (OTCBB:FCSC.OB), a cell therapy company focused on the development of autologous (personalized) cell therapies for aesthetic, medical and scientific applications, announced today that the U.S. Food and Drug Administration (FDA) approved the Company’s Biologics License Application for its lead product, laVív® (azficel-T) late last night. laVív is the first and only personalized aesthetic cell therapy approved by the FDA for the improvement of the appearance of moderate to severe nasolabial fold wrinkles (smile lines) in adults. In clinical trials, laVív was well tolerated with the majority of adverse events being injection-site reactions that were of mild to moderate intensity and resolved within one week.
The cells are the patient's own, removed and grown outside the body for reinjection.
The patented technology behind laVív is an advanced process that extracts and multiplies a specific kind of a person’s own skin cells (fibroblasts) to create LAVIV, which is then injected into the patient to improve the appearance of smile lines. In normal skin, fibroblasts are responsible for producing collagen.
While this therapy probably works an even better one would include added steps to select fibroblast cells which are least damaged from aging, more steps to rejuvenate those cells (e.g. make longer telomeres and reduce the DNA methylation that accumulates with age. Techniques to make cells younger and less damaged will lower the risks of cell therapies while at the same time make the therapies more effective and longer lasting.
Since the cells get injected a few times over a few months and then they divide and make collagen it takes months for the full benefit.
“The concept of using a patient’s own collagen-making cells is a revolutionary way to help treat nasolabial fold wrinkles and help restore a fresh appearance,” said Dr. Robert A. Weiss, Clinical Associate Professor, Johns Hopkins School of Medicine and Director, Maryland Laser Skin & Vein Institute, and an investigator for the LAVIV clinical trials. “Since this is a biological process that works over time, LAVIV is able to provide gradual and natural-looking results.”
We could have more stem cell therapies with existing biotechnology. How about anterior cruciate ligament repair with stem cells? Stem cell therapy to fix race horse joints is already done because animal treatments are much less regulated than human treatments. I never realized before that I had an important reason to like horse racing: the revenue from horse racing helps fund rejuvenation therapies that will also some day get used to treat humans. The same is true for pet stem cell therapies.
(thanks Lou Pagnucco for the latter 2 links)
This Wall Street Journal article is worth reading in full. Stanford researchers find that young people shown what their faces will look like in their 60s become more willing to save for retirement.
In one experiment, young people who saw their elderly avatars reported they would save twice as much as those who didn't. In another, students averaging 21 years of age viewed avatars of themselves that smiled when they saved more and frowned when they saved less. Those whose avatars were morphed to retirement age said they would save 30% more than those whose avatars weren't aged.
The potential real-world applications of the Stanford research are promising. "An employee's ID photo could be age-morphed and placed on the benefits section of the company's website," says Dan Goldstein of London Business School, another psychologist who worked on the project.
The thinking is that people who can see what they'll look like when old become better able to identify with their older self. The future self becoming less of a stranger makes people perhaps more sympathetic with that future person and more eager to take steps to help out that future person.
To use this capability only to get people to save more would be a waste. What's needed is a tie-in with efforts to develop rejuvenation therapies. Software that shows us aging to a point and then reversing aging could help build up support for the development of such therapies. Imagine watching a time-lapsed video of your aging face up to, say, age 60. Then the software would show different kinds of rejuvenation therapies applied. For example, one kind of cell therapy could restore areas that droop due to less collagen or other specific changes. Another kind of cell therapy could regrow receded gums on teeth.
Does any open source software for facial aging exist? It would be worth taking a crack at developing this capability for public web sites.
Reviewing a collection of 120 facial CT scans taken for other, unrelated medical reasons, plastic surgeons measured changes that occurred to facial bones over time. The CT scans were divided equally by gender and age, 20 men and 20 women in each of three age groups: young (ages 20-36), middle (41 to 64), and old (65 and older). Researchers used a computer program to measure the length, width, and angle of the mandible, or jaw bone, for each scan, and compare the results for each group. Using CT scans for this study allowed for more accurate three-dimensional reconstruction and increased accuracy of measurements, disputing previous research that relied on traditional head x-rays and suggested that the jaw bone expands with age.
So facial rejuvenation will require guiding bone development to gradually restore youfhful proportions and thicknesses.
The angle changes and jaw bone volume decreases.
The angle of the jaw increases markedly with age, which results in a loss of definition of the lower border of the face, according to the study. Jaw length decreases significantly in comparisons between the young and middle age groups, whereas the decline in jaw height from the middle to old group was noteworthy.
“The jaw is the foundation of the lower face, and changes to it affect facial aesthetics,” said Howard N. Langstein, M.D., professor and chief of Plastic and Reconstructive Surgery at the University of Rochester Medical Center. “These measurements indicate a significant decline in the jaw’s volume as a person ages, and therefore less support of soft tissue of the lower face and neck.”
To do bone rejuvenation we'll need youthful stem cells to make new osteoclasts and osteoblasts for resculpting the bones. We'll also need techniques for guiding the cells to reshape bones in desired ways. My guess is a lot of people will opt for new faces that make them even more attractive than they were when young the first time.
We do not just lose the ability to make hair pigment as we get older. Oh no, it is worse than that. Old hair cells pump out hydrogen peroxide (a toxic compound!) which turns our hair white.(thanks Lou Pagnucco for the heads-up)
Wash away your gray? Maybe. A team of European scientists have finally solved a mystery that has perplexed humans throughout the ages: why we turn gray. Despite the notion that gray hair is a sign of wisdom, these researchers show in a research report published online in The FASEB Journal (http://www.fasebj.org) that wisdom has nothing to do with it. Going gray is caused by a massive build up of hydrogen peroxide due to wear and tear of our hair follicles. The peroxide winds up blocking the normal synthesis of melanin, our hair's natural pigment.
This reinforces a belief I've long held: some of our cosmetic changes as we age aren't just cosmetic. The causes of the age-related changes in appearances exact a larger toll on the body. Hydrogen peroxide is toxic. We don't just go gray. Our heads get bathed in the constant release of a peroxide. When you see gray hairs in the mirror think "poison".
"Not only blondes change their hair color with hydrogen peroxide," said Gerald Weissmann, MD, Editor-in-Chief of The FASEB Journal. "All of our hair cells make a tiny bit of hydrogen peroxide, but as we get older, this little bit becomes a lot. We bleach our hair pigment from within, and our hair turns gray and then white. This research, however, is an important first step to get at the root of the problem, so to speak."
My guess is that skin aging similarly causes the skin cells to release compounds that make us less well in the rest of our body. If we could rejuvenate our skin cells we'd probably feel better as a result.
Our hair follicle cells do not make enough of the catalase enzyme which breaks down hydrogen peroxide. Would a gene therapy help or do we need cell therapy that replaces the aged cells?
The researchers made this discovery by examining cell cultures of human hair follicles. They found that the build up of hydrogen peroxide was caused by a reduction of an enzyme that breaks up hydrogen peroxide into water and oxygen (catalase). They also discovered that hair follicles could not repair the damage caused by the hydrogen peroxide because of low levels of enzymes that normally serve this function (MSR A and B). Further complicating matters, the high levels of hydrogen peroxide and low levels of MSR A and B, disrupt the formation of an enzyme (tyrosinase) that leads to the production of melanin in hair follicles. Melanin is the pigment responsible for hair color, skin color, and eye color. The researchers speculate that a similar breakdown in the skin could be the root cause of vitiligo.
"As any blue-haired lady will attest, sometimes hair dyes don't quite work as anticipated," Weissmann added. "This study is a prime example of how basic research in biology can benefit us in ways never imagined."
So your cells get too old and they start spewing toxins. That makes them age even more rapidly and things go from bad to worse in a vicious cycle. What's the answer? We need therapies to rejuvenate our bodies. We start with youthful healthiness. But things start falling apart. Everything else is the slow slide into disease.
Laure Rittié, Ph.D., and colleagues at the University of Michigan Medical School, Ann Arbor, recruited 70 healthy volunteers (40 postmenopausal women and 30 men, average age 75 years) with photodamaged skin. For two weeks, volunteers were treated with estradiol three times every other day both on sun-protected areas near the hip and photodamaged skin on the forearm; a 4-millimeter biopsy (tissue sample) was taken from each treatment area 24 hours after the last treatment. Participants also applied estradiol, incorporated into moisturizing cream, to their faces twice per day during the two weeks. A 2-millimeter biopsy was taken from the crow's-foot area near the eye before and 24 hours after the last treatment.
But this treatment does not work on skin suffering from sun damage.
After the two-week treatment period, applying estradiol to the sun-protected hip skin increased levels of collagen and other compounds that promote its production in the women and, to a lesser extent, in the men. "Surprisingly, no significant changes in production were observed in women or men after two-week estradiol treatment of photo-aged forearm or face skin, despite similar expression of estrogen receptors [protein molecules to which estrogen binds] in aged and photo-aged skin," the authors write.
"These findings suggest that menopause-associated estrogen decline is involved in reduced collagen production in sun-protected skin," the authors write. "Because photo-aging is superimposed on natural aging in sun-exposed areas of the skin, our results suggest that alterations induced by long-term sun exposure hinder the ability of topical estradiol to stimulate collagen production in aged human skin in vivo."
This seems doable pretty much immediately. Estradiol is already available. At least in the United States doctors have broad authority to use approved drugs for unapproved reasons. So a willing doctor could write a prescription for estradiol mixed into a cream carrier.
"Frankly, we were very surprised to find that stimulation of collagen production by topical estrogen treatment was restricted to skin not chronically exposed to sunlight. These results suggest that sun exposure alters the ability of skin to respond to topical estrogen, and point out how difficult it is to repair photoaged skin," Rittie says. The study appears in the new issue of the Archives of Dermatology.
I wonder whether transfer of skin cells from a more shaded part of the body to the face would lead to facial skin that is more responsive to estradiol.
DALLAS — June 24, 2008 — Rejuvenating newly identified fat compartments in the facial cheeks can help reduce the hollowed look of the face as it ages, according to new research by plastic surgeons at UT Southwestern Medical Center.
Researchers used special dyes to identify and map four cheek-fat compartments hidden deep beneath the skin. When these compartments are restored using fat, tissue fillers or artificial implants, the result is a more youthful and less hollow look to the overall face, according to Dr. Joel Pessa, assistant professor of plastic surgery.
Restoring these compartments also improves volume loss under the eyes, helps eliminate lines around the nose and mouth and gives more curve to the upper lip, all of which restore a more youthful appearance to the face, Dr. Pessa said.
I continue to wonder why facial fat shrinks with age while fat in other parts of the body tends to grow in size. I also wonder where plastic surgeons take fat from in order to fill in the face. If they take the fat from the stomach is there a harm to health for the same reason that a fat stomach correlates with cardiovascular and other health risks more than fat on the hips?
Does Angelina Jolie still have a natural face? Or has she had facial fat implants?
“This research breaks new ground by identifying the boundaries of specific fat compartments that are key to facial rejuvenation involving the cheeks, and as a consequence, the overall look of the face,” said Dr. Pessa, a co-author of the study, which appears in the June issue of Plastic and Reconstructive Surgery. “Cheeks are vital to what we consider beautiful — from chubby-cheeked infants to Hollywood stars like Angelina Jolie.”
Lots of people get fat injections but far more get hyaluranoic acid injections (which last for a much shorter period of time).
Plastic surgeons performed nearly 8,000 cheek implants in 2007, according to the American Society of Plastic Surgeons. In addition, nearly 47,000 fat injections and 1.1 million injections with hyaluronic acid fillers were performed last year.
ARLINGTON HEIGHTS, Ill. – Not only are cheeks central to your face – they are central to the American concept of beauty. A study in June’s Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS), found that a deep fat compartment located within the cheek is vital to a youthful-looking face. Not only does rejuvenating or returning volume to this fat compartment make the cheek more youthful, it also improves volume loss under the eyes, helps eliminate “parentheses” lines around the nose and mouth and gives more curve to the upper lip – essentially restoring a youthful appearance to the overall face.
“From the irresistible urge to pinch the cheeks of adorable infants to our admiration of Hollywood stars like Audrey Hepburn and Angelina Jolie, we’ve known for a long time that cheeks are vital to what we consider beautiful,” said Joel Pessa, MD, ASPS Member Surgeon and study co-author. “Adding volume rather than lifting is not a revolutionary concept in plastic surgery. But the idea that restoring volume to deep cheek fat will affect so many areas of the face is a breakthrough in our understanding of how to better treat facial aging.”
Why do fat compartments in the face shrink in the first place? In other parts of the body people fight lifelong battles with too much fat. Are we some day going to get fat stem cell injections in our faces?
STANFORD, Calif. - Researchers at the Stanford University School of Medicine have reversed the effects of aging on the skin of mice, at least for a short period, by blocking the action of a single critical protein.
The work could one day be useful in helping older people heal from an injury as quickly as they did when they were younger, said senior author Howard Chang, MD, PhD, assistant professor of dermatology. However, Chang and his colleagues warned their finding will likely be useful in short-term therapies in older people but not as a potential fountain of youth.
Imagine the size of the market if this could be done safely. Even a risky way to do this would have a big market if regulatory agencies allowed drugs for restoring youthful appearances to be sold with known publicized risks.
NF-kappa-B regulates gene expression. Gene expression changes as we get older. Suppression of NF-kappa-B restored a more youthful pattern of gene expression and made mice look younger.
Chang said people had long known that NF-kappa-B winds its way into a cell's nucleus to control which genes were active. What they didn't know is that many of those genes regulated by the protein have a role in aging.
Chang and Adler tested whether blocking the activity of NF-kappa-B in the skin of older mice for two weeks had a youthful effect. "We found a pretty striking reversal to that of the young skin," Chang said.
First they looked at the genetic changes resulting from blocking NF-kappa-B. After two weeks, the skin of 2-year-old mice had the same genes active as cells in the skin of newborn mice-a striking difference when compared with the skin of a normal 2-year-old mouse. The skin looked more youthful too. It was thicker and more cells appeared to be dividing, much like the skin of a younger mouse.
Sounds great. So why not just develop drugs that suppress NF-kappa-B and slather them on our faces? We'd run the risk of getting cancer.
Chang and Adler caution that their findings aren't likely to be the source of the long-sought fountain of youth. That's because they don't know if the rejuvenating effects of NF-kappa-B are long-lasting. Also, the protein has roles in cancer, the immune system and a range of other functions throughout the body. Suppressing the protein on a long-term basis could very well result in cancers or other diseases that undermine its otherwise youthful effect.
Effective non-toxic cures for cancer would enable the use of many rejuvenation therapies. Lots of mechanisms by which cells become less active as we age are probably anti-cancer defenses. Turning down the metabolism of old damaged cells reduces their ability to start dividing uncontrollably. Only a very very small fraction of all old cells have accumulated the right set of mutations needed to start a cancer. But the body has to suppress a much larger number of cells in order to make sure the smaller number which are near cancerous won't develop into fully cancerous cells.
Another possibility: Gene therapies will some day repair cells that have mutations that increase the risk of cancer. Then drugs that suppress NF-kappa-B could be applied to the skin without risk of cancer.
Using CT scans of 100 men and women, the researchers discovered that the bones in the human skull continue to grow as people age. The forehead moves forward while the cheek bones move backward. As the bones move, the overlying muscle and skin moves as well and that subtly changes the shape of the face. "The facial bones also appear to tilt forward as we get older," explains Richard, "which causes them to lose support for the overlying soft tissues. That results in more sagging and drooping."
The problems from these aging changes extend beyond cosmetic concerns. Drooping tissues around the eyelids can lead to vision problems, dry eyes, and excessive tearing.
Richard and colleague Julie Woodward, MD, Duke's head of oculoplastic and reconstructive surgery, also determined that women experience more rapid bone changes then men. That, says Richard, opens new areas of research, including the role of menopause in facial bone growth, and whether drugs commonly used for osteoporosis may affect the aging changes seen in the facial skeleton.
This study by researchers at Duke University reaches conclusions similar to a previous study at Stanford. For the results from Stanford see my post. Facial Bone Aging Contributes To Aged Appearances.
DALLAS — Aug. 6, 2007 — The longstanding idea that the entire human face ages uniformly is in need of a facelift, say researchers at UT Southwestern Medical Center who have found that multiple, distinct compartments of fat in the face age at different rates.
The findings, published in a recent issue of Plastic and Reconstructive Surgery, challenge previously held theories regarding aging and may offer new ways to help turn back the clock, UT Southwestern plastic surgeons say.
“For hundreds of years, everyone has believed that the fat on the face is one confluent mass, which eventually gets weighed down by gravity, creating sagging skin,” said Dr. Joel Pessa, assistant professor of plastic surgery and the study’s lead author. “In our studies, however, we were surprised to find that this is not the case; the face is made up of individual fat compartments that gain and lose fat at different times and different rates as we age.”
We lose the smooth continuous appearance of our faces as the compartments shift, shrink, and grow in size.
The study involved injecting different types of dye into facial cavities of 30 cadavers. Despite at least 24 hours of settling time, the dye, rather than permeating the entire face, stayed in separate areas — showing that individual facial compartments have boundaries between them that act like fences. These fences, which seem to be composed of fibrous tissue, allow the face to maintain its blood supply should it become injured.
Dr. Pessa said the face resembles a three-dimensional puzzle, with fat divided into distinct units around the forehead, eyes, cheeks and mouth. Facial aging is, in part, characterized by how these separate compartments change as we grow older.
A youthful face is characterized by a smooth transition between these compartments. As people age, contour changes occur between these regions due to volume losses and gains as well as repositioning of the compartments. Eventually, this can result in sagging or hollowed skin and wrinkles.
We need youthful fat cells to put into the facial cavities that hold our aging facial fat tissue. Plastic surgeons of the future are going to become stem cell therapists who deliver rejuvenated stem cells into many parts of the body. We need a more rapid rate of advance in stem cell research so that we get these youthful stem cells sooner.
The demand for beauty enhancement treatments is growing so rapidly that doctors from other specialties are switching fields to complete against dermatologists and plastic surgeons. The New York Times reports that dermatologists and plastic surgeons are complaining that doctors from other specialties lack the training needed to properly provide competent service.
Dermatologists and plastic surgeons refer to their new colleagues as “out of scope” or “noncore” physicians, and they strongly object to the intrusion, insisting that cosmetic medicine requires lengthy training.
But the dispute also has all the elements of a turf war, with specialists reluctant to cede ground in a field in which Americans spend an estimated $12 billion a year.
“Dentists are doing Botox, and urologists are doing hair transplants and vein removal,” said Dr. Ellen Gendler, a dermatologist in Manhattan who is a clinical associate professor at New York University School of Medicine. “Everyone wants to be a plasticologist.”
For their part, some doctors from other fields contend that the latest cosmetic procedures, like facial injections and vein removal, are far less complicated and risky than Caesarean sections or appendectomies and that the fundamentals can be learned in continuing-education classes.
Certainly some of these treatments are not hard to deliver and even a nurse could be trained to do them. But I'd be really hesitant to have plastic surgey on my face by someone who until recently was delivering babies or removing appendixes. Buyer beware. Try to meet people who have used a particular doctor for the type of treatment you want. Look up information about malpractice lawsuits. Be careful.
Family docs are switching to beauty therapies and cosmetic treatments.
The American Academy of Family Physicians, a national group that represents 94,000 family practitioners and medical students, has started offering courses for its members on how to use Botox, facial fillers, lasers and chemical peels.
As I've argued previously, the growing popularity of therapies aimed at rolling back the signs of aging and increasing beauty are great market signals that provide great incentives for the development of more effective treatments. I expect the more entrepreneurial market for optional but popular plastic surgery and dermatological treatments will pioneer many stem cells therapies and gene therapies.
Although men still comprise only 12% of all cosmetic surgery patients, a growing number are seeking minimally invasive procedures to take the edge off aging. From 2000 to 2005, the number of men seeking these procedures increased 44% to 911,850, according to the American Society of Plastic Surgery.
The two biggest factors driving this trend, say experts, are the advances in products used to minimize wrinkles, and a growing feeling among men that getting cosmetic procedures is acceptable. "Men used to say, 'So what? I'm a guy. Who cares?' " says Dr. Brian Kinney, a Los Angeles-based plastic surgeon. "Now they do care. A lot of guys reach age 35 and want to nip any signs of aging fast. They consider it part of their upkeep."
Are guys doing this more to look young and virile in the workplace or in order to be more appealing to women?
I think having a middle aged or old aged look used to be more of a prerequisite for moving up the corporate ladder in large and slow changing corporations. Now the examples of business success tend to be guys in their 20s and 30s who made it big in venture capital start-ups. Youthfulness is more correlated with the qualities needed to success in business. So I'd expect a middle aged guy who wants to present his ideas to venture capitalists to worry that the VCs want to see someone young and energetic looking. Hence the desire for treatments that help a guy look bright eyed and bushy tailed.
What's the best news in all this? The bigger demand for treatments that simulate youth also means a bigger the demand for products that actually restore youth. All those guys who are buying the nip/tuck treatments are a potential market for stem cell therapies. People making pitches to venture capitalists to fund a start-up to develop stem cell therapies for facial collagen production are going to be able to point at the big bucks guys and gals are willing to spend on plastic surgery.
We are already seeing crude forms of cell therapies now where fat cells are taken from other parts of the body and injected into the face in order to restore shrunken facial appearances. Methods to train cells to grow and to become other cell types will be eagerly embraced by plastic surgeons and plastic surgery patients. Their demand for stem cell therapies will provide revenue flows to fund refinements of the first stem cell therapies that hit the plastic surgery market.
Cincinnati, OH (October 24, 2006) -- A new study is revealing that wrinkles aren't the only cue the human eye looks for to evaluate age. Facial skin color distribution, or tone, can add 10-12 years to a woman's perceived age.
The study, published in the latest issue of the journal Evolution and Human Behavior, used three-dimensional imaging and morphing software to remove wrinkles and furrows from pictures of women, leaving skin tone as the only variable. Researchers were then able to determine exactly what impact facial skin tone has on how young, healthy and attractive people perceive the women to be. Faces with more even skin tone were judged to be younger.
"Until now, behavioral scientists have mostly ignored the overall homogeneity and color saturation of a person's skin," says lead researcher Dr. Karl Grammer. "This study points out that wrinkles aren't the only visual cue to a woman's age.
"Skin tone and luminosity may be a major signal to suitors of a woman's attractiveness, as well as of her assumed age," said Grammer, who is founder and scientific director of the Ludwig-Boltzmann-Institute for Urban Ethology at the University of Vienna, Austria.
The researchers used software to take skin of women of different ages and electronically drape on onto a single standardized underlying facial structure. Then they showed these images to hundreds of observers who rated the age of each picture.
The researchers took digital photographs of 169 Caucasian women between the ages of 10 and 70. Then they used specialized morphing software to "drape" each subject's facial skin over a standardized model, in effect, taking 169 different skin tones and applying them to a common canvas.
In the process, other potential age-defining features such as facial furrows, lines and wrinkles were removed, leaving skin tone as the only variable. Then, these models were viewed by 430 observers who were asked to estimate each model's age and gauge her health and attractiveness.
The models who had the most even skin tone received significantly higher ratings for attractiveness and health, and were also judged to be younger in age. The models with uneven, blotchy skin tone were judged to be significantly older.
"Whether a woman is 17 or 70, the contrast of skin tone plays a significant role in the way her age, beauty and health is perceived," says study co-author Dr. Bernhard Fink. "An even skin tone can give visual clues about a person's health and reproductive capability, so it is considered most desirable."
Women (and men for that matter) who go for plastic surgery to lift and tuck ought to look at techniques for making skin color more even. Anyone know of safe home remedies that decrease skin discoloration?
These researchers will next look at the distribution of melanin, hemoglobin, and collagen for effects on skin tone.
Next Phase of Tone Research – Getting Under the Skin As a next step, Drs. Grammer and Fink will partner with scientist and skin imaging expert Dr. Paul Matts, from P&G Beauty (a division of Procter & Gamble that funded the study) to look at the distribution of 3 chromophores – melanin, hemoglobin, and collagen -- in the skin of study subjects and correlate this distribution with perceived attractiveness. A non-invasive imaging technology called SIAscopy--originally developed by UK-based Astron Clinica for early skin cancer detection--will help the scientists study the chromophores. These 3 chromophores directly affect how the human eye perceives qualities such as luminosity in young skin or dullness in aging skin.
Venture capitalists, biotech companies, and beauty products companies would all do well to pay attention to these results. Products that remove damaged clumps of melanin and other accumulations of intracellular and extracellular trash will find a large market.
Accumulation of junk both in and outside of cells is a major cause of aging. The accumulated trash is probably a source of free radicals and also crowds out cellular components that perform basic tasks. The development of full body rejuvenation therapies will be helped by the development of products that remove accumulated trash from the skin. The widespread willingness to spend big dollars to enhance outer appearances will therefore accelerate the development of rejuvenation biotechnologies.
STANFORD, Calif. — Gravity and sagging skin aren’t the only roadblocks to a perpetually youthful face. Aging facial bones may be just as guilty of the telltale signs of advancing years, according to new research from the Stanford University School of Medicine.
This “dramatic” aging of facial bones also happens at a significantly younger age for women than men.
“As the skin sags, the bony framework underneath the skin deteriorates as well, contributing to the development of new folds, creases, wrinkles, droops and valleys,” said David Kahn, MD, assistant professor of plastic and reconstructive surgery. Crow’s-feet, drooping brows, sagging facial folds—it’s not just skin deep.
Two studies by Kahn and Robert Shaw, MD, a resident at the University of Rochester Medical Center who was a medical student at Stanford when the research was conducted, document this problem. The second study is being presented Oct. 10 at the American Society of Plastic Surgeons yearly convention in San Francisco; the first was presented at the same conference last year and is scheduled for publication this winter.
In a way this is disturbing. Look at yourself in the mirror. It isn't just the soft stuff that is aging and thinning. Your facial bones are decaying while you are alive.
Skin rejuvnation is not sufficient to rejuvenate appearances.
“If plastic surgeons attempting facial rejuvenation are only considering skin changes, it’s not enough,” Kahn said. “Skin tightening, collagen and fat injections, Botox injections, don’t take into account changes to the bones.”
Today’s single-dimensional approach to facial rejuvenation, Kahn said, may explain the sometimes-negative results of plastic surgery to the face that can result in odd, distorted looks.
“After you do a face-lift on some patients and look at photos of them when they were young, they look very different,” said Shaw. “Part of that may be the tightening of the skin over a bony scaffolding that has deteriorated and changed in shape from when they were 18.”
There’s a change in morphology or shape to the bones as well as a general shrinkage, Shaw said.
Dr. 90210 can't turn back the clock all that much. We need better treatments that go deeper.
Women experience facial bone aging sooner than men.
For the two studies, the researchers analyzed 30 men and 30 women separately using advanced, three-dimensional, computerized reconstruction of the facial skeleton. The participants were separated into three different age groups identified as young (25 to 44), middle-aged (45 to 64) and old (65-plus). They then measured the various bony structures in the face—the slope of the cheekbone and the opening for the nose, for example—and compared these changes between age groups and genders.
“In general, for most of our measurements, women experienced aging between young and middle age, and the men between middle age and old,” Shaw said.
Specific changes to different bony structures in the face seem to correlate with the various well-known visible changes to the face due to aging, Kahn said. Changes to the orbital aperture, or bony area around the eye, for example, could account for crow’s-feet and the drooping of the skin above the eye.
Aging bones in the cheeks could be part of the cause of the deepening of the creases between the lips and the nose and could cause the fat pad in the cheeks to sag and become more prominent. Much of these changes may be due to decreasing bone support, Kahn said.
The earlier aging of facial bones in women than men parallels the earlier aging of skin in women than in men. What I find puzzling about this is that women live longer than men on average. In more essential parts of the body men wear out more rapidly than women do. What accounts for this pattern of differences in body aging between men and women? Is it due to selective pressures where since women lose fertility sooner than men they also lose the need to look physically attractive sooner than men lose that need?
Plastic surgeons can implant materials that will lift up the skin. But we really need stem cell and gene therapies that'll up the supply of healthy young osteoblast cells. The osteoblasts build up bone while the osteoclasts tear it down.
The aging process also reduces muscle mass and increases fat. So full rejuvenation of appearances will require rejuvenation of skin, collagen, cartilage chondrocyte cells, bone osteoblasts, muscles, capillaries, and likely other cell types and structures as well.
Strangely enough, the fact that aging appearances have so many causes is a reason to be optimistic about the rapid development of rejuvenation treatments. People are willing to spend big money on treatments to improve their appearances. Plastic surgery is a rapidly growing industry. Biotech companies are developing cell therapies to treat hair loss and other signs of aging. The identification of a greater list of causes of aging appearances translates into demand for a larger range of products to make people look young again. The greater demand will spur more development of appearance rejuvenation treatments. Some of the products developed to rejuvenate appearances (e.g. stem cell therapies to restore facial bones) will also reverse aging in the rest of the body.
Physicists and medical researchers for the first time have demonstrated a new technique that non-invasively measures in real time the level of damage to the skin from sun exposure and aging, and initial results suggest that women’s skin ages faster than men’s. Findings appear in the October 1 issue of Optics Letters, a journal of the Optical Society of America.
This new laser-based technique images the fabric of the deeper layers of the skin, combining methods for imaging collagen and elastin, whose degeneration causes the appearance of wrinkles and the progressive loss of skin smoothness. The technique measures relative amounts of collagen and elastin by a single factor, which can be positive or negative, like temperatures. Higher values of the factor correspond to higher collagen content, and to lower elastin content. Previously, each of the imaging techniques had only been tested on tissue extracted from live patients. Last year, Sung-Jan Lin, of National Taiwan University in Taipei, and collaborators, defined the collagen/elastin factor and demonstrated that it gave results consistent with the results of existing lab techniques.
In the new paper, researchers at Friedrich Schiller University, in Jena, Germany, at the Fraunhofer Institute of Biomedical Technology, in St. Ingbert, Germany, and at JenLab GmbH, a Jena-based laser technology company, tested the technique directly on the forearms of 18 patients, measuring the collagen/elastin factor. The team was also able to obtain images of tiny swaths -- one-fifth of a millimeter wide -- of the proteins' fibrous matrices, showing the physical appearance of the dermis, the white lower-layer of skin that gets exposed in deep abrasions.
Large variations appeared from patient to patient, and even from one part of a patient's forearm to another. “In a healthy 35-year-old, some areas can appear like the skin of a 25-year-old, and others like that of someone who's 50,” said Johannes Koehler, a dermatologist at Friedrich Schiller University and a coauthor of the Optics Letters paper. But on average, both the collagen/elastin factor and the physical appearance of the network showed a clear dependence on the patients' age. The dependence appeared to be sex-dependent, with women's skin losing collagen at faster rates than men's.
The two methods combined in the imaging technique use the ability of ultra-brief pulses of laser infrared light to stimulate tissues to emit light at shorter wavelengths -- blue in the case of collagen, and green in the case of elastin. Since the upper layer of the skin, called the epidermis, is virtually transparent to infrared light, the infrared laser can reach the dermis with intense pulses of light without damaging the upper layers. By two different quantum processes, collagen and elastin will then respond by glowing blue and green.
Skin makes a great target for gene therapies and stem cell therapies because it is so much more easily accessible than the rest of the body. Combine the accessibility of skin with the widespread willingness of people to spend large amounts of money to look younger and I predict one of the earlier stem cell therapies will be for rejuvenating the skin and its underlying layers. Plastic surgery is a booming growth injury. When the TV show Dr. 90210 shows the first women to receive stem cell therapy to make their faces look truly young again the stampede for dermal stem cell therapy will be huge.
Skin rejuvenation will provide body-wide benefits. Old skin probably generates free radicals and inflammatory compounds. Make the skin young again and that'll remove one source of oxidative stress on the body.