A Primer on Potential Uses of Stem Cells in Plastic Surgery w/ Dr. Steve Cohen

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Welcome to another episode of
Park Avenue Plastic Surgery Class,

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the podcast where we explore controversies
and breaking issues in plastic

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surgery. I'm your co-host, Doreen Wu.

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I'm excited to be here with Dr. Lawrence
Bass, Park Avenue plastic surgeon,

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educator, and technology innovator,
and our special guest plastic surgeon,

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Dr. Steve Cohen from
San Diego, California.

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The title of today's episode is "A Primer
on the Potential Uses of Stem Cells in

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Plastic Surgery.".

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I'm really delighted to have Dr. Steve
Cohen, a plastic surgeon in San Diego,

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California, back with
us on the podcast today.

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He is a very accomplished surgeon,

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but he has also been a
very active researcher

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in the fields of regenerative medicine,

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and particularly looking at stem cells,

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how they can be obtained from
harvested fat and how they can

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be used therapeutically,
not just in plastic surgery,

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but in a whole range of medical
applications. So, Dr. Cohen,

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welcome and thank you for joining us.

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Thank you, Larry. Nice to be here.

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Stem cells have captured the imagination
of scientists and researchers due to

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their regenerative abilities. Dr. Bass,

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we've all heard of stem cells and their
myriad of applications in medicine and

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research. Why is this an
important topic for us?

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Well,

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let's back up for a second and talk
about what plastic surgery tries to

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do and what stem cells are. So again,

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plastic surgery is designed
to rebuild or regenerate

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part of the body that's
been damaged by trauma,

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damaged by disease, affected by aging,

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or is congenitally in

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some way deficient.
And so for a long time,

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plastic surgery has tried
to rework body tissues

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borrowing from other parts of the body.

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Stem cells are cells that are
not fully differentiated and have

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the ability to turn into a muscle cell,

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a skin cell, a blood vessel lining

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cell so they're cells that
are not fully differentiated.

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And that flexibility allows
them potentially to be used

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in the service of that
plastic surgery mission.

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And that potential is so powerful,

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it's captivated the imagination
of both the public and of many,

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many in medicine.

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And Dr. Cohen, in more detail,
what are stem cells exactly?

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How could they be useful
in medicine more generally?

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There are two types that we think about.
One are your embryonic stem cells,

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which are pluripotent,

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meaning those cells can
turn into anything versus

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adult stem cells,

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which basically are mesenchymal
stem cells that have the

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ability with certain
tweaks to turn into certain

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tissues, but still somewhat
limited relative to the embryonic,

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the embryonic, we're years away.

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There are so many regulatory issues
and other things we don't fully

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understand that

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that's a science that is still
undergoing a lot of work in the lab.

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Whereas mesenchymal stem cells are
widely available either through

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harvesting them in the bone marrow
or harvesting them in our fat.

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And our fat has so many more of
them relative to bone marrow,

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that that's become a
very important source.

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So these stem cells being uncommitted,
you know, can turn into other things.

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That's the theoretical benefit.

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The practical benefit of using
these are that they have known

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effects in improving blood
supply, making new blood supply,

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reducing inflammation and
repairing tissue. So for instance,

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as a plastic surgeon,

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my first involvement in this
field was to harvest fat

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after a patient had a heart attack
because we were going to take the

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stem cells and the regenerative
cells out of the fat and inject them

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into the coronary artery
that had been now opened up.

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And those cells were gonna go into
the area of injury and they were gonna

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stabilize some of the cells that,
you know, got hit in their head.

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But we're starting to recover,

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but some were going to die and
others are going to get better,

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and hence limiting the size of the
heart attack or the injured muscle.

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So that's my first involvement.

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And when you saw some of
the anecdotal results,

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again, without realizing, without
testing the genetics of these cells,

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because some again,

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are not going to be effective and
others are going to be very effective,

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we saw amazing results.

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We saw a reduction in the
number of patients that died,

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a reduction in the number of patients
that went on to develop heart failure

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because they had more muscle intact,

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and a reduction in the number of
patients that had serious rhythm

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abnormalities because these cells
were being irritated by low oxygen and

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the heart attack. That was my
first introduction. And as I said,

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what I was convinced of is that, you know,

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we find amazing medications in fungi, in

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things like, you know, plants.

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And yet we ignore the
human body's ability to

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repair itself in a complex way. So
this is where we get these things.

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And so in plastic surgery, stem cells,

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unfortunately at the beginning
took on a lot of hype.

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Everybody was marketing stem
cell, breast augmentation,

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stem cell facelift.

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It was really disappointing because they
were taking a highly scientific field

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and turning it into kind of a circus show.

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And that led to many of
the societies condemning

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the use of these things.

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And it's been 20 years and things
are just beginning to turn around

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where people are realizing these are
going to be the future treatments that

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all of us are involved in.

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So what are some of the big studies that
are going on now that are starting to

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be done to meaningfully evaluate
the role of stem cells in different

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medical therapies?

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Well, there've been studies
by a company called Mesoblast,

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which are taking, these are stem cells
that are called allogeneic stem cells.

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So these are from patients that have
died and donated their tissues to medical

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science. You can harvest
their stem cells, purify them,

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clean them, and make them
ready to be injected.

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So there's many studies in
orthopedics and in cardiac

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that are beginning to demonstrate
effectiveness in certain disease

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conditions. And again, it
may turn out that we see,

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you know,

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a huge effect in certain
patients with angina of a

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certain variety, and we see very
little effects in another group.

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So these are the things that we have
to begin to hone in and understand.

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So if we then turn back to
aesthetic plastic surgery

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specifically what do you think
the potential applications

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are for stem cells?

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Probably going to be obtained from fat
because that's something plastic surgeons

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know how to do. So where,

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where do you see that being
applied going forward?

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So I think, you know,

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if you look at the world
landscape in the US

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most of what we're doing is
related to anti-aging or breast

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reconstruction or reconstruction
of various deficits.

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In the aesthetic world,

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I see most of the benefit
in anti-aging using stem

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cells and their associated, you know,

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elements like exosomes and other
regenerative cell populations

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as a means of reducing
the rapidity of aging in

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facial tissue.

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So I think that's going to be
something that is being done right

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now. And I'm sure this is a
question that's going to come up.

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There have been some regulatory hurdles.

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So early on we were able
to obtain stem cells using

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enzymatic dissociation,
meaning if you take out fat,

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you gotta separate out
those cells somehow.

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So how do you pluck those cells out?

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You would use an enzyme called collagenase
and that would break the bonds of

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these cells. And then with
rinsing and centrification,

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the cells have a certain weight,

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they would fall to the bottom and they
would stick to plastic and you could

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collect them,

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you could clean them further and
use them for different applications.

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But the problem was that the FDA
deemed that is more than minimal

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manipulation.

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So researchers and clinicians have
had to come up with other mechanisms

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of basically segregating
those cells from fat.

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So one way of doing it is
to harvest the cells and

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to break them down by a
process called emulsification,

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where basically you just take two syringes
filled with fat, go back and forth,

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you gradually reduce the size of the fat,

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and then you pass it through small
filters to collect what are called

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nano fat. Nano fat is unfortunately
a name that's caught on,

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but is a type of stromal vascular
fraction that is mechanically produced

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with a small number of cells. Now,
somebody comes to you and says,

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here's a good nano fat device.
Well, not all nano fat is the same.

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It's like platelet-rich plasma. One
device is going to yield more cells.

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And almost all researchers working in
this have come to their point of view

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that more cells is better.

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But because the mechanical
ways of making or collecting

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these cells retains
certain cell aggregates,

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it's not like a pure population of
cells only there seem to be more

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effective for certain things
like wound healing. Now,

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with non enzymatic techniques,
up until about a year ago,

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we're able to obtain about 40
to 50% of the yield of cells

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that we can get from an
enzyme. So less powerful,

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but still potentially effective.
About a year ago, again,

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a group that I've been
working with in out of the UK,

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basically a group of
scientists from Turkey, Israel,

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Switzerland,

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and the US have come up
with a means of harvesting

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mechanically these cells in the equivalent
amount that you get from an enzyme.

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And that's done by a combination
of emulsification to break the

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cells down centrifugation and

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certain filters that don't
filter out the excess

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tissue,

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but actually downsize the fat
into smaller and smaller particles

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until what you're left with are mainly
the cells that fall to the bottom when

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you spin them around.

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And then if you take that quantity
of cells that are about 40

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to 50% of what you get from
an enzyme, you go, well,

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where are the rest of the
cells? They haven't disappeared.

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The rest of the cells are
actually in the buffy coat.

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So if you take the buffy coat
and add that to the cells at the

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bottom, you now get something called
hybrid stromal vascular fraction,

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and it's an equivalent amount to
what you would get using an enzyme.

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So we've been able to now get
over the barriers of the FDA

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because that's mechanically produced.
Now, how else can you get nano fat?

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You can design cannulas.

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Cannulas are metal tubes
with holes in them.

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You can design those holes
to only collect nano fat.

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So you can go in and collect nano
fat. It's not quite as powerful.

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You don't get as many cells because you
haven't been able to separate as many

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with emulsification and centrification
and adding the buffy coat,

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but you get about 40% of
what you get from an enzyme.

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There are other ways of doing
this, but presently hybrid SVF,

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when you compare it to four or
five different ways of obtaining

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mechanical cells, yields
the highest number.

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So as we now overcome those barriers,

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these stem cell facelifts,

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these stem cell breast augmentations
will at least be more effective.

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But we just, again,

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have to understand how effective
that might be is still going to be

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variable based on the patient's
age, the patient's tissue,

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the patient's genetics.

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And so these stem cell
fractions that you are

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producing these from the
patient's point of view,

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would be applied in a treatment similar
to the way a fat grafting treatment

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for facial rejuvenation,
facial volume restoration,

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or for breast reconstruction,
might be applied.

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But the hope is that the healing behavior,

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the other biological effects are going
to be different than fat grafting alone.

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Because the dose of stem
cells that they're receiving

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and the biological impact of those
stem cells is so much greater

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than the very low dose of stem
cells that's present in an

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unmodified fat graft.

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Right. And also, Larry,
they're going to be, you know,

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you kind of think of it
like a menu of options.

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But in the reconstructive world,
for conditions like scleroderma,

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which are autoimmune conditions
associated with vasculitis and

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reduction of blood supply,

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these are going to be potentially
home run therapies for these

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kinds of patients. You
know, and the more cells,

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the better in aesthetics. To
me it's a question of age.

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If you are older and you
have more senescent cells,

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you want more of the effect of
these stem and regenerative cells.

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If you're younger, it probably
doesn't matter quite as much.

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You're probably getting quite the
similar effects with lower doses.

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Now let's talk about what's
coming down the pike.

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Where might we get in the next five
to 10 years? What is in the pipeline,

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Dr. Cohen?

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Well, I think, you know,

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the pipeline has got a ton of
these kinds of little devices

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and these kinds of concepts.

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But I think what's in the pipeline is
as they become more effective and more

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of us adopt them, they're
relatively inexpensive.

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So it's a matter of helping to educate
the public at why they're effective and

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why we're using them.

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I would think that most doctors doing
breast reconstruction on radiated breast

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tissue would want to use these
hybrid stromal vascular fractions

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not so much an augmentation,

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00:15:52,420 --> 00:15:57,320
but to rehabilitate the tissue perhaps
even before you put a breast implant

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in, which in the past we wouldn't
dare put into radiated tissue.

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So that will reduce the
complexity of procedures. Two:

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patients that have facial irradiation
for head and neck cancers,

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they go on to develop some pretty
serious problems related to

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non-healing wounds,
difficulty with movement,

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because muscles become very fibrotic.

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Some of these treatments may reverse
some of these conditions as well.

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So in the reconstructive world,

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I think these stem cell applications
will become really important.

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00:16:33,660 --> 00:16:34,201
You know,

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00:16:34,201 --> 00:16:39,000
we may be spraying burns with
cells that we collect from

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the patient's own fat to
heal them more rapidly in

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conjunction with skin grafting,

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00:16:47,450 --> 00:16:50,880
cranial facial abnormalities,
which are associated with, again,

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00:16:51,470 --> 00:16:54,480
loss of blood supply. So
the tissues are not normal.

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We'll be able to normalize those tissues,

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and so the results will get better
and better. You know, as time goes on.

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And as we begin to utilize these more.

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So to me,

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the key thing right
now is getting industry

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to step up to the plate to
find the pioneers and the

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00:17:16,921 --> 00:17:20,120
visionaries like a
Richard Branson type guy,

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but who runs a medical company and
realizes that the power of this is gonna

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be enormous. Once people start
to teach this on a regular basis.

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Once people begin to come up
with a systematic approach,

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and they don't go, "oh, well I
do fat grafting." Well, okay,

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but are you getting 80% volume
effects two years later because you

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do fat grafting?

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So these are the things that take kind
of a lot of effort to move the mountain.

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And again, I think we're getting
closer, but there are days where I go,

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"oh my God,

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00:17:55,001 --> 00:17:59,680
I don't think it'll ever happen and
I won't ever see this truly main

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00:17:59,681 --> 00:18:04,560
mainstream." But we really
need industry now to step into

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00:18:04,561 --> 00:18:08,040
this arena and to realize
how valuable this will be.

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Because fillers won't disappear.
Breast implants won't disappear,

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but there'll come a day
where we'll bioprint a breast

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or we'll use a cadaver
breast that has been

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00:18:21,340 --> 00:18:23,880
decellularized, put it in the patient,

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populate it with stromal
vascular fraction,

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00:18:26,580 --> 00:18:31,440
and we'll have a new breast that's a
real breast and maybe even a functioning

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breast.

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00:18:32,610 --> 00:18:35,320
So I have a question for you. You know,

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00:18:35,330 --> 00:18:39,880
in the sixties we planned
to land on the moon.

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And at the time when that
was proposed, the technology,

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00:18:44,660 --> 00:18:49,520
the knowledge of
technology was adequate to

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00:18:49,550 --> 00:18:52,760
understand what had to
be done to get there.

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00:18:52,780 --> 00:18:56,280
And it just had to be engineered
into a working system.

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00:18:56,940 --> 00:19:01,160
And in the very early 1970s,
another American president said,

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"by the end of the decade, we're going
to cure cancer." And that was not nearly

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00:19:05,730 --> 00:19:10,650
as, that was not a good

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00:19:10,651 --> 00:19:15,090
bet because we didn't understand
so many things about the biology

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00:19:15,380 --> 00:19:18,490
of all the different diseases
that represent cancer.

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00:19:19,420 --> 00:19:23,610
We did not have the sequencing
of the human genome at that time

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00:19:24,470 --> 00:19:26,090
and so on and so forth.

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00:19:26,660 --> 00:19:29,910
So with stem cells today,

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00:19:31,020 --> 00:19:34,370
is it more of a landing on the
moon problem where we have,

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00:19:34,371 --> 00:19:39,010
we understand what needs to be done,
but we have to engineer the process?

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00:19:39,300 --> 00:19:44,290
Or is it still like a
curing cancer in 1970

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00:19:44,291 --> 00:19:49,170
problem where we still have a lot to
learn about the biology and we need

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00:19:49,171 --> 00:19:51,770
some breakthroughs to make it happen?

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00:19:52,730 --> 00:19:55,490
I think a little bit of both,
Larry. I think, you know,

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00:19:55,491 --> 00:19:58,050
only because having
followed immunotherapy,

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00:19:58,240 --> 00:20:02,930
I was at the NIH and when
Donald Morton was there and the

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00:20:02,950 --> 00:20:06,890
effectiveness of
immunotherapy on melanoma was

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00:20:07,530 --> 00:20:09,970
mild and you kind of looked
and went, I don't know.

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00:20:09,971 --> 00:20:12,450
I mean it doesn't seem all that dramatic.

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00:20:12,950 --> 00:20:17,410
And now we're at a point where it's
very dramatic and you have Israeli

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00:20:17,850 --> 00:20:19,970
scientists recently, maybe a year ago,

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00:20:19,971 --> 00:20:24,290
announcing that with combinations
of these immunotherapy approaches,

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00:20:24,500 --> 00:20:27,930
they're going to eradicate
most cancers. So,

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00:20:28,060 --> 00:20:30,210
or at least allow us to live with them.

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00:20:30,700 --> 00:20:33,690
So I think some things
just take a long time.

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00:20:34,400 --> 00:20:36,610
I think that to your point,

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00:20:37,040 --> 00:20:41,490
what we have to do is figure out what
are the most valuable approaches.

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00:20:41,491 --> 00:20:43,890
So for instance, to me, facial surgery,

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00:20:43,960 --> 00:20:47,640
I mean there are very few facelifts
that are done now without fat grafting.

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00:20:47,990 --> 00:20:52,360
When I gave a talk in 2009

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00:20:52,720 --> 00:20:56,560
in Chicago at the, not the
aesthetic meeting, but at

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00:20:58,830 --> 00:21:02,770
ASPS, our bigger society, and I
asked people to raise their hand,

325
00:21:02,771 --> 00:21:06,050
"how many people are fat grafting
during facelifts?" You know,

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00:21:06,370 --> 00:21:09,010
probably 80% of people raised
their hand when I said,

327
00:21:09,110 --> 00:21:13,770
"how many people are using more
than 10 milliliters?" Probably

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00:21:13,950 --> 00:21:16,130
10% raised their hand. When I said,

329
00:21:16,131 --> 00:21:20,370
"how many people are using
50 milliliters?" Maybe
there was nobody who raised

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00:21:20,371 --> 00:21:21,204
their hand.

331
00:21:21,230 --> 00:21:25,850
Now most people are using
large volumes because

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00:21:26,330 --> 00:21:31,250
they recognize that to actually
do a good job on a facelift is a

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00:21:31,950 --> 00:21:33,250
multi-dimensional approach.

334
00:21:33,251 --> 00:21:38,170
It's not just lifting skin and trying
to fold tissue underneath to make

335
00:21:38,171 --> 00:21:41,770
look like you have more volume. It's
actually going right to the problem,

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00:21:42,050 --> 00:21:46,170
which is the loss of fat tissue
in specific compartments.

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00:21:47,250 --> 00:21:52,250
So as we begin to become more precise in

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00:21:52,450 --> 00:21:55,370
our understanding, our treatments
are getting better and better.

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00:21:56,050 --> 00:21:59,690
So I would imagine that we're going
to see more and more facelift patients

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00:22:00,370 --> 00:22:03,890
having much longer term effects.
And even with the fat grafting,

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00:22:04,050 --> 00:22:08,530
as I was saying, you have a patient
who is a kind of slower ager.

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00:22:09,250 --> 00:22:11,090
You know, I have patients six,

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00:22:11,410 --> 00:22:16,330
seven years out from fat grafting that's
never used a filler again and never as

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00:22:16,570 --> 00:22:20,210
needed in another treatment, and
their skin looks amazing still.

345
00:22:20,890 --> 00:22:21,890
So how does that happen?

346
00:22:23,490 --> 00:22:26,050
And as we begin to understand
more and more how that happens,

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00:22:27,090 --> 00:22:31,970
it's hard for me to imagine not using
some of these techniques with every laser

348
00:22:32,080 --> 00:22:35,970
I do or every kind of
skin delivery system.

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00:22:36,520 --> 00:22:39,610
Lastly, before we close, Dr.
Cohen, I'd like to ask you,

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00:22:39,640 --> 00:22:43,170
what should our listeners take away
from today's discussion of stem cells?

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00:22:44,050 --> 00:22:47,540
I think they should take
away two things. One,

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00:22:47,541 --> 00:22:52,380
it's a serious scientific effort
and they're going to benefit from

353
00:22:52,381 --> 00:22:53,620
this. And two,

354
00:22:54,080 --> 00:22:58,900
you have a group in the aesthetic
world that are marketing and

355
00:22:58,901 --> 00:23:01,260
those marketing people,

356
00:23:01,260 --> 00:23:04,620
you have to differentiate what
is marketing and hype from what

357
00:23:04,621 --> 00:23:08,370
is legitimate, clinical science.

358
00:23:08,880 --> 00:23:11,170
I think that's a very important thing.

359
00:23:11,180 --> 00:23:16,170
So you wanna be with physicians
that are looking at this in a

360
00:23:16,171 --> 00:23:20,410
responsible way, not marketing
it as a means of simply,

361
00:23:20,790 --> 00:23:24,610
"I'm getting a lot of new patients
because of this." So I think that's an

362
00:23:24,611 --> 00:23:29,250
important differentiation is
to make sure that the hype is

363
00:23:29,530 --> 00:23:33,530
backed up by a more serious
understanding of the field.

364
00:23:34,280 --> 00:23:35,710
Dr. Bass, anything to add?

365
00:23:36,290 --> 00:23:36,711
Yes,

366
00:23:36,711 --> 00:23:41,710
I think Dr. Cohen was just
talking about combining

367
00:23:42,490 --> 00:23:44,870
use of stem cells with surgery,

368
00:23:45,100 --> 00:23:47,880
use of stem cells with
energy-based treatments.

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00:23:48,420 --> 00:23:53,280
And it's a certainty
that almost everything

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00:23:53,560 --> 00:23:57,040
we do is going to be some
kind of combination therapy.

371
00:23:57,480 --> 00:24:01,520
The ability to get the
most complete correction is

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00:24:02,560 --> 00:24:05,480
absolutely going to rely not on one single

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00:24:07,160 --> 00:24:08,880
silver bullet, but on

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00:24:10,700 --> 00:24:15,020
pushing every option at its optimum amount

375
00:24:15,980 --> 00:24:18,740
so that we get maximum improvement.

376
00:24:19,400 --> 00:24:22,020
The other thing that I think we're
going to see with stem cells,

377
00:24:22,021 --> 00:24:25,500
there's been so much focus
on getting our hands on them,

378
00:24:25,501 --> 00:24:30,180
separating them out from
harvested fat that we

379
00:24:30,181 --> 00:24:35,020
haven't yet had the chance
to fully investigate how

380
00:24:35,021 --> 00:24:38,220
we're going to control the
behavior of stem cells.

381
00:24:38,221 --> 00:24:39,860
And part of that is just dosing,

382
00:24:40,160 --> 00:24:44,620
but part of it is controlling
their behavior because they can

383
00:24:45,250 --> 00:24:47,860
change in multiple different directions.

384
00:24:48,160 --> 00:24:50,860
How are we going to
control differentiation?

385
00:24:51,360 --> 00:24:56,220
How are we going to signal stem cells
and modulate their behavior when

386
00:24:56,221 --> 00:25:00,700
they're placed in rather
than just shotgunning it at
the patient and hoping it

387
00:25:00,890 --> 00:25:03,540
sticks and acts in the
fashion that we hope.

388
00:25:03,830 --> 00:25:07,740
So that's going to be the next
phase of development as I see it.

389
00:25:08,460 --> 00:25:13,060
But we're going to need to be routinely
working with stem cells and having them

390
00:25:13,061 --> 00:25:17,700
available to be able to start
doing those studies in earnest.

391
00:25:18,450 --> 00:25:21,340
I would echo what you
said Larry is right on.

392
00:25:21,341 --> 00:25:26,180
I think combination therapy
is so critical for patients to

393
00:25:26,700 --> 00:25:31,060
understand because when patients come
into your office and you ask them,

394
00:25:31,180 --> 00:25:33,380
"have you had any treatments?"
And they say, yes,

395
00:25:33,381 --> 00:25:35,340
I had this laser five years ago.

396
00:25:36,780 --> 00:25:40,300
Immediately you realize
that these patients have not
been educated what lasers

397
00:25:40,500 --> 00:25:45,180
are there for, and that lasers are
not ordinarily a single treatment,

398
00:25:45,740 --> 00:25:48,700
but it's like car detailing.
You want your car to stay nice,

399
00:25:49,460 --> 00:25:50,300
you're driving it around,

400
00:25:51,100 --> 00:25:53,900
you're going to take care of it and you're
going to need to do it on an ongoing

401
00:25:54,300 --> 00:25:58,300
basis. Or if you're a statue in
Italy and you get sandblasted,

402
00:25:58,540 --> 00:26:00,740
but they put you back in
front of the fountain,

403
00:26:01,580 --> 00:26:04,260
you know what's going to happen
to your beautiful white marble.

404
00:26:04,540 --> 00:26:05,660
It's going to get sooty again.

405
00:26:06,380 --> 00:26:10,540
So as we begin to look
at multiple modalities,

406
00:26:10,780 --> 00:26:14,540
we need to be treating sun
damage, volume loss, laxity,

407
00:26:15,140 --> 00:26:19,300
and we're drilling down into the cellular
and tissue events that are occurring

408
00:26:19,500 --> 00:26:23,820
with aging so that we can come up with
better and better combination treatments

409
00:26:24,060 --> 00:26:28,060
that legitimately will
alter aging. Legitimately,

410
00:26:28,780 --> 00:26:30,500
and that includes surgery in some cases.

411
00:26:30,890 --> 00:26:33,860
Well, I think that's a
beautiful way of summarizing it.

412
00:26:34,310 --> 00:26:37,500
So I'd like to thank you again,
Dr. Cohen, for joining us.

413
00:26:37,501 --> 00:26:42,020
It's been a very stimulating discussion
and we're glad that you were willing to

414
00:26:42,021 --> 00:26:46,920
come back and talk with us again
on the podcast and contributed your

415
00:26:46,921 --> 00:26:49,440
expertise. Thank you for having me.

416
00:26:49,790 --> 00:26:53,120
Well, this was certainly
a thought-provoking
episode. Thank you again,

417
00:26:53,121 --> 00:26:56,960
Dr. Cohen, for sharing your expertise
and insightful perspective with us today.

418
00:26:56,961 --> 00:27:00,480
And thank you to our listeners for joining
us to hear about the expanding role

419
00:27:00,481 --> 00:27:02,440
of stem cells and aesthetic medicine.

420
00:27:02,810 --> 00:27:06,360
If you think of other exciting
developments or trends
in plastic surgery that

421
00:27:06,361 --> 00:27:08,560
you would like us to discuss
in upcoming episodes,

422
00:27:08,561 --> 00:27:11,800
please reach out by email or
Instagram. We'll see you next time.

423
00:27:12,900 --> 00:27:16,550
This is Doreen Wu, thanking you
for joining Dr. Bass, Dr. Cohen,

424
00:27:16,551 --> 00:27:20,030
and me for this discussion of stem
cell-based regenerative medicine.

425
00:27:20,480 --> 00:27:24,670
Be sure to tune in next time and don't
forget to subscribe to our podcast to

426
00:27:24,671 --> 00:27:27,710
stay up to date with all of the exciting
content that is coming your way.

427
00:27:28,910 --> 00:27:33,110
Thank you for joining us in this episode
of the Park Avenue Plastic Surgery

428
00:27:33,111 --> 00:27:37,710
Class podcast with Dr. Lawrence
Bass, Park Avenue plastic surgeon,

429
00:27:38,510 --> 00:27:40,270
educator, and technology innovator.

430
00:27:40,410 --> 00:27:43,070
The commentary in this
podcast represents opinion.

431
00:27:43,270 --> 00:27:45,910
This podcast does not
present medical advice,

432
00:27:46,090 --> 00:27:50,310
but rather general information about
plastic surgery that does not necessarily

433
00:27:50,311 --> 00:27:53,390
relate to the specific conditions
of any individual patient.

434
00:27:53,680 --> 00:27:58,510
No doctor patient relationship
is established by listening
to or participating

435
00:27:58,511 --> 00:27:59,344
in this podcast.

436
00:27:59,480 --> 00:28:03,550
Consult your physician to advise you
about your individual healthcare.

437
00:28:03,920 --> 00:28:05,470
If you enjoyed this episode,

438
00:28:05,500 --> 00:28:09,790
please share it with your friends and
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439
00:28:09,791 --> 00:28:13,710
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440
00:28:13,880 --> 00:28:16,270
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