Age Management Medicine Group > AMMG e-journal > October 2010 > AestheticMedicine-Oct2010
e-Journal of Age Management Medicine | October 2010
A monthly column on practice trends in Aesthetic Medicine 
'Vampire Facelift' Uses Patient's Own Blood to Rejuvenate Aging Skin

Could a 20-minute treatment that uses a patient's own blood to rejuvenate the skin be the perfect filler?

Joanne Laucius, Postmedia News

OTTAWA — The fashion magazines have dubbed it the "vampire facelift," a 20-minute procedure that uses components of the patient's own blood to plump up aging skin.

The patented process, approved in Canada only late last year, was officially launched this month. But there has been significant buzz, both in the style press and in the esthetic medicine community.

Last week in the conference room of the Brookstreet Hotel, a Kanata physician demonstrated the process, which she has been using in her practice for about nine months.

Breaking open a sealed Selphyl kit, Dr. Suman Khulbe, who has been practicing esthetic medicine since 2001, drew a vial of blood from a volunteer, and spun it for six minutes in a centrifuge. This separates the plasma, the red and white blood cells and a layer of platelets.

The yellowish platelet layer, which represents about four cubic centimetres of the total, results in a "platelet-rich fibrin matrix" that contains growth factors that promote healing, circulation and collagen production.

This was then re-injected into the volunteer's facial lines, softening the "tear troughs" under the her eyes and the nasolabial folds, or the "smile lines" that connect the nose and mouth.

"People want to look rested, not Hollywood," says Khulbe, who runs Dr. Khulbe's Medical and Laser Aesthetic Medicine and is also the medical director of Foundations Med-Spa in Stittsville.

"It's like a tire. You're inflating the tire back to normal. You're not overinflating it."

There are three signs of aging. The first is "descent," what most people would call the effect of gravity. The second is "deterioration" or wear and tear. The third is "deflation" or loss of volume -- as a face gets older, it loses the look of youthful fullness.

"Selphyl is a wonderful technique for all of this," says Khulbe.

So far she has used it for 15 or 16 cosmetic cases, including facial regeneration, wrinkles and hand rejuvenation, stretch mark and scar reduction. Other than mild bruising or puffiness, there are few side effects. The results are subtle, but develop over the course of the next few months.

While results vary, they are believed to be relatively long-lasting. Results are expected to last a year, possibly up to four years, according to reports from the U.S. The best part is that a year later, the patient always looks better than they did before the treatment, says Khulbe.

"Platelets really are where the action is," says Dr. Anthony Sclafani, a Manhattan-based plastic surgeon and professor at New York Medical College who has been using the process for about four years. "Patients were coming to me after a week and saying 'This looks terrific.' "

Non-invasive cosmetic procedures such as this one are also a growing market. In the U.S., 8.5 million of the 10 million plastic-surgery procedures performed in 2008 were minimally invasive treatments like this one.

And there is a lot of room for growth, despite the recession, Sclafani told the doctors at the Brookstreet.

Surveys show that while just over half of people consider dermal fillers to be acceptable and 89 per cent are aware of them, only two per had ever been injected with a dermal filler. About 11 per cent said they would consider one.

Using the patient's own blood will likely ease misgivings for some, says Sclafani.

"There is a whole untapped market of people who don't want filler."

Dr. Yves Hébert, medical director at Médecine Esthétique in Montreal and president of the Canadian Association of Aesthetic Medicine, has only been using the process for a few weeks, but he has been keeping his eye on similar protocols used in Europe for years.

He's impressed because this is not a superficial treatment.

"There's no perfect filler. We're always looking for the perfect filler. We're always looking for something that looks natural, has no side effects and is long-lasting," he says. "This almost fits the bill. Will it be the wonder injectable? I don't know. But all the check marks are there. It's exciting."

While only a small minority of the population has had a cosmetic procedure, half are interested, Hébert says, in part because there is no downtime. Laser resurfacing, for example, has more dramatic results, but requires some recovery time.

"If you want more results, you have to accept that there is more downtime. It's a question of what the patient is willing to endure," he says.

"There's still a big, big untapped market. The interest is there, the curiosity is there. In the next five to 10 years, there will be a big surge in non-invasive cosmetic procedures."

Khulbe stumbled onto platelet treatments while she was researching alopecia treatments for her mother in the medical journals. She found an article about a Florida physician who was having some success with hair loss patients, particularly women. That led to a meeting with a British Columbia researcher. At the time, the problem was that it took an hour and a half to extract the platelets.

Khulbe points out that the principle behind Selphyl has been used since 1987 in cardiovascular surgery to prevent bleeding and has been used in recent years in sports medicine for healing and in veterinary medicine to repair tendon damage in racehorses.

There are dozens of potential uses. It reduces scarring, helps heal burns and has potential for osteoarthritis. It works for hair loss, but only if not too much hair had already been lost. Injected into the scalp of the patient, it has resulted in a 25- to 30-per-cent increase in hair density, says Khulbe, who has also used it in conjunction with other esthetic treatments, such as cosmetic fillers.

But results vary, she says.

"You have to choose the patient carefully. The platelets are only as healthy as the person themselves." Pregnant and breast-feeding mothers are not candidates, for example, nor are those on blood-thinning medication.

Then there is the cost: $800 to $1,200 for a session. Patients have to consider the economics of their decision. Botox, for example, is much less expensive. But while Botox can stop the facial movements that cause lines, it can't erase the lines themselves.

"Sometimes there is sticker shock. Sometimes people want this gone, or that gone," says Khulbe, who advises that patients should point out their concerns, but also have faith in their doctor. She has to be an artist as well as a physician. For example, patients sometimes don't understand that erasing the nasolabial folds completely will result in a "chipmunk cheeks."

Sclafani says one of the problems he faces is patients with unrealistic expectations. About 10 per cent of his patients don't get a really "vibrant" clinical response from Selphyl.

"You can't get the Hollywood lips of Restylane," he says, referring to a popular filler.

Although most fillers last a year at most, Sclafani and his patients have noticed the improvements linger for up to four years.

"I'm hesitant to use the word 'permanent.' But it is lasting," says Sclafani, who also uses platelet therapy during facelift surgery to reduce post-operative bruising.

Khulbe tells patients they need to address lifestyle issues before getting cosmetic treatment. That includes quitting smoking, taking vitamins, especially vitamin D, and to exercise.

Patients are increasingly well-versed in rejuvenation options. They have done their research on the Internet, and they know what they want, says Hébert. He believes it's an extension of the emphasis people put on taking care of themselves.

"It's just the way we look at beauty now. We put a lot of energy into a balanced lifestyle, how to eat and how to exercise. It's just natural to take care of the envelope."

From The Vancouver Sun, September 27, 2010
© Copyright (c) The Ottawa Citizen



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