The woman’s complaint almost sounded more appropriate for a mechanic, not a cosmetic surgeon: She had been hearing a strange clicking noise. But the noise, as described in a new article in Scientific American, was coming from the woman’s right eyelid—“a sharp sound, like a tiny castanet snapping shut.”
A Los Angeles resident in her sixties, the woman had received a new kind of face-lift treatment three months earlier at a clinic in Beverly Hills. Along with the clicking noise, she had difficulty opening her right eye, and experienced a good deal every time she forced it open. She had contacted Dr. Allan Wu, another cosmetic surgeon, whose offices were near Palm Springs, to get his opinion.
As Farris Jabr describes for SciAm:
After examining her in person at The Morrow Institute in Rancho Mirage, Calif., Wu could see that something was wrong: Her eyelid drooped stubbornly, and the area around her eye was somewhat swollen. Six and a half hours of surgery later, he and his colleagues had dug out small chunks of bone from the woman's eyelid and tissue surrounding her eye, which was scratched but largely intact. The clicks she heard were the bone fragments grinding against one another.
Back in Beverly Hills, cosmetic surgeons had extracted adult stem cells from the woman’s own fat, liposuctioned from her abdomen. Using adult stem cells for cosmetic purposes is still fairly new: For this procedure, doctors isolated a type of stem cell called mesenchymal cells, and injected them into the woman’s face.
Mesenchymal stem cells are like other stem cells, defined by the FDA as “the precursor cells that develop into blood, brain, bones and all of your organs." These cells, in particular, can become cartilage, fat, or—you guessed it—bone. The idea with the face-lift, which, SciAm reports, cost the woman more than $20,000, is that by injecting such stem cells into skin, they will grow “into brand-new tissue and release chemicals that help heal aging cells and stimulate nearby cells to proliferate.”
There was just one problem, which the woman’s doctors had failed to anticipate: In conjunction with the stem cell treatment, doctors had also injected the woman’s face with dermal filler—long recognized as a safe way to smooth wrinkles. That filler, however, contains a material called synthetic calcium hydroxylapatite, which can stimulate mesenchymal stem cells to turn into bone.
Et voilà: It's crazy bone eye lady. Now, give me some candy.
As I’ve noted previously for Motherboard, so-called minimally-invasive cosmetic procedures are extremely popular in the United States, getting more popular each year. In, 2011, the American Society for Plastic Surgeons (ASPS) documented 286,179 calcium hydroxylapatite procedures in the U.S.—a recession-proof, 36 percent increase over the year before. (The number of Botox procedures nearly hit 6 million, having grown by 621 percent from 2000 to 2010.) Calcium hydroxylapatite was officially approved for cosmetic use by the Food and Drug Administration in 2006, and, like Botox, has been amply used and tested. (Though it’s worth remembering that all this stuff is poison and can have deleterious—even deadly—side-effects if improperly administered.)
It’s easy to see why these procedures are so popular: They’re a lot less scary than going under the knife, and require much less recovery time. A standard face-lift, cosmetic surgeons have told me, requires at least two weeks of recovery time—not something many people are particularly keen on or can afford (unless that’s really how you want to spend your vacation).
But stem cell treatments are still pretty new and relatively untested. On one hand, the possibilities they offer are exciting; on the other, it’s a bit like the Wild West out there. As SciAm notes, the FDA is yet to approve any of the various adult stem cell treatments being offered at clinics around the country for cosmetic use (only one use for stem cells has been approved by the FDA, and unless you have blood cancer, it’s not for you). Various creams, oils and ointments are appearing online and in pharmacies, derived from plant and animal stem cells, which promise to rejuvenate skin or slow the aging process. Some of those products, it must be said, carry the unmistakable whiff of snake oil. (“Extremely Popular in Europe!” one advertises: “Swiss Patented Formula!”)
But it isn’t just charlatanry that consumers should be worried about, as the bone-eye story illustrates. Given the rising popularity of such treatments and products, the FDA was compelled earlier this year to issue a public warning, over concerns “that the hope that patients have for cures not yet available may leave them vulnerable to unscrupulous providers of stem cell treatments that are illegal and potentially harmful.”
“There is a potential safety risk when you put cells in an area where they are not performing the same biological function as they were when in their original location in the body,” said Dr. Stephanie Simek, deputy director of FDA’s Office of Cellular, Tissue and Gene Therapies, in the warning. The release went on to note what we have since gone on to discover through stories like the Los Angeles woman’s: that “cells in a different environment may multiply, form tumors, or may leave the site you put them in and migrate somewhere else.”
The FDA has tried to be diligent. Last December, for example, feds arrested three men and charged them with 15 counts of criminal activity for manufacturing stem cells and performing unapproved treatments on patients in Mexico suffering from diseases like cancer and multiple sclerosis. But as a simple Google search for stem-cell related products reveals, it's still a bit of free-for-all out there.
Stem cells hold exciting possibilities for the future: As testing progresses and the FDA approves more uses for stem cells, such procedures will no doubt provide a verifiably safe, less-invasive alternative to going under the knife for all kinds of treatment—cosmetic or otherwise. In the meantime, caveat emptor.