Can Injecting Your Face with Your Own Cells Make You Look Younger?
Aphrodita Kabashi has a surprisingly calm demeanor for someone who's just had her face injected 120 times in 25 minutes. Maybe it's because she's in the hands of Fredric Brandt, the sought-after New York-and Miami-based dermatologist known for keeping Hollywood's A-list faces looking ageless. Kabashi, a 38-year-old New Yorker and a manager of the chic Garren New York salon, is visiting Brandt for her first LaViv treatment-a breakthrough antiaging procedure that promises to eliminate wrinkles and smooth skin by injecting a patient's own amped-up collagen-producing cells into problem areas. A self-proclaimed sun worshipper, Kabashi says she wants to erase years of UV damage and have a glowing complexion without it looking unnatural. Brandt is the go-to doc for LaViv, having worked as a principal investigator on the clinical trials that led to FDA approval. "Aphrodita is the perfect LaViv candidate because she has sun damage, large pores, and fine lines around her mouth and chin," explains Brandt. "This is a great way to retexturize and plump up her skin." She's guaranteed to have natural-looking results, he says, adding, "No one will ever know she had anything done."
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Botox and hyaluronic acid fillers may be the gold standard for eliminating lines and adding volume, but LaViv is the first injectable to also wipe out sun damage, shrink pores, and safely combat scars on all skin types. (Until now, lasers were the treatment of choice, which provided little help to those with darker tones because of the risk of burns and hyperpigmentation.) Brandt, an antiaging pioneer who injects more Restylane and Botox than literally any other doctor on the planet, says he considers LaViv to be in a separate category from fillers and adds that many of his patients use it as an adjunct to their current lineup of youth-enhancing treatments. "Fillers can restore volume, but LaViv improves texture and treats areas that may be too delicate or difficult to fix with fillers," he says. And, unlike fillers, which can puff out the skin, and Botox, which can leave patients looking frozen, LaViv fills wrinkles gradually and discreetly through the growth of the patient's own new collagen. It's for that very reason Kabashi is here. "I got Botox a couple of years ago and didn't like the end result," she says. "It was very unnatural, and I looked surprised."
HOW IT WORKS
LaViv received FDA approval in 2011 for treatment of the nasolabial folds, or smile lines, and "is the first process that allows us to inject a patient's own fibroblasts [active stem cells that produce collagen] into the skin to produce new collagen and elastin," says Brandt. "The results are exceeding everyone's expectations." After a skin biopsy is taken from behind the ear, the cells are sent to a lab. There, the fibroblasts are isolated and grown in a souped-up blend of sugars, amino acids, vitamins, salts, water, and animal-derived growth factors (which Fibrocell Science, the company that makes LaViv, says is "common and not new to the industry") for a period of two to three months. Three separate injection sessions are spaced three to six weeks apart, with results starting to appear after the second appointment. "This is not a quick fix," says Brandt. The process can take up to six months and cost up to $5,000, though Brandt insists that it's worth it--especially for people who are "wary of injecting anything foreign into the body." Janet David, 65, of Baltimore, is a perfect example. "I'm highly allergic to a number of things, so I've always been afraid of Botox and fillers," says David, who participated in a clinical trial in 2004. "I didn't want to chance trying something and having a problem, but with LaViv I felt comfortable because how could you be allergic to yourself?"
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When it's time for Kabashi's treatment, Brandt gently stretches the skin on her numbed face, superficially injecting her smile lines, crow's-feet, chin, cheeks, forehead, and the corners of her mouth to achieve what he calls "total facial rejuvenation." "We should see an improvement in the fine lines on her forehead, smile lines, pores, skin texture, and the crepiness under the eyes," he predicts. As for Kabashi, she swears that the pain factor is low, describing each injection as "a pinch with a bit of pressure." Immediately following her first treatment, red bumps resembling bee stings formed at the injection sites. "But each time I had the procedure, I was fine to go out the next day," she says. Bruising and swelling are the most common side effects, but Fibrocell also lists bleeding, lumps, irritation, and itchiness for up to a week as potential side effects.
THE DEBATE
Unsurprisingly, not all doctors are ready to rule out the possibility of more serious adverse effects. "I don't want to sound like a party pooper, because this is very exciting," says Macrene Alexiades-Armenakas, director of the Dermatology and Laser Surgery Center in New York, "but it doesn't have the long-term follow-ups that other fillers have because we simply have not treated enough patients." She questions whether fibroblasts injected into the skin last for the long term-"Are they behaving the way the company is hypothesizing they are? I would argue probably not"-and cites infection as another downfall. "There's always a risk for contamination when you're dealing with fibroblasts and tissues that are being manipulated," she says. And perhaps the biggest fear is that "once you transplant fibroblast stem cells, you may not be able to turn them off," meaning that over time, the face may continue to add volume. Robert Weiss, one of the LaViv clinical-trial investigators and an associate professor of dermatology at the Johns Hopkins Hospital, says that this last concern was brought up during the FDA panel hearings prior to approval of the product, "but with thousands of patients being treated, including in the clinical trials, we've never seen that occur." John Maslowski, vice president of scientific affairs at Fibrocell, seconds Weiss, saying, "We adhere to rigorous FDA testing requirements and closely monitor for microbial fungal injections." He adds that there's a good chance "fibroblasts may signal other fibroblast cells that are latent in the area" to reproduce the proteins responsible for keeping skin tight and taut-something that can't be accomplished with fillers.
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THE FUTURE
While other injectables often require touch-ups every six months, the benefits of LaViv may last much longer. David, for one, says she's as thrilled today as she was eight years ago, when she discovered her smile lines fading. "They started to disappear a few months into the treatment, and it still looks as if I had it done yesterday." Although she hasn't needed additional treatment, others may. The clinical trials followed LaViv patients for only six months post-treatment, so Fibrocell cannot legally say the results will last longer. However, Brandt reports that patients who were questioned by phone a year after treatment "were happy," though he adds,"Not that that's scientific." He advises his patients to come back six months after their third appointment as part of an ongoing maintenance schedule.
Another compelling aspect of this technology is the ability to treat other areas of the body. Brandt is using it to experiment with everything from eliminating stretch marks, wrinkled knees, and hand crepiness (which Restylane can't fix, he says) to stubborn acne and chicken-pox scars. "I think using a patient's own cells will play a bigger role in dermatology as time goes on," he says. "This is just the beginning."
For now, Kabashi is back in Brandt's office, having just completed her third and final LaViv treatment of 120 injections. "I get compliments on my skin all the time," she says, noting that her dark spots, smile lines, and pores have vanished. "I would recommend this to anyone."
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