Stem cells in oculofacial plastic surgery

Abstract

In the field of oculofacial plastic surgery, stem cells are beginning to be used in reconstructive and aesthetic applications. Adult mesenchymal stem cells, specifically adipose-derived stem cells (ADSCs), with their abundant supply, ease of harvest, and ability to differentiate into fat, bone, cartilage, muscle, and blood vessels appear to be excellent progenitor cells for use in facial reconstruction. ADSCs secrete cytokines which can enhance their own survival and engraftment. In addition, ADSCs have been utilized clinically for tissue engineering of facial structures including bone, cartilage, and fat and have the potential for engineering other mesenchymal structures the tarsus. Stem cells may augment wound healing, especially in the case of chronic wounds, free grafts, and flaps and theoretically could improve surgical outcomes, especially in high-risk settings. Lastly, the paracrine effect of adult mesenchymal stem cells has the potential to mitigate, and in some instances reverse, the process of age and oxidative skin damage. Well-designed, prospective, quantitative human trials need to be conducted to bring stem cell technology into standard oculofacial plastic surgical practice.