Three minimally invasive beauty enhancements that offer natural results

The most recent ASPS statistics reveal a continued upward trend in cosmetic enhancements in 2018, with an increase in both surgical and minimally invasive procedures.

Nonsurgical options may be performed as standalone treatments, or as complementary to aesthetic surgery in order to address a broader range of cosmetic concerns. Additionally, many patients prefer to choose natural options – over artificial or synthetic alternatives – in order to achieve their rejuvenation goals.

Three key therapeutic interventions – collagen induction therapy (CIT), platelet-rich plasma (PRP) and autologous fat transfer (AFT) – provide effective methods of improving appearance while relying on a patient's own cells and tissues, as well as natural-healing and youth-enhancing processes. As such, there is no risk of adverse effects due to an allergic or immune-mediated reaction.

Collagen Induction Therapy (CIT)

Collagen Induction Therapy (CIT) is based on the notion that creating finite, minute areas of micro-injury to the skin will promote healing and stimulate collagen production.

The most common type of CIT is called microneedling, which involves a special instrument with tiny rotating needles that penetrate through the skin. The resultant channels in the skin allow for the delivery of hydrating or rejuvenating products directly into the dermis. New collagen and elastin production and turnover of the top layers of the skin over the ensuing weeks produce smoother, tighter and younger looking skin.

Microneedling is effective in treating the following conditions:

• Superficial fine lines and wrinkles
• Ages spots and pigmentation
• Depressed scars such as acne scars and chicken pox scars
• Stretch marks

Advantages of microneedling include:

• Adjustable depth of penetration for individualized treatment
• Appropriate for any anatomic areas
• Safe for all skin pigmentation types
• Performed as an in-office procedure under local anesthesia with minimal downtime

Optimal results from microneedling are observed with multiple treatments spaced at 4-6 week intervals, which boost visible improvements in skin tone, texture and appearance.

Platelet-Rich Plasma (PRP)

Platelet-rich plasma (PRP) has been used in various medical fields for many years to help promote healing of injured tissues, such as in arthritic joints, torn tendons and burns. It has more recently been touted as an effective tool in regenerative medicine with its positive impact on open wounds and hair loss. Treatment with PRP is based on the premise that it contains a concentrated supply of growth factors that increase blood flow to an area of injury and assist with the repair of the affected tissues.

In the field of plastic surgery, PRP has cosmetic applications for improving the appearance of aging skin as it promotes blood flow, along with collagen and elastin production. PRP treatment starts with drawing a patient's blood, then centrifuging it to separate plasma from the other components and finally injecting the PRP into target areas.

Although PRP may be effective if injected alone, its effects are enhanced when used in combination with microneedling procedures, which create a zone of injury that functions as a target for growth factors.

The rise in popularity of PRP may be attributed to some of the following advantages:

• Uses only the patient's own plasma, thus making it 100% natural
• Improves skin appearance due to regenerative effects including better blood flow and increased collagen and elastin production
• Effective both as a standalone and adjunctive procedure that may be combined with microneedling or cosmetic surgery (e.g. facelift)
• May be used in all skin types and all over the body
• Incremental benefits are observed when performed in a series of multiple sessions

There are ample benefits of growth factors found in PRP, and although currently, plastic surgeons use a number of different techniques, additional studies will aim to standardize methods and optimize results.

Autologous Fat Transfer (AFT)

Whereas CIT is primarily designed to improve the quality and tone of the skin, Autologous fat transfer (AFT) aims to correct contour irregularities and volume deficiencies. AFTs are commonly referred to as fat injections and fat grafts and describe a minimally invasive procedure that uses a patient's own fat to restore a smoother and more youthful appearance. Both CIT and PRP may also be performed in conjunction with AFT for enhanced overall results.

AFT treatment begins with removing – or harvesting – fat from another part of the body, such as the abdomen or thighs, using a process similar to liposuction. The fat is then purified or processed prior to being injected into an area of volume deficiency or contour irregularity due to aging, trauma or prior surgery.

Some of the unique advantages of AFT include:

• Permanent results: Injected fat is composed of living cells that become incorporated into the tissues where it is placed. Although a small percentage of the fat may not survive the transfer process, the majority of cells will do so and produce a permanent effect. The addition of PRP to fat may also improve the survival of fat grafts.
• Stem cells: Fat contains some of the highest concentration of stem cells of all tissues. Stem cells promote new blood vessel growth into the treated area, and this new inflow contributes to skin rejuvenation in addition to volume enhancement provided by fat cells.
• Advantages over fillers: Since AFT involves injecting patients with their own fat, it provides the most natural option for volume enhancement. Unlike fillers, there is no possibility for allergic reaction or side effects due to the product. In addition, the quality of the overlying skin is improved due to the benefits of stem cells.

In some patients, AFT serves as an adjunctive procedure to more invasive surgeries, thus enhancing the overall results of traditional cosmetic surgery such as facelifts. AFT may also be used as a permanent solution for hand rejuvenation.

For patients who are interested in breast augmentation but prefer an alternative to breast implants, AFT to the breasts can produce a moderate increase in breast cup size and correct mild asymmetry.

AFT is also beneficial for improving cosmetic deformities secondary to prior aesthetic or reconstructive surgery.

Whether used as standalone treatments, together in various combinations or as adjunctive procedures to more invasive plastic surgery, these three minimally invasive offer a broad range of options for aesthetic rejuvenation and cosmetic enhancement.