Multidisciplinary Cosmetic Surgery – Why hormones are often better than scalpel

Recently, a female patient consulted me, as she needed an autologous fat injection in the cheeks, at least she thought so. A plastic surgeon in Vienna had administered one such injection on her due to hollow cheeks and now the object had degenerated. I looked up her year of birth and saw, that she was around 10 years younger than she looked. According to her account, she was under treatment for several years due to her chronic illness and had to take medicines. All this let her body age prematurely.

Another fat injection could not improve anything for her. Instead of that, I now looked at her more closely: her face and her body showed the clear symptoms of the depletion of the hormonal glands, which are normally seen only from around 50 to 60 years. We then spoke no more about fat injection, rather about the Hormonal Regeneration® with bioidentical hormones and their regenerative effect. After a few weeks of therapy, her hollow cheeks would again become filled up, her flaccid skin would again become taut and her livid face would give way to a healthy, vital complexion.

Why do I know that – as I could often observe it sufficiently in male and female patients. After a few weeks of Hormonal Regeneration®, the rejuvenating and vitalizing effect can be more intensified by a regenerative stem cell therapy (de Leons “Fountain of Youth”). Any surgical symptom treatments can be saved by the female patient as a result.

Had all cosmetic surgeons been exclusively trained in surgery, such patients would well have been recommended a facelift, artificial fillers, or silicon cheeks. It is indispensable for the optimal care of the patients, that the cosmetic surgeons (aesthetic practitioners) are capable to select their methods from all disciplines of medicine: from surgery, dermatology, hormonal medicine, stem cell technology.

For this purpose, these physicians must have learned this, as well as may do so according to law. Physicians for general medicine, as I am one, are authorized according to the Austrian law, to combine therapeutic methods from all branches of medicine for the treatment of their patients. Naturally it is a prerequisite, that they have also learned these procedures verifiably and mastered them. On the contrary, a plastic surgeon may only use those surgical procedures, which are mentioned in his medical specialist catalog. Not a miracle, if he will more often advise surgical operation.

This general authorization of general practitioners is a prerequisite for the further development of the medical art there, where it happens: in the medical practice! It is essential, that this general authorization of general practitioners remains maintained for the Austrian patients also in future, as it means advancement of medicine and optimal security for the patients.

DDr. Heinrich, MD

Wrinkle treatment: Why Botox & Co. make look old

For several years, facial and dermal treatments with artificial fillers such as Hyaluron as well as with Botox are very popular. They should promptly eradicate wrinkles through small injections. But the treatment of the external signs of age with artificial fillers has a series of severe disadvantages: the treatment results functions unnaturally and the “rejuvenating” effect prevails only for a limited period. The New Cosmetic Surgery is therefore based on the regenerating potency of the stem cells from natural body fat for the rejuvenation of face and skin, which renders an appreciable and sustainable rejuvenation of the skin appearance possible!

The application of artificial fillers in the face or for skin rejuvenation on other body regions is by no means advisable. The filler substances change namely the natural maneuverability of the skin and reduce its elasticity. Moreover, the skin functions irregularly and unnaturally after a treatment with artificial fillers over several years. In many cases, the filler causes fibrotic lumps under the skin on the treated skin areas. It is likewise advised against wrinkle treatment with Botox (Botulinumtoxin), as Botox causes the degeneration of the skin glands and thus the skin becomes drier and thinner.

Just the opposite happens in case of facial and skin rejuvenation with fat and natural stem cells: the injected fat becomes seamlessly incorporated into the existing tissue, wherefore the result looks essentially more natural. Beside the filling material – natural body cells are more preferable to artificial fillers – the injection technique also plays an important role for the success of the treatment. In most of the cases it is less advisable to inject liposuctioned fat directly into the wrinkles elsewhere on the body. Wrinkles are the result of the mechanical pressure, which the muscles exert on the tissue. If fat is injected into the wrinkles, it is pushed away to the surrounding regions from the point of injection by the muscle pressure. Thus the undesired result becomes only more pronounced.

Instead of direct injection of fillers into wrinkles as well as the nasolabial wrinkles, a treatment of the total skin region with stem cell-enriched autologous fat or a stem cell suspension is recommended. The stem cells reinforce and rejuvenate the tissue and as a result the skin becomes smooth and wrinkles disappear. Depending on the individual conditions, this treatment should be repeated several times.

If the nasolabial wrinkles were already well visible in early years, one should never attempt to simply “fill” them or “inject” them away. The face would lose its character through this treatment and look unnatural. Such unnatural results are often seen on prominent persons, who had let their wrinkles be “filled” with artificial fillers. Only in the case of the emergence of the nasolabial wrinkle as a result of skin aging, a direct treatment through injection of stem cells and autologous fat is sensible. Beside the restoration of the lost face volume by injecting stem cell-enriched autologous fat, however, the total face should be treated with stem cell injections, in order to achieve a significant rejuvenation.

By combination of wrinkle treatment with stem cells on face and skin with a Hormonal Regeneration® (BHRT), the rejuvenating effect can be more intensified. Many signs of age are namely symptoms of a chronic hormone deficit, which can be successfully treated by systematic application of bioidentical hormones tailored for the patient. As a result of the combination therapy, the skin appearance improves and even more stubborn wrinkles become smoothened.

DDr. Heinrich, MD

New Cosmetic Surgery abandons silicon and scalpel

Dr. Pitanguy is a founding father of cosmetic surgery – at the start of the sixties his name was already well known in glossy magazine articles. I myself got to know him at a conference in Atlanta, where he described some of his operation procedures. I personally held him in high regard and his achievements in the trade are inimitable – nevertheless, unnoticed by most doctors and media a new era of cosmetic surgery has begun. Busty models made of silicon, ageing Hollywood celebrities with lifted, over-tightened doll faces – all this could soon belong to the past. Out of the world of cosmetic surgery, an interdisciplinary cosmetic and rejuvenative medicine is already emerging, where silicon and scalpel can be dispensed with in most cases!

New Cosmetic Surgery works with minimally-invasive, gentle cosmetic procedures under local anaesthetic. An example of minimally-invasive surgery is microcanular liposuction, which allows a very gentle and precise shaping of the body and face with only a few days of aftercare. In addition, the body’s own stem cells are used, which are obtained from fatty tissue with microcannulas, and with which e.g. lasting breast augmentation without silicon has become possible! This technology also dispenses with Dr. Pitanguy’s famous facelift methods tried by many celebrities, such as eyelid corrections and wrinkle treatments with “fillers.” Stem cells act as a rejuvenator and regenerator in specific areas and can thus be used in many aesthetic treatments, such as stem cell facelift and stem cell breast augmentation, instead of the lifting and gathering treatment of symptoms with the scalpel!

Because many seemingly “natural” cosmetic and functional problems of age, which to date were tackled with the scalpel, are obviously symptoms of a chronic lack in certain hormones, in New Cosmetic Surgery we use bioidentical hormones to raise the age-related, falling hormone level to the individual optimal value again. Thanks to regeneration and rejuvenation from within, this treatment leads to a 15-year younger, more radiant appearance and greater vigour.

The great potential of New Cosmetic Surgery lies in the perfect and balanced combination of these treatments! Nearly all cosmetic problems of the face, body, and skin can therefore be optimally treated with completely natural results. Cutting away with the scalpel and implanting silicon cushions will only be considered in the future in exceptional cases!

DDr. Heinrich, MD

With radiant skin in the summer

The Bikini season is knocking on the door! Often not only the skin becomes paler during the cold seasons, but also the signs of skin aging emerge more clearly and disturbingly than the year before: the dermal tissue loses tautness and “freshness” and wrinkles become more strongly and durably imprinted. In many cases, an appreciable improvement of the skin appearance can be achieved by means of the effective, gentle treatments of the New Cosmetic Surgery!

The treatments for skin rejuvenation stems from all branches of medicine: besides stem cells taken from the body’s own fat skin growth factors, the liposuction with microcannulas, the fat-away injection, and even therapies with bioidentical hormones are used. This shows once more, that the optimal treatment for a particular cosmetic problem is to be found in the repertoire of all medical branches.

Stem cells taken from the body’s own fat are suitable for sustainable rejuvenation of the skin of the total body as well as the face. Applied as suspension, the stem cells cause a regeneration of the skin and the subcutaneous tissues. Stem cell-enriched natural body fat is ideally appropriate for long-term tenable correction of volume deficits and tissue defects. In the stem cell facelift, wrinkles can be eradicated by virtue of the biological potential of the autologous stem cells.

As a simplified alternative for skin treatment with the body’s own stem cells, a mesotherapy with skin growth factors is offered. With this novel therapy, the rejuvenating effect of the treatment of the natural stem cells can be imitated up to a certain degree, in which skin growth factors can be applied through micro-needles into the skin without any skin injury.

“Holiday Pounds,” which appear to defy the physical training, can be removed by means of a liposuction with microcannulas in a tissue-protective manner. In microcannular liposuction, no visible scar arises as a rule. Excess and troublesome fat can be removed from all body parts, in which fat deposits are situated. Thus, considerable improvements are possible also in the facial area: special, very fine facial microcannulas are suitable for the correction of a double chin.

Therapies with bioidentical hormones render a rejuvenation of the skin appearance possible by up to 15 years. With increasing age, the activity of the hormonal glands sinks down and the hormone level goes down. As a result, the skin relaxes and becomes wrinkled. By supplying bioidentical hormones as part of a tailored Hormonal Regeneration® (Bioidentical Hormone Replacement Therapy, BHRT), the hormone level of a young adult can be reproduced. Within a brief period, the skin quality improves and lost elasticity and volume can be recovered.

DDr. Heinrich, MD

Are stem cells from fat the Fountain of Youth?

The Spanish conqueror Ponca de Leon was instructed by Cortez in the 16th Century, to search somewhere in Mexico for the source of eternal youth. He at that time did not find it, but it however seems that we are today quite close: We carry it on the body; it is – indeed – the fat!

In my previous blog entry, I introduced you to the gentle microcannular liposuction. Besides the application for body contouring, it forms the basis for opening up the rejuvenating and regenerative power of stem cells from autologous fat. The fat obtained through microcannular liposuction entails large numbers of autologous stem cells that enrich cosmetic surgery in a very astonishing way.

In the past, doctors carelessly threw away the fat suctioned in the course of the liposuction, and patients were happy to be rid of the troublesome and seemingly worthless fat stores. We in the meantime know the true value of adipose tissue such as the so called “love handles” and what’s in it: the stem cells entailed in the fat are in fact something similar to the Fountain of Youth that Captain de Leon vainly sought – they have an amazing regenerative potential that medicine is only just beginning to discover. Adipose tissue is also the richest source of stem cells in the human body; it entails much more of it than bone marrow, the best known source of stem cells.

When used as part of a regenerative therapy, the power of autologous stem cells is opened up to rejuvenate the tissues, organs, and the whole organism. On the part of the aesthetic treatments, stem cells derived from autologous fat enable sustainable breast augmentation over the long term, skin rejuvenation, the stem cell facelift, as well as a natural, scar-free contouring of the silhouette in various body regions.

Whereas stem cells have been primarily used in the treatment of leukemia (blood cancer), developments now show that they can be used due to their regenerative potential for a variety of therapeutic and cosmetic treatments. The mechanisms through which the regeneration takes place is the subject of numerous scientific studies worldwide.

The regenerative stem cell therapy offers a comprehensive approach to regeneration and rejuvenation of the whole body. It is as such in cosmetic medicine also increasingly replacing “symptom treatments” with a scalpel and artificial fillers. Depending on the goals of the therapy, advisable can be a combination of Hormonal Regeneration® (BHRT), whereby the bio-identical hormones to compensate for age-related hormone deficiencies are administered. Existing signs of aging are as such carefully made to disappear or subside: the body is again stronger and enduring, the libido increases, and the skin gains freshness and firmness.

What all therapies that use stem cells from autologous fat have in common is that the stem cells entailed in the adipose tissue of the previously suctioned fat are extracted and subsequently administered to the body. Autologous stem cells open up their regenerative power in those places in the body, where they are needed. Organs and tissues are apparently regenerated and rejuvenated, and the stem cells can be even used as the basis of therapies for many degenerative and chronic diseases. Although many of these therapies are of course still subject to clinical research, one can nevertheless more or less say: here lies a great future!

In comparison to aesthetic treatments, in the course of regenerative stem cell therapies, smaller amounts of fat are initially suctioned away. The stem cells isolated through a complex laboratory procedure are successively administered to the body. Depending on the indication, they are either injected systemically or locally in a concerned organ or tissue. The surgery – including liposuction – is executed as an outpatient procedure under local anesthesia. By the intravenous administration, the stem cells find their way to the construction sites in the body, where their regenerative and healing effect is needed.

The therapeutic effect of stem cell therapy usually occurs several weeks after application. The rejuvenating and regenerative effect of stem cells leads to noticeable improvements in appearance, vitality and body functions that can even take on the character of a general rejuvenation.

Modern medicine may have found what Cortez and Ponca de Leon searched for in vain – the regenerative stem cell therapies have brought us a decisive step closer to the dream of the Fountain of Youth!

DDr. Heinrich, MD

Microcannular liposuction: The most gentle form of liposuction

Microcannular liposuction is an important pillar of gentle treatments in the repertoire of New Cosmetic Surgery. It is used both for contouring the body silhouette as well as for the extraction of fat for the stem cell facelift, skin rejuvenation with stem cells, breast augmentation with stem cells or regenerative stem cell therapies. What however makes microcannular liposuction the King under the different methods of liposuction?

Manual microcannular liposuction – also called liposculpture – is the mildest form of liposuction! In my clinic it is performed without the use of mechanical suction with the help of manual vacuum syringes. The thereby used real microcannulas were partly developed by me. Real microcannulas have a diameter of 1.0 to 2.5 mm! They generally permit scar-free, tissue-friendly, and very thorough vacuuming with an excellent cosmetic result. This process is naturally, more complicated, and therefore more expensive than liposuction with thicker regular liposuction cannulas.

The method of microcannular liposuction was by the way decisively developed and propagated by the Californian dermatologist and internist Dr. Jeff Klein. His ground-breaking development of the tumescent anesthesia has revolutionized cosmetic surgery, by making cosmetic surgery possible under local anesthesia. This is a good example of how on the one hand, the cosmetic surgery is propagated by doctors of all disciplines and on the other hand shows how the invention of an internist has enriched entire surgery sector – functional surgery is today also very often conducted subject to the use of tumescent anesthesia.

Liposuction under local anesthesia has significant advantages over those conducted under general anesthesia: In addition to the much lower risk of local anesthesia for patients, the patients can have the suctioning away done either lying or else while standing. This allows a more accurate and better contouring of the treated body regions.
Microcannular liposuction is also convincing due to the particularly very simple follow-up of a few days of light compression. The reason for this: Due to the thin microcannulas, the body tissue is less injured than with regular liposuction cannulas. The small injection sites of liposuction heal quickly without scarring, which would be visible to the naked eye, compared to a liposuction with regular liposuction cannulas, whereby 4 to 8 weeks firmer compression are required. Due to the very gentle approach of the microcannular method, pain and swelling after liposuction is low.

Microcannulas are also excellent for the correction of irregularities and dimpling of the body contours, which were caused by accidents or suboptimal successful liposuction with thick cannulas. Due to their small diameter, thin microcannulas enable a precise body contouring; that would not be achieved with thicker regular liposuction cannulas.

In addition, microcannulas are also used to extract those small amounts of fat that serve as a source for stem cell derivation for regenerative stem cell therapies. In a future posting I will bring you closer to the amazing therapeutic potential of stem cells from autologous fat.

DDr. Heinrich, MD

Starlett Naddel: Arm paralyzed after plastic breast surgery…

Time and again we read in the media that famous women have problems after transplantation of silicone implants in the chest. As an extreme example, I recall the renowned German Adult Movie Actress “Sexy Cora” (23) famous from the reality show Big Brother, who died as a result of her sixth breast augmentation with silicone implants. The young woman of good health had suffered from cardiac arrest during a general anesthesia and had subsequently fallen into a coma and eventually died. This time around the Big Brother participant and Model “Naddel” (28), bourgeois Nadine Sommerfeld, had suffered from a Paralysis of the left arm after a corrective surgery on the breast (also the sixth!).

Similar to Sexy Cora, Naddel had also subjected herself to several breast operations in her life. She had enlarged her breasts with silicone implants from a B-cup to size D. But Naddel was dissatisfied with the outcome of the breast augmentation and decided according to the Bild newspaper to subject herself to a scar correction in a private clinic in Leipzig.

When Naddel awoke from the general anesthesia after the surgery, she could neither feel her left arm nor move it. According to the newspaper the surgery through the nervous tissue in the armpit in the course of the previous breast augmentation had led to damage of the nerves that in turn could have led to the paralysis of the arm. The rehabilitation was envisaged to take up to three years. We want to wish her all the best!

There is always a search for culprits whenever such a thing happens. Obvious candidates for blame are naturally the surgeon and the anesthesiologist. Almost all the deaths and serious complications resulting from cosmetic surgery are directly or indirectly related to general anesthesia. I do not blame the doctors, but rather the operation guidelines that are based on reconstructive surgery on diseased or traumatized people where they are entirely appropriate.

I like to leave you with this: Cosmetic surgery is surgery on people without urgent medical necessity. Therefore, a careful gentle approach is paramount in order to minimize the risk for patients as far as possible. This to this end involves minimally invasive surgery under local anesthesia instead of the burdensome, invasive procedures with a scalpel and under general anesthesia! Operational guidelines, which were created for surgery on traumatized patients, are in the cosmetic surgery counterproductive or even dangerous!

I extremely recommend the careful gentle methods of New Cosmetic Surgery as a safer and more natural alternative to general anesthesia, silicone, and a scalpel! Autologous stem cells are isolated from the patient’s fat and can be used for a variety of aesthetic and regenerative treatments: Stem cell breast augmentation and stem cell facelift are prominent examples of this gentle treatment that patients are already benefiting from in my Clinic DDr. Heinrich ®. Both can be performed as outpatient procedures, only require local anesthesia and the nature of the results is very convincing!

I will tell you more in further blog posts about how these procedures with autologous stem cells from fat are performed in practice. You will be amazed at what great and impressive therapeutic benefit that can be achieved with the unpopular fat pads in the beauty and regeneration sectors!

DDr. Heinrich, MD

Press interview about stem cell breast augmentation

1. Is it the use of fat augmented with stem cells instead silicone implants approved by the FDA yet? In what other area of the body this technique can also be used in addition to the breasts?

Stem cell-enriched autologous fat can be used as natural filler on all regions of the body. It has not been approved by the FDA yet. To our knowledge approval is pending. Besides stem cell breast augmentation its main application is the stem cell facelift. Instead of lifting the face using a scalpel, stem cell-enriched autologous fat is injected into the face, both filling the signs of aging and rejuvenating the tissue by the power of the stem cells. Stem cell-enriched autologous fat can also be used for dimple correction and for skin rejuvenation. Additionally fat stem cells are used for used for regenerative medical treatments and anti-aging purposes.

2. Is there any clinic dedicated to this type of procedure even as a trial?

Some clinics worldwide are offering treatments with autologous stem cells from fat to their patients. Also a lot of trials are being conducted recently with it. Stem cell breast augmentation was originally developed to provide women with an alternative to silicone implants after breast cancer surgeries. Research started in 2003 and was sponsored by the Japanese government.

3. Who can undergo to this procedure? What is the ideal percentage of fat so it can be effectively used to extract stem cells?

In general any healthy woman can undergo stem cell breast augmentation. However, in the case of very thin women the technique used to harvest the fat is crucial. Only liposuction with very thin and gentle microcannulas and without the use of machines allows for smooth harvesting of enough fat for breast augmentation.

4. What are the risks associated to Cell-Assisted Lipotransfer? Could it interfere with mammography?

The risks of Cell-Assisted Lipotransfer are the same as with traditional fat transfer. Typically stem cell breast augmentation, like other methods of breast augmentation, causes harmless minimal fibrosis, cysts and sometimes microcalcifications. Experienced radiologists are able to distinguish them from breast cancer in mammography.

5. To what extent is it possible that this technique could disseminate to the point of replacing the silicon that is now in widespread use?

Stem cell breast augmentation has already reached the point of replacing silicone implants! In my Clinic DDr. Heinrich® we have treated lots of women since early 2007. Typically an augmentation of one cup size can be achieved, sometimes even two cup sizes. In these cases the result looks natural because the breast size fits with the body proportions. When larger augmentations are desired and in patients that do object to liposuction silicone implants or hyaluronic acid injections may still be used.

6. How much is the average cost? Is it possible to store the liposuctioned fat for later use?

The fee for breast augmentation with stem cells is individual, the minimum fee is around USD 10,000, but can be much higher. The individual fee depends on a lot of details: Standard cannulas or microcannulas used, just fat harvesting or also forming of the silhouette, ways of cell enrichment, breast forming, and volume. Storing and preservation of cells is typically not done in breast augmentation as all the cells/fat is used during surgery.

7. How much fat can be removed without causing damage to health?

International standard is to not extract more than 4,000 ml of fat per session. In Clinic DDr. Heinrich® we do not extract more than 2,000 ml per session.

8. How long does this procedure take between removal of silicone implants and replacement by stem cells? And how long does the patient have to wait for the final desired result?

Stem cell-enriched autologous fat can be used to replace silicone implants. The breast augmentation with stem cell-enriched autologous fat is typically performed some weeks after implant removal. We have treated a number of patients who wanted to get rid of their silicone implants in favor of a natural breast augmentation. The final result would be seen 3 weeks after the initial swelling has resolved.

DDr. Heinrich, MD

Bid subcutaneous fat farewell: A gentle approach to attaining a bikini figure

The first flowers are already blossoming and the warmth of the rays of the sun can already be felt: the spring has begun. Time again to show more skin! Whereas one could hide winter subcutaneous fat and problem areas simply under the winter coat, they are in particular often disturbingly discernable in the warmer seasons. The gentle treatments of the Clinic DDr. Heinrich® are a remedy to this specific problem!

The repertoire of the New Cosmetic Surgery propagated by us entails treatments that are gentle for a variety of body contouring needs, be it for getting rid of stubborn subcutaneous fat that defies all removal attempts, or for the optimization of the body’s contours. Common to all of these treatments – from microcannular liposuction up to the body forming with stem cells – is that they do not require a scalpel and thus lead to scar-free results that only necessitate simple and short follow-ups, which in particular constitute a very convincing argument.

Microcannular liposuction is performed by hand with thin, to this end developed and patented cannulas. It allows a particularly gentle suctioning of disturbing subcutaneous fat and a precise modeling of the body silhouette. Smaller pockets of subcutaneous fat as well as superficial cellulite can also be brought to disappear with the help of a Fat-Away Injection and a little patience. Autologous fat, with or without stem cell enrichment, is not only suitable for the sustainable correction of dents and tissue defects, but also for the optimization of various body parts. Benefits of microcannular liposuction and body contouring with stem cells and autologous fat are: the interventions are executed on an outpatient basis, under local anesthesia, require minimal aftercare (compression only for a few days) and the results are usually of a durable nature!

Caution: Whereas the extracted fat was formerly usually thrown away, there is today the possibility of isolating the entailed stem cells in a complex laboratory procedure, for use in a variety of therapeutic, aesthetic, and regenerative stem cell therapies. This is an important option that should be considered by all patients over 35 or 40. I’ll tell you more about this in a later newsletter, or else even in the course of a personal conversation that we can arrange at any time.

There is also another reason that makes spring the ideal time of the year for the body forming: The intensity of the rays of the sun is not yet so strong and any bruising after liposuction or body contouring with stem cell-assisted lipotransfer can thus disappear in time for the bikini season!

DDr. Heinrich, MD

No Silicone for Mermaids in Pirates of the Caribbean!

Production of the next sequel to the box office hit Pirates of the Caribbean is currently underway. The title of the fourth film in the series will be On Stranger Tides. On the quest for the legendary Fountain of Youth, Jack Sparrow (Johnny Depp) meets the mermaid Syrena.

In the magazine EW, Producer Jerry Bruckheimer recently expressed his views on the casting of the actresses for the mermaid roles: Everything down to the fins must be real! “I don’t think they had breast augmentation in the 1700s. So it’s natural for casting people to say, ‘We want real people.’”

Last spring, it was reported that the casting call included the proviso that actresses with breast implants need not apply. But what exactly is the reasoning behind the refusal of breast implants?

Silicone implants possess several serious drawbacks: In most cases implant-augmented breasts do not look natural and they feel artificial. Furthermore, the implanting usually leaves visible scars in the lower breast fold or around the nipple. Plus frequent use is made of implants that are way too large, which has negative effects on breast shape.

In contrast, breast augmentation with autologous fat stem cells enables a completely natural and permanent enlargement of the breasts by as much as two cup sizes. A major advantage of this method is the fact that breasts augmented with stem cell-enriched autologous fat look completely natural in any position because they consist of autologous tissue. The liposuction and the implanting of the stem cell-enriched autologous fat are performed with fine cannulas and ultrathin injection needles and leave no scars.

Hence stem cell breast augmentation would surely have been no grounds for excluding someone from the casting call for Pirates of the Caribbean! At any rate we can assume that Àstrid Bergès-Frisbey, the French-Spanish actress playing the mermaid Syrena, doesn’t have silicone implants.

DDr. Heinrich, MD