Further, these cells have built in restraints that halt growth when their job is done, producing no more and no less new tissue than their host cells demand. This erases the chance that injected cells will produce excess growth or tumours.

While researchers have continued to explore the many possible uses for all stem cells, the availability, reliability and lack of ethical questions have made adult stem cells the more commonly visible of the two.

For Dr. Amar, this acceptance and wide use of adult stem cells represented the next logical step in the evolution of FAMI. Already familiar with the power of regenerative cells, Dr. Amar recognized the role adult stem cells, or pre-adipocytes, could play in providing a natural and precise alternative to traditional fat injections.

Already equipped with a thorough, three-dimensional view of the facial structure, Dr. Amar now had the organic ingredient to produce a natural, lasting result. Familiar with the process and practice of liposuction, Dr. Amar knew that these cells could be easily extracted from a patient and injected to produce the kind of three-dimensional volume he knew was possible.

Still, the question of how he could deliver the safest possible sample, in the safest possible way remained. Traditional methods had relied on clumsy and imprecise scalpels and debris-ridden fat samples, producing dismal and unpredictable results. To ensure the level of quality he knew was possible, Dr. Amar understood that the limitations of modern surgery would have to be pushed – a challenge he would ultimately have to face himself.

While other surgeons had used centrifuges to varying degrees of success when it came to purifying samples, Dr. Amar believed that more could and should be done to assure the cleanest and safest sample possible. Believing that the commonly used centrifuge, produced by New York surgeon Sydney Coleman, was too limiting due to its strict controls, Dr. Amar turned to a machine that allowed him to control both time and pressure. Fig 27.

The resulting machine gave Dr. Amar the opportunity to circulate fat samples, always extracted from the same patient, at pressures measuring 13,000G. Fig 28

Placed in context an astronaut experiences only 3Gs of pressure during the launch of the Space Shuttle. In addition to producing a pure and safe sample to be use at a later time, the centrifuge separated the unhelpful oils from destroyed big fat cells and debris from the extraction, leaving only the needed adult stem cells. Fig 29

This purity would not only increase the chance that the cellular graft would take, but also limit the side effects associated with healing, such as bruising and swelling. Content with the quality and effectiveness of the adult stem samples he intended to use to complete the FAMI procedure, Dr. Amar then turned his attention to the challenge of precision.

As a defining factor in the formation of the FAMI technique, Dr. Amar had concluded that the adult stem cells needed to be delivered directly into the fine strands of muscle and beneath the periosteum, the thin layer membrane that envelops bones and facilitates growth. Such a feat would require not only an encyclopedic knowledge of the facial anatomy, but also a level of precision that was impossible achieve with the tools available to surgeons at the time. In addition to protecting the layers of muscle that made up the face, Dr. Amar realized that he needed a non-invasive solution that could also respect the complex system of nerves and vessels that resided beneath the skin. A sharp and clumsy scalpel simply would not do. To effectively deliver the stem cells to the necessary, deep plane muscle tissue and along the bone where needed, Dr. Amar began to create a series of tools designed to adhere to the specific curvatures of the human skull. Comparing it to the challenges faced on a golf course, Dr. Amar concluded that each specific muscle and curvature would need its own tool, with an angle, length and girth designed for one area and one area only.

Using the contemporary selection of cannulae available at the time – a straight trio measuring essentially the same length and width at 7cm and 17 gauges, Fig 30 – Dr. Amar began reshaping each to fit a specific area of the face and skull.

What followed was a steady and precise evolution of cannulae as Dr. Amar used natural and synthetic models to help determine the exact length, angle and width needed to be able to offer the perfect tool, no matter what a patient needed. Fig 31 Recognizing the importance of these instruments in determining the success of FAMI, Dr. Amar observed that they were the result of years of experience with the facial framework combined with advances in medical technology, allowing him to test their effectiveness on natural models. These designs, he concluded, could not have come at any earlier point in his career. Starting with those cannulae needed for the facial muscles, Dr. Amar turned his attention to the bone in 2002, completing a final set of 19 soon thereafter. Each distinct and unique in its own ability, these cannulae were chosen for use according to the specific needs of a patient. Most importantly, however, these tools provided the final component in the creation and implementation of the FAMI technique. Equipped with the tools, the knowledge and the experience to feel certain he could guarantee the results of his procedure with absolute certainty, Dr. Amar realized it was time to move forward. Fig 32.

 

Or visit:   The Amar Clinic website: Stem cells FAMI rejuvenation