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Future of plastic surgery Z. Kruppa plastic surgeon Medisch Esthetisch Instituut Amsterdam. Club of Amsterdam Amsterdam Fashion Institute 22 January 2009. Future of plastic surgery. Plastic surgery. Improvement of the quality of life
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Future of plastic surgeryZ. Kruppa plastic surgeon Medisch Esthetisch Instituut Amsterdam Club of AmsterdamAmsterdam Fashion Institute 22 January 2009
Plastic surgery • Improvement of the quality of life • Reconstructing the functional integrity • Restoring the aesthetic appearance • Refined techniques and instruments • Construction and creativity
Technical innovations • Tissue transfer
Tissue transfer • Lipofilling – fat transplantation • Natural and long lasting • No allergic reactions • No foreign body reaction • Additional improvement on the donor site • Rejuvenating effect of the harvested stem sells (?) • Combination with other techniques • Applications: • Facial rejuvenation • Breast enlargement • Body contouring
Technical innovations • Tissue transfer • Transplantation
Technical innovations • Tissue transfer • Transplantation • Stem cells
Stem cells • Multipotencial cells are able to transform to any tissue cell • Stem cell harvesting: • Embrional stem cells (destruction of human embryos, immunological rejection) • Genetic induction or reprogramming (the details of the regulation are quite unknown) • Patients own stem cells – umbilical cord (limited number)
Development Tissue repair Cancer
Stem cells - application • Tissue repair • Cardiac muscle (heart infarct) • Diabetes (insuline producing islet cells) • Neurodegenerative diseases (Parkinson, Alzheimer) • Brain and spinal cord damage
Technical innovations • Tissue transfer • Transplantation • Stem cells • Tissue engineering
Tissue engineering Human cells and biomaterial Substitution of organ transplantation Arteficial heart valves, pancreas, kidney, liver, cartilage and bones Possible combination with cloning and stem cells No immune reaction – no need for immunosuppression
Technical innovations • Tissue transfer • Transplantation • Stem cells • Tissue engineering • Genetic engineering
Genetic engineering Modification of the human DNA Changing or replacing the information Production of lacking hormones, growth factors, structural elements
Technical innovations • Tissue transfer • Transplantation • Stem cells • Tissue engineering • Genetic engineering • Cloning
Technical innovations • Tissue transfer • Transplantation • Stem cells • Tissue engineering • Genetic engineering • Cloning • Scarless healing
Technical innovations • Tissue transfer • Transplantation • Stem cells • Tissue engineering • Genetic engineering • Cloning • Scarless healing • Injectables and biomaterials
Injectables, biomaterials • Requirements for the fillers • Safe • Reliable • Natural • Predictable volume • No long term side effect • Long lasting
Technical innovations • Tissue transfer • Transplantation • Stem cells • Tissue engineering • Genetic engineering • Cloning • Scarless healing • Injectables and biomaterials • Lasers
Lasers • Selective destruction of various cells • Tattoo removal • Epilation • Scar treatment • Vascular malformations • Collagen induction • Photo-rejuvenation
Lasers - future • Fractional treatment • Rejuvenation with less side effect.
Technical innovations • Cloning • Scarless healing • Injectables and biomaterials • Lasers • Meso-therapy • Tissue transfer • Transplantation • Stem cells • Tissue engineering • Genetic engineering
Meso-therapy • Local application • Higher concentration • More effective • Less complication
Meso-therapy Lipolysis, cellulite Wrinkles, stretch marks Hair loss, alopecia Muscle and joint pain
Meso-therapy • Future improvements: • Needleless mesotherapy • Electrophoresis • Jet-peel
Moral considerations New fields in aesthetic surgery New age groups in plastic surgery