Stem Cell Lift® for Lichen Sclerosus

Lichen Sclerosus is an auto-immune disease that is commonly mis-diagnosed.  Dr. Newman has been treating Lichen Sclerosus for about 5 years and has seen over 100 patients.  Treating Lichen Sclerosus (LS) with the Stem Cell Lift has shown promising and positive results, currently the average improvement after 1 treatment is 60%.  Dr. Newman’s office administers a Facebook group that is able to be joined upon invite by one of the staff members, anyone with Lichen Sclerosus can join and this group is ‘secret’ in Facebook standards.  It is a great resource and offers ample support for anyone who suffers from Lichen Sclerosus as the members in it also have LS.  If you would like to join please call or e-mail Dr. Newman’s office, info@nathannewmanmd.com, 310-273-3344, to read more about the treatment, go Here.  To see a treatment timeline review, and procedure information, go Here and here

Although the exact cause is unknown, Lichen Sclerosus(LS) is a disease of multi-factorial etiology. Associated factors include: genetic predisposition, epigenetic factors, autoimmune diseases, hormonal influences, infectious triggers, and a stressed immune system. Lichen Sclerosus may be more common in some families and can often be triggered by trauma, hormonal changes, infection, and surgery. Patients with Lichen Sclerosus have a higher risk of developing other autoimmune disorders, which develop when the immune system attacks and injures its own body’s tissues. Associated autoimmune disorders may include thyroid disease, anemia, diabetes, alopecia areata, and vitiligo.

Signs and Symptoms Of Lichen Sclerosus
Lichen Sclerosus is a chronic disease that has a spectrum of symptoms, from asymptomatic to mild to severely progressive. Most of the symptoms are from inflammation of the affected areas that may include the clitoris, vulva, vaginal opening, perineum and anal area. Symptoms may include fusing, erosion, itching, fissures, burning, pain with intercourse, pain with urinating and bowel movements.  Sitting for extended periods of time, wearing jeans, and exercising all may be very uncomfortable or is not able to be done. Early in the disease, small white shiny and smooth spots appear on the skin in the genital and anal areas. Many patients may not initially notice the disease, as they may not have any symptoms. As the disease progresses, the spots grow into bigger patches and the skin becomes thin and crinkled. Bright red or purple bruises and patchy white and dark skin color changes are common. The skin becomes very fragile, tearing easily with the slightest friction. Eventually chronic inflammation results in scarring of the tissues.

Excluding Other Conditions
Tests may be done to exclude other conditions that could cause symptoms similar to those of Lichen Sclerosus, such as:

  • Lichen planus (a skin disease that can also cause itching and burning of the genital skin. Lichen planus can occur together with Lichen Sclerosus.)
  • Low estrogen level (can cause vaginal dryness, thinning of tissues and painful intercourse.)
  • Vitiligo (an autoimmune skin disorder that can cause white skin patches similar to those of lichen sclerosus. Vitiligo can occur together with Lichen Sclerosus.)
  • Pemphigoid (a rare blistering skin disorder that also causes scarring of the vulva.)
  • Hemorrhoids (which can also cause irritation in the skin of the anus)

Problems With Conventional Treatment Options
To date, there has been no effective treatment for Lichen Sclerosus. Most treatments use anti-inflammatory steroids such as clobetasol or hormones to reduce the symptomatic itching, burning and inflammation. However, these drugs are not addressing the disease but merely reducing the symptoms and over time are associated with side effects such as thinning of the skin. The long-term use of steroids can cause dependence of the skin on the steroid and when it is discontinued abruptly it can result in a rebound flare. This becomes a vicious cycle of steroid dependence as “the flare” from steroid “withdrawal” is difficult to differentiate from that of Lichen Sclerosus. When this happens, the tissues need to be weaned off the steroids gradually to prevent the rebound “flare” reaction. Lasers and focused ultrasound treatments also have been used with little success to address the symptoms of Lichen Sclerosus but these treatments may result in reduce blood flow and cause scarring of the tissues.

Procedure
Lichen Sclerosus is a chronic inflammatory autoimmune condition that over time causes scar-like fibrotic changes in the skin and mucus membrane. These changes result in individual physical symptoms that are seen and felt by each person. Over time the chronic inflammation causes poor blood circulation, loss of elasticity, and nerve sensory hypersensitivity. The Stem Cell Lift® method delivers an enhanced amount of the stem cells found in your fat to the affected areas. These cells are tasked with reducing inflammation, improving circulation, repairing the collagen scaffolding, restoring elasticity, and repairing damaged cells and tissues. The autoimmune response may also be mitigated through the effects of the stem cells.  In the first three months after the procedure the stem cells attach and become incorporated into their new surroundings.  They may continue to improve the tissues for about one year after the procedure. In doing so, patients report marked improvement in their symptoms, with noted reduction in pain, burning, itching, and improved look and feel of the anatomy of the treated areas.  Patients treated with the Stem Cell Lift® procedure report having less frequent flare ups that are shorter in duration with far less intense pain and discomfort. Most patients are able to discontinue the use of topical steroids and hormones and may be able to resume intimacy and sexual intercourse. You may need to have a series of treatments (usually 2-3) to achieve the desired improvement and relief from Lichen Sclerosus symptoms. As this is a new treatment, long-term results in terms of duration of benefits are not yet known. To date, all patients have had significant improvement with the Stem Cell Lift®.

Pre-Op
We ask that you arrive at Dr. Nathan Newman’s office one hour before your scheduled procedure time.  Parking is available in our structure and we offer validation.  Discontinue use of aspirin (Bayer, Ecotrin, Plavix) NSAID’s (Advil, Celebrex, Ibuprofen, Naproxen) at least five days prior to your procedure.  In addition, if you take the following medicinal herbs, you will also need to stop them 1 week prior to your procedure: Cayenne, Cowhage, Echinacea, Ephedra, Feverfew, Garlic, Ginger, Ginkgo, Ginseng, Goldenseal, Kava-Kava, Licorice, St. John’s Wart, Saw Palmetto, Fish oil, Vitamin C, Vitamin E, Omega complexes, and Valerian.

If you take prescription anti-anxiety medications, do not take them 24 hours before your procedure.  Some patients may be prescribed oral antibiotics for particular medical reasons, but they are not routinely prescribed.  Should you require prophylactic antibiotics, please bring this to Dr. Newman’s attention. You will be asked to start them the day before your procedure.  Oral Arnica (such as Sinnech) is recommended and will be given to you after the procedure.  Because the Stem Cell Lift is done without the use of local anesthesia, you may eat a light breakfast the morning of your procedure, however, do not drink coffee or take medications, such as Advil or Ibuprofen.  All patients require someone to drive them home and to stay with you a few hours, as you may be drowsy when you arrive home and wish to sleep.  We highly reccomend that you bring a family member or friend.  If you must travel alone we can provide information on car service and a care giver to accompany you and as a concierge service we can book this for you prior to you coming for your procedure.  Wear loose-fitting, comfortable clothing and shoes without heels the morning of surgery.  It is fine to wear socks, if you desire to wear them during your procedure.   You will be given a hospital gown to wear.  Your belongings will be secured in a locker and you will retain the key.  We request that you do not bring valuables to the Surgery Center.

While you are undergoing your procedure, your friends or family may wait in the lobby or choose to shop or eat in the many venues Beverly Hills offers.

Post-Op
When the procedure is completed, the fat harvesting area is dressed with a bandage and paper tape.  You may be given a compression garment  to decrease swelling and discomfort.  It is not uncommon to have some drainage of pink-tinged fluid that night and usually stops by morning. Some swelling and mild bruising may be expected at the harvesting or injection sites and is completely normal.  You may shower and remove all dressings the next day.  Dr. Newman and/or the nurse will see you the following day for your first post-operative check.  Tylenol is usually sufficient for pain relief.  You may eat a light dinner.  Do not exercise for a few days.

Liposuction Area
The area where the fat was harvested will be draining the night of the procedure and will usually stop by the following morning. The drainage will be pinkish-reddish this is all of the fluid that was injected before harvesting the fat, this is not blood. The white pads given to you (called “ABD” pads) can be used to change the pads initially covering the incision, should they get saturated.  A compression garment can be used to secure the pads (if you do not require a compression garment you may secure the pads with the lining of your pants or tape. Be careful, repeatedly removing the tape can irritate your skin).  Place one of the green pads (“chux”) in the car and one on the bed tonight to help absorb any drainage. DO NOT shower until after your post op appointment the following morning.  Dr. Newman will tell you when it is ok to shower, please keep them short and use lukewarm water.

The area where the fat was taken will be sore (similar to muscle soreness) for 2-3 weeks. You may wear spanx or a girdle to help alleviate any tenderness.

Wait at least 1 week before bathing or going into a hot tub (if the incision sites from the liposuction are not closed up in 1 week, wait until they are closed before bathing or using a hot tub)

IMPORTANT: DO NOT USE ICE directly on the skin; make sure to put a barrier between your skin and the cool compresses (a gauze or washcloth)

Recovery
After your procedure please enjoy a nice rest at home or hotel. Over the following days and weeks you can expect some swelling and/or bruising, the extent of which varies from patient to patient.  For the first 2-3 days post-procedure you may apply cool compresses (no ice) to the areas treated up to 10 minutes every hour. The cool compresses will help reduce swelling in the affected areas.  After the 3nd post-operative day, you may begin applying warm compresses to the fat harvested areas treated (do not use warm compresses in the LS area) up to 10 minutes every hour.  The warm compresses promote circulation and healing. Also, to help diminish bruising, please take the Arnica provided and incorporate pineapple juice in your diet. You may resume taking your blood thinners and supplements after 48 hours post-op.

The results vary from person to person.  It will take approximately 3 months for the stem cells and fat to become incorporated into the existing tissues.  At 2-3 months we can assess the results to see if additional injections may be beneficial.  Because there may be a need for future injections for touch-up purposes, your fat and stem cells will be stored at our clinic for up to 12 months.  The price of your procedure includes 2 additional injection sessions, if needed. 

FAQs

What are stem cells from fat?
Non-embryonic adult stem cells are found most concentrated in the fat. Adult stem cells remain dormant (non-dividing) until they are activated by a normal need for more cells, or by disease or tissue injury. Serving as part of the repair and maintenance system, they can theoretically divide without limit to replenish others. When activated, the stem cell in the fat has the potential to either remain a stem cell or become a fat cell, a muscle cell, a bone cell, a cartilage cell, or a nerve covering cell.

How do you obtain the stem cells? How are they injected?

Dr. Newman first injects the area used for harvesting fat with a local anesthetic, usually abdomen, inner or outer thighs, or lower back area. A tumescent fluid, which contains medications to further anesthetize the area and reduce bleeding is carefully injected into the area using a cannula (special needle). The fat is manually harvested using a cannula and syringe. The stem cells are separated, concentrated, and prepared for injection. Local anesthesia is injected into the treated areas. Using a special cannula the stem cells and fat cells are injected into the desired area.

Do I need to be put to asleep?
No. The procedure is minimally invasive and does not require general anesthesia.  We administer an oral sedative (Halcion) to relax the patient during the procedure.

Is it safe?
Yes. Since it is your own fat there is no allergic or adverse reaction that can happen from the fat or stem cells. Also, since there is no need for general anesthesia, serious risks associated with being put to sleep are eliminated.

Is it painful? Most patients report feeling mild pressure during the injection that is controlled with local anesthesia and some soreness in the areas treated for about 1 to 2 weeks after the procedure that does not require pain medication.

How long is the recovery?
You will be able to resume your normal daily activities the following day if you are taking the oral sedative during the procedure. The soreness from the lipo portion of the procedure can last 1-2 weeks.  The area where the stem cells were injected may be very itchy for a couple of days and sore.

Can I travel to do the procedure alone?

It is mandatory to have someone accompany you back to a hotel after the procedure as you are under medication.  We are contracted with several nearby hotels, listed here that offer lower rates to our patients.  If you cannot bring a family member or friend with you to the procedure, as a concierge service we can set up a trained Care Giver and hire a car service that will transport you back to whichever hotel you choose.   The care giver & car service are an additional cost that can be finalized if you require these services.

Can I do the procedure in one day or does it take longer?

If you are coming from out of state, we can make it easier for you and do a consult, exam and procedure all in one day.   If you come for a consult/exam first, that is fine too, we can schedule a procedure if you decide to move forward with the procedure at a later date.

How long do I need to remain in town for the procedure/after the procedure?

Since the procedure and consult are done in one day, we only require that you come the next morning for a post op appointment then you are free to travel home, only requiring you to stay in town for 2 nights.

What should I expect after the procedure?

You will be sore for up to 2 weeks, sometimes less.  The area that was injected may also be irritated for a few days.  You may ice the areas as needed and wear spank that do not have legs in them, so as not to irritate the LS area but to help with the soreness of the lipo sites.  If you are able to stay in town longer than the 2 days, we can do healing treatments for the lipo site and the LS area to help speed of the process of healing for you.

Is this procedure covered under insurance?

Unfortunately at this time the Stem Cell Lift treatment for Lichen Sclerosus is not covered under insurance.

How much does it cost?

We have two different protocols with different costs.  The choice in protocol is based on the patient and their needs, to get information on cost please call our office or e-mail us for more information and our staff would be happy to assist you.  310-273-3344

 

 

Updates & Articles

An Update on This New, Promising and Natural Treatment
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Lichen Sclerosus Published Article