The Potential Role of Exosomes in Aesthetic Plastic Surgery: A Review of Current Literature

Abstract

Background: Despite an increasing surge of exosome use throughout the aesthetic arena, a paucity of published exosome-based literature exists. Exosomes are membrane-bound extracellular vesicles derived from various cell types, exerting effects via intercellular communication and regulation of several signaling pathways. The purpose of this review was to summarize published articles elucidating mechanisms and potential applications, report available products and clinical techniques, and prompt further investigation of this emerging treatment within the plastic surgery community. Methods: A literature review was performed using PubMed with keywords exosomes, secretomes, extracellular vesicles, plastic surgery, skin rejuvenation, scar revision, hair growth, body contouring, and breast augmentation. Publications from 2010 to 2021 were analyzed for relevance and level of evidence. A Google search identified exosome distributors, where manufacturing/procurement details, price, efficacy, and clinical indications for use were obtained by direct contact and summarized in table format. Results: Exosomes are currently derived from bone marrow, placental, adipose, and umbilical cord tissue. Laboratory-based exosome studies demonstrate enhanced outcomes in skin rejuvenation, scar revision, hair restoration, and fat graft survival on the macro and micro levels. Clinical studies are limited to anecdotal results. Prices vary considerably from $60 to nearly $5000 based on company, source tissue, and exosome concentration. No exosome-based products are currently Food and Drug Administration–approved. Conclusions: Administered alone or as an adjunct, current reports show promise in several areas of aesthetic plastic surgery. However, ongoing investigation is warranted to further delineate concentration, application, safety profile, and overall outcome efficacy.

Autologization of Exosomes with Deparenchymized Adipose Tissue: An Innovative Approach for Regenerative Medicine and Surgery

“…1 Exosomes are nanovesicles that transport bioactive molecules to regulate cell behavior and ECM remodeling. [2][3][4][5] However, current exosome products lack ECM, which plays a crucial role in modulating their uptake, distribution, and signaling effects. The ECM is a complex network of structural and signaling molecules that control cell fate and tissue repair.…”

“…Exosomes are complex nanovesicles that are continuously released by cells into the extracellular environment. 2 With a diameter of about 40–100 nm (Fig. 1 ), they contain various biomolecules that interact dynamically with the extracellular matrix (ECM).…”

Autologous Stem Cell-derived Therapies for Androgenetic Alopecia: A Systematic Review of Randomized Control Trials on Efficacy, Safety, and Outcomes

“…It has been found that human ADSCs within the dermal white adipose tissue have stimulatory effects on DPCs and promote HF cycling via extracellular vesicles and complex signaling pathways. 15,[42][43][44][45][46][47] Finally, HF organoids 48 and 3D scaffolds (Fig. 4B) are emerging solutions with clinical applications in virtually all aspects of regenerative plastic surgery.…”

Exosomes - breakthrough in the regenerative medicine and a way to improve the quality of the life

“…Exosomes derived from adiposederived stem cells, for example, can carry factors that support tissue regeneration, contributing to better outcomes in aesthetic procedures. [39] Exosomes possess antiinflammatory properties, which can be beneficial in managing inflammatory skin conditions.…”