Bigger than Botox?

Wrinkle-busting toxin injections have revolutionised attitudes to cosmetic procedures. But a new treatment using your own cells could prove even more popular, reports Hester Lacey

In recent years, the frontline skirmishes in the battle against ageing have been fought with syringes. Injecting facial wrinkles to plump them out has become something of a craze. But the search for the holy grail of the perfect "filler" has encompassed some fairly gruesome options – until now.

First there was collagen extracted from cows, leading to jitters in American socialite circles over both mad cow disease and foot-and-mouth (though there was no actual fall in take-up, wrinkles being deemed worse than any other potential hazard). Gel fillers based on hyaluronic acid are popular too; hyaluronic acid is found in roosters' combs, though it can also be made synthetically.

One of the best-known injectables is Botox, which uses the toxin that causes botulism food poisoning to paralyse facial muscles and smooth the skin. Fifty thousand vials of Botox were ordered in the UK last year. Botox parties, where clients get giggly over a glass of wine while waiting their turn for the needle, are so popular that the American Academy of Dermatology issued a stern warning that alcohol can intensify any bruising, and also wash the toxin away from the target muscle.

The truly determined can seek out doctors who will administer collagen taken from human cadavers or from the by-products of circumcision (that is, infant foreskins), both available in the US. Once suitably purified, they too can be pumped into the face.

The latest breakthrough, however, looks set to cause a revolution in cosmetic treatments. It doesn't involve cows, corpses, chickens, circumcision off-cuts or food-poisoning toxins. Scientists are now able to take samples of the patient's own cells, grow them in a laboratory, and inject the patient's own tissue back into the face to erase wrinkles and scars. This new process, Isolagen, has just become available in the UK.

The Cranley Clinic in London is one of the first in the UK to offer Isolagen. Dr Nick Lowe, the consultant dermatologist, has taken the initial samples from a number of patients, and expects to start re-injecting cultivated cells in a few weeks' time. "You take a little skin sample from an area that has been shielded from the sun, usually behind the ear, sometimes under the arm," he explains. "This sample contains fibro-blasts, which are the cells that sit in the support structure of the skin and produce collagen and elastin. Sun can damage the fibroblasts, and undamaged fibroblasts grow more efficiently in the laboratory."

The sample is sent off to be cultured. "It takes six to eight weeks to grow the first syringes for injection," says Dr Lowe. "Then the mixture is sent back and I inject it back into the patient." An initial course of treatment would involve three or four injections every six weeks. Once the desired effect is achieved, the cells can then be stored, using a sophisticated freezing technique, to be revived in case another course of treatment is needed in future years.

One bonus is that the stored cells don't age; cells frozen when a patient is, say, 35, will always be 35 years old. But there are other advantages. "Because the treatment uses your own cells, there is no risk of any allergy or adverse reaction." And, says Dr Lowe, the treatment is relatively painless. "The initial biopsy is very small; four millimetres across. It needs one or two tiny sutures, and really isn't noticeable afterwards. It doesn't hurt if the physician uses a local anaesthetic before taking the sample."

The development of Isolagen began in the early 1990s, when an American cell biologist, Olga Marko, began investigating the use of technology to stimulate a patient's own cells to produce collagen. She developed a method of extracting a patient's own collagen-producing cells – the fibroblasts – growing and expanding them, and reintroducing them by injection into the skin of the patient's face to repair skin defects. By 1995, the cosmetic applications had been recognised, and since then it has been tested on more than 1,000 patients in the US.

"We have had seven years' experience of Isolagen in the US," says Brian Whitley, the managing director of Isolagen UK, the British branch of the company. "Some patients are still showing good effects seven years after having the treatment. It's possible that it lasts a lifetime." The injections seem not only to fill in wrinkles, but also to stimulate neighbouring cells into growth.

Whitley says the main market for Isolagen is likely to be people who have tried other treatments such as Botox. He also believes it will appeal to others who wouldn't dream of using existing procedures. "Many would never consider plastic surgery, but perhaps would consider this, because it is natural and uses their own cells."

Isolagen can also be used on facial scars from acne or chickenpox. Dr Lowe says that about one-third of his initial clients are having the treatment for facial scarring. In future Isolagen could also be used to repair skin damaged by burns or cancer. Its potential for rebuilding joints worn down by arthritis and rebuilding receding gums is being researched.

It has taken over a year's preparation to bring Isolagen to Britain. The company has set up a laboratory in London specifically to culture the cells, with an identification system to ensure that samples don't get mixed up. Last weekend, an initial training session for a dozen selected British plastic surgeons took place. By Christmas, Whitley estimates, Isolagen will be available nationwide. From here, the company will target the rest of Europe. The cost of a course of treatment? About £2,500.

Richard Yeo, who pioneered keyhole surgery in this country and now specialises in cosmetic surgery, is impressed by what he has seen of Isolagen. He has performed several initial biopsies and, like Dr Lowe, is waiting to perform his first injections. "Isolagen is very different from collagen or other inert materials, which can cause an adverse reaction or be absorbed into the body very quickly," he says. "I tend to be sceptical of new treatments, and I always consult other surgeons rather than taking the manufacturers' hype at face value. But this does sound very exciting."

Yeo finds that treatments such as Isolagen are not only less invasive than face-lifts, but that they give a more natural-looking result. "A treatment may not take you back to the perfection of your twenties, but it allows you to retain the character of your face, with the main defects much softened."

Dr Lowe believes that, as with all filler treatments, Isolagen's results will vary from person to person. "I don't think it will replace surgery or laser treatment in someone with a lot of sun damage or lines. And there is still research to be completed. Some US patients have seen benefits that have lasted years, but I think there will be greater benefit for younger patients with finer lines and earlier signs of damage."

He and Brian Whitley will be among the first British recipients of Isolagen. Small bits of each are now multiplying in flasks. "My cells should be ready for first injections next week," says Whitley. "It's all very exciting."

Dr Nick Lowe, Cranley Clinic (020-7499 3223); Richard Yeo (01424 774884)