Stem Cell-Based Aesthetics: Integrating Regenerative Science with Patient-Centered Ethics

Abstract

Regenerative medicine is transforming aesthetic surgery by shifting its purpose from temporary cosmetic correction to true biological restoration. This multicenter study, conducted in Mexico, Colombia, and Ecuador with 180 participants, evaluated the clinical efficacy, histological performance, safety, and ethical perception of three aesthetic interventions: adipose-derived stem cell (ADSC)-enriched fat grafting, platelet-rich plasma (PRP) therapy, and hyaluronic acid filler. Standardized assessments were carried out at 1, 3, and 6 months, measuring satisfaction, volumetric retention, dermal elasticity, adverse events, histological regeneration, and ethical comprehension using validated instruments. The results demonstrated that ADSC-enriched fat grafting achieved the highest overall outcomes, with a mean satisfaction score of 8.6 ± 0.9, volumetric retention of 72.3%, and superior skin elasticity (0.89 mm), while maintaining the lowest complication rate (28.3%). PRP therapy provided moderate dermal improvement and high safety (38.3% minor events), whereas hyaluronic acid fillers showed reduced durability (28.7% retention) and greater inflammatory response (51.7%). Histological analysis confirmed enhanced angiogenesis, organized collagen alignment, and minimal fibrosis in ADSC-treated tissues. A strong positive correlation was observed between ethical perception and patient satisfaction (r = 0.71, p < 0.001), underscoring the importance of communication and transparency in aesthetic outcomes. Autologous regenerative therapies therefore emerge as superior alternatives, integrating efficacy, biocompatibility, and ethical confidence. The convergence of regenerative biology and bioethical responsibility defines the new paradigm of next-generation aesthetic surgery, merging innovation with integrity to achieve sustainable and patient-centered beauty.