Cosmetic Medicine / Plastic Surgery

Can this technique revolutionize reconstructive surgery?

A new, quick and easy technique for reshaping cartilage and other living tissue could change the way surgeons carry out certain reconstructive interventions, such as repairing septum deviations.
photo showing a person's nose
A quick and easy new technique could reshape cartilage, such as that of the nose, without the unwanted side effects.

The originators of the new technique described it yesterday at the Spring 2019 National Meeting and Exposition of the American Chemical Society in Orlando, FL. The method suggests an innovative way of reshaping cartilage and other tissue containing collagen easily — and without scarring.

The research team — from Occidental College in Los Angeles, CA, and the University of California in Irvine — explains that, as it stands, much of reconstructive surgery, such as interventions to reshape the nose or ears, are invasive and may lead to scarring.

Such procedures involve cutting through live tissue, carving into cartilage, suturing the skin, and potential scarring after the intervention, as well as a long recovery period.

However, the new technique would do away with almost all of these inconveniences, according to the developers.

“We envision this new technique as a low-cost office procedure done under local anesthesia,” says one of its lead developers, Michael Hill, Ph.D.

The whole process would take about 5 minutes.”

Michael Hill, Ph.D.

The new technique and its potential uses

Ears and parts of the nose contain cartilage, a type of tissue consisting of loose strands of collagen fibers that special macromolecules hold together. “If you picked [this structure] up, the strands wouldn’t fall apart, but it would be floppy,” Hill explains.

Moreover, different kinds of cartilage contain negatively charged proteins and positively charged sodium ions, which are present at different densities, determining whether the cartilage is tougher or softer.

Through various experiments, Hill and colleagues found that if they delivered electrical current at a constant voltage through cartilage, this would determine the water in that tissue and split it into its components — oxygen and hydrogen ions or protons.

When this happens, the positively charged protons neutralize the negatively charged proteins, which renders the cartilage softer and easier to reshape. As Hill puts it, “Once the tissue is floppy, you can mold it to whatever shape you want.”

To test the effectiveness of this method, the researchers decided to try it out on a rabbit’s ear, working on an ear that usually sits upright, and aiming to reshape it so that it stayed bent.

The procedure involved the team applying a local anesthetic, then using microneedles to insert tiny electrodes into the tissue, and applying constant electrical current for a few minutes. Once they had softened the cartilage, it took the form of a premade 3D mold in the shape they desired.

In the rabbit model, once the researches turned off the electrical current and removed the mold, the ear cartilage was able to harden, maintaining the new, bent shape.

This new technique, the team says, does not cause the pain and scarring of a typical remodeling intervention.

While the method could apply to cosmetic procedures, the researchers emphasize that it would also come in handy for people who, for instance, have a septum deviation that affects their breathing, or who have to deal with immobile joints.

The researchers also believe they could adapt this method to reshape the cornea, the front, outermost layer of the eye that also contains collagen. When the cornea is too curvy, it can cause nearsightedness, and so finding a way to adapt this minimally invasive technique for eye surgery would make cornea corrective procedures much easier.

At the moment, Hill and colleagues are looking at licensing their innovative technique with dedicated companies that create medical devices. However, they acknowledge that, before these procedures become available for humans, they must first pass safety and effectiveness tests in clinical trials.

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