Reprogenesis: Bulding a Better Breast

[Guest guest]

Here's that article. Maybe this will come to pass in my lifetime!~ If this were a safe option over implants, I would be tempted to give it a try, (I am almost ashamed to say it).

From Mirabella, the September/October issue (1998) Building a Better Breast? An experiemental new procedure would allow women to cultivate their ownbody tissue to create natural implants. Now imagine that these homegrownC-cups could be yours without surgery. Will the Barbie aesthetic triumph atlast? By Blow "We think it looks like a pretty good nipple," says Dan Omstead. The affable, rumpled New Jersey native is pointing at a slide projected on the conference room wall at Reprogenesis, the biotechnology company he runs. The image looks more or less like a woman's nipple, but the skinsurrounding it appears strangely taut and the color is a little off. I mention these blemishes to Omstead, a chemical engineer who's done stints at drug giants Merck and & . "Well," he says, "you're the first person we've shown it to who doesn't think it looks pretty good." It's possible I'm being overly critical. The nipple in question, for one thing, isn't human. It belongs to a pig. Nor is it real--at leastnot in the usual sense of the word: The scientists at Reprogenesis createdit. But in an important sense, it is natural, made from cartilage cells extracted from the pig's ear, grown in test tube-like bottles, theninjected under the animal's skin to form a small protrusion. So when you consider that the nipple is a man-made experiment, it starts to look pretty good. It also looks medically significant. Soon--probably in the firsthalf of next year--Reprogenesis will begin testing its tissue-engineeringprocess on human volunteers, first on women awaiting breast reduction surgery (nipples will be "injected" on the tissue scheduled to be removed), lateron breast cancer patients who've had lumpectomies or mastectomies. The company's goal is to eventually use a woman's own cells to reconstruct not just her nipple but her whole breast--all without protracted surgery, scarring, or silicone implants. "If you can make a woman who's had a mastectomy feel okay about looking at herself in the mirror , that's a pretty worthwhile endeavor," Omstead says. If Omstead sounds a bit defensive, that's because he is. He's well aware that what Reprogenesis is pushing toward, in a nothing-fancybuilding in Cambridge, Massachusetts, could just as easily be used by healthy women who want bigger breasts as by cancer patients. And the cosmeticapplication comes with huge philosophical question marks. If breast augmentation canbe performed safely, easily, and comfortably, using cells from a woman's own body, couldn't implants become a rite of passage like circumcision, the absence of which is often considered aberrant? After all, one of the fewcounterbalances on our society's veneration of large breasts is theinvasiveness, the falsity, the foreignness of silicone and saline. That stigma helps to check the countless cultural billboards telling girls and women that it's better to be bustier. But think about a future where getting implants is essentially a question of rearranging what you've already got: How many American women would choose natural implants?Surely more than the 122,000 who already undergo augmentation annually.

(Patty's note: that number has gone up, up, up....)

But how many more? Enough so that those who didn't would become a stubborn minority? In short, this new technology could forever change thedefinition of a "normal' female body. The people at Reprogenesis don't want to entertain issues like these.Not now. They still have scientific work to do (transplanted cells arealso being tested to strengthen the muscles in the bladders of incontinent patients), and in the meantime, the firm doesn't want to get a reputationas a breast factory. "At these early stages, we are focusing on sickpeople," says Bill Romeo, the company's chief financial officer. He pauses, and I can almost see him struggling to contain his understandable enthusiasmabout the potentially large market for "natural" breast implants. "I'm notsaying we will never do this," he concedes. But for now, he doesn't "want Stern calling up asking how we can grow 'bigger tits.'" Generally speaking, tissue engineering is the use of cells andtissues to restore or repair a body part or re-create bodily functions. Reprogenesis is hardly the only company in the burgeoning field: Organogenesis just won FDA approval for a "skin" made from cow collagenand the discarded foreskins of newborn boys. It is already being used as askin graft for leg ulcers, and the company plans to seek FDA approval to treat burn victims. It has long been possible to transplant tissue from one part of the body to another; plastic surgeons use cartilage from the ear to fill outthe nose in rhinoplasty operations. But when scientists have tried to transplant smaller, more malleable clumps of cells, the cells have died, either for lack of blood supply or because they didn't recognize their new home and malfunctioned. Reprogenesis solved that problem by developing a three-dimensional matrix--a gel made from seaweed-derived material--that mimics cells' natural environment, allowing them to thrive. Applied to humans, the process would begin by extracting a dime-size amount of cells from several sites on the body (for people, as opposed to pigs, thecompany plans to use a cocktail of fat, muscle, and cartilage cells, so that the implant will feel more like a breast than, say, an ear). Once enoughcells grow in the matrix, the substance would be injected into the body with a needle, using a topical anesthetic. Then, as the matrix breaks down over several months, the surrounding tissue should develop new blood vessels to nourish the transplanted cells. (Reconstructing a mastectomy patientwould be more complicated, requiring enough cellular material "to fill a coffee cup", Omstead suggests, as well as surgery or multiple injections.) Prominent plastic surgeons--such as Mark Sultan, of Beth IsraelMedical Center in New York--say they would welcome a method of reconstruction that employs tissue engineering. Now plastic surgeons give patients newnipples by cutting a star-shaped flap in the skin, pulling up the corners andstitching them into a knot, then tattooing the knot for color. Aesthetically, these creations leave something to be desired, and, overtime, can lose "projection," to use Reprogenesis scientist Gentile'sword. As for breast reconstruction, surgical techniques have advanced inrecent years, but they're still far from perfect. For women who've hadlumpectomies, doctors tend to do nothing, leaving the breast with a sortof divot. After mastectomies, breasts can be rebuilt either with implants (which can look artificial and whose potential serious health risks,though scientifically unproven, are unnerving) or with the creation of what'scalled a "flap"--fat and muscle from the lower back or abdomen aretunneled under the muscle lining in the chest area, pushing it out to create a newbreast. Although it's too early to say for sure, Omstead says transplantingone's own cells doesn't seem particularly risky. As with any injection orsurgery, there is some possibility of infection or tissue damage. "Idon't want to tell you that there won't be any risks, but I don't see a big problem," he says. Ultimately, Reprogenesis's future depends on winning FDA approval for its technique, and this is the hurdle that makes Omstead extremelyreluctant to discuss the company's cosmetic future. "It's very difficult to get the FDA's attention when they think you're trying to make bigger breasts, " he says. "But you can imagine that someday this could be used for cosmetic applications." And would Reprogenesis be interested in profiting offthose applications? Omstead sighs. "We're not stupid," he says finally."We're capitalists."