Dr. David Evdokimow explains the fundamental approach, each and everything about Regenerative Medicine. Dr. Evdokimow compares and shows the fundamental differences between a traditional medicine and Regenerative Medicine. The components of Regenerative Medicine, the uses, and the Future of Regenerative Medicine is being discussed greatly in this document. Please share and spread the knowledge of advance medical science. Thanks!

1. Regenerative Medicine- A Fundamentally Different Approach to
Individual’s Health
Traditional Medicine
Treats disease that, once developed, subsequently leads to dependence of the medical care
system
Unhealthy but functional individuals with the high demand of medical care dominate the society
today.
For the last decade, the health delivery system has been depleted of preventive measure and
the proactive approach to individual health is more or less inexistent, leading to increased
dependency on government health regulations.
As a comparison, the post-rehab relapse of the heroin addict is 97%, the current health care
relapse is 100% - dependency worse than heroin addiction.
Integrated Regenerative Medicine
This is a fundamentally different approach to individual’s health.
 Integrated- healthy lifestyle and prevention of diseases.
 Regenerative-Use of the body own cells and properties to restore or establish normal
function. True understanding of the aging process; slows down the biological aging process
and facilitates healthy functional life with increase endurance, mental capacity, libido and
sleep. Today’s 70-year old is yesteryear’s 30-something.
 The goal is to cure the health care dependency and join the path of personal freedom
Components:
 Healthy lifestyle
 Normal physiologic weight
 Nutritional knowledge
 Smart exercise program
 Bio-identical hormone replacement
 Non-surgical and surgical reduction of exercise resistant fat deposit
 Reduction of intra-abdominal fat
 Growth factor therapies
 Fat transfer (fat is the mantra today)
 Stem cells and /or exosomes enriched fat transfer
 Stem cell therapies
 Exosomes
 Stem cells/exosome therapies
 Molecular breakdown therapies (nearest future)
Non-Surgical and Surgical reduction of Exercise Resistant Fat Deposits
After a certain age, the subcutaneous fat deposits of the abdomen and flanks no longer
respond to healthy lifestyle and the most advanced exercise routines.

2. The reasons are decreased active hormonal levels and decrease the sensitivity of the cell
receptors to the circulating active hormone metabolites. This is also associated with the
conversion of beneficial hormones in the fat tissue of the abdomen and flanks to hormone
exercising deleterious functions.
The amount of fat around the abdomen and flanks is a stronger prognostic factor for
numerous diseases than genetic predisposition. The risk for the conditions listed below is
directly associated with the amount of fat around the abdomen and flanks:
 Type 2 Diabetes
 High Blood Pressure
 Metabolic Syndrome
 Heart disease
 Heart attack
 Stroke
 Non-alcoholic fatty liver disease (excess of fat in the liver of people without alcohol
consumption)
 Cancer such as breast, colon, kidney, endometrial (related to the lining of the uterus),
ovarian
 Decreased libido and erectile dysfunction
 Depression
 Alzheimer’s disease
 Dementia
In summary, whether an individual will enjoy healthy and functional life after the age of fifty
or assume the shape of a pretzel in a nursing home bed, is directly correlated to the truncal
obesity (the amount of fat around the abdomen and flanks).
Intra-abdominal (the amount of fat around the internal organs of the abdomen) is also a risk
factor, especially in men. Intra-abdominal fat cannot be reduced with surgical or non-
surgical fat reduction strategies because of the inherited complications. This is subject of
intensive research and some exosomes associate with specific fat types in fetuses might give
a promising solution.
Liposuction of the abdomen and flanks is not a strictly cosmetic procedure but also carry
significant health benefit. They’re a numerous methods for a non-surgical fat reduction on
the market today. Most of them with minimal or no side effect and absence of permanency.
Some cryo and laser based treatments have shown up to
25% reduction of fat deposits in the area of the abdomen and flanks. These treatments are
by no means replacement for liposuction but are considered a good alternative for people
who cannot have surgical procedures.
Growth factor therapies

3. Different cell populations are able to secrete growth factors, which actively participate in
the tissue repair. They play fundamental role in wound healing, immune defense,
regeneration and tissue repair after fat transfer, stem cells and exosome treatments
Fat transfers
During the last decade, fat transfers became a powerful method in reconstructive and
cosmetic surgery. Due to the unique properties of the fat as a metabolically active tissue, fat
transfers become an integral part of regenerative medicine. Stem cells and or exosome fat
transfers expanded the horizon of regenerative medicine and will continue to do so in the
future.
Stem cells
Definition: A cell, which can reproduce itself and has maintained its capabilities to
differentiate in different tissue types such as fat, bone, muscle, cartilage etc.
Stem cells can be derived from embryos, placenta, umbilical cord d blood, human tissue
such as fat, bone marrow, and peripheral blood after bone marrow stimulation. In adults,
fat has the largest number of stem cells followed by the bone marrow. Stem cells age and
decrease in number as the biological ages increases. The difference between the stem cells
in young and old individuals is the number and frequency of the growth factors they secrete.
There are multiple ethical and medical issues associated with the use of embryonic stem
cells, which require further clarification. Adult stem cells use as autologous (from the same
individual) transplant is effective therapy and can improve many chronic conditions and are
used in regenerative protocols. The allogeneic (from another individual) stem cell transfer is
currently illegal in the US with exception of bone marrow transplantation after chemo and
radiation therapy.
Stem cells exercise their positive effect trough eliciting differentiation of the organ cells via:
 Signaling-exosomes, growth factors,
 Angiogenesis (new blood vessel formation),
 Anti-apoptosis (delaying cell death),
 Cell preservation,
 Anti-inflammation including inflation associated with autoimmune disease,
 Neuromodulation- restoring nerve function and nerve repair.
During the therapies the most common ways of delivering the stem cells are as follows:
 Intravenous (through a vein)
 Intra-arterial (through an artery)
 Intra-muscular/intra-tendinous under XR or ultrasound guidance
 Intra-articular –In the joints under XR or ultrasound guidance
 Into or around intervertebral disks- through XR or Ultrasound guidance
 Into the spinal canal (itrathecal)-trough XR guidance
 Perivascular (around the blood vessels)

4.  Perineural (around the nerves)
 Intradermal (in the deep layers of the skin)
 Subcutaneous (in the fat layer under the skin)
 Other methods of delivery can be chosen depending on the desired effect
Exosomes
Definition: Small vesicles secreted by the cells and taken up by the neighbouring cells as a
cell to cell communication. They contain messenger RNA, micro RNA, growth factors and
can induce the desired behaviour in the neighbouring cells.
Without exosomes, a simple viral infection can kill any human within hours.
Years ago, the exosomes were considered the waste product of the cells. For the last 15-20
years, it has been a subject of intense clinical research leading to an understanding of their
important function. The exosomes are not cells and cannot be rejected. The exosomes
producing stem cells can be directed to follow specific cell lines to create specific exosome
product.
When combined with adult stem cells, exosomes can elicit behavior typical for stem cells
from a much younger individual.
In 2014 a Hong Kong billionaire financed/helped scientists from Stamford (Wyss- Corray) to
start Alkahest Inc. in Menlo Park, CA - the company prepares plasma from people bellow 30
years of age and transfuses it to Alzheimer’s patients.
Another company, Ambrosia, is giving plasma transfusions to the 35+ age-group of
individuals harvested from people below 25 years of age. Why these very unspecific
infusions have regenerative properties is the presence of exosomes
The US military is investing a lot of money and resources in stem cell-directed therapies.
Because of the significant improvement of the protective gear the head and the torso of the
troops is well protected but not the face and the extremities. That’s why extremity and
craniofacial injuries spinal cord injuries remain a big problem and stem cell therapies are
used for their treatment.
Types of clinical conditions that can be improved by stem cells, exosomes, and stem
cells/exosomes therapy.
 Musculoskeletal: joints, tendons, tendon insertions, ligaments, muscles, bones,
intervertebral disk and any other musculoskeletal structures, plantar fasciitis
 Autoimmune: RA (Rheumatoid arthritis), Lupus, Scleroderma, Dermatomyositis, Ankylosing
Spondylitis, Muscles Dystrophies and other autoimmune syndromes
 Lungs: COPD, asthma
 Neurodegenerative: Alzheimer’s disease, Parkinson’s disease, Myelitis
 Neuropathies, complex regional pain syndromes-RSD, chronic pelvic pain, other nerve
associated pain conditions

5.  Erectile dysfunction, including the one caused by prostatectomies, anorgasmia, certain type
of urinary incontinence, balanitis and chronic inflammatory disorders of the genitalia
 Vaginal, vulvar and penile rejuvenation of the combined with other therapies e.g. fat
grafting
 Symptoms of acute and chronic Lime Disease in combination with appropriate antibiotic
therapies trough up regulation of the macrophage function
 Acute burn injuries and reconstruction of sequel of burn injuries
 Multiple vasculopathies- conditions including blood vessels
 Diabetic foot ulcers and neuropathies
 Reconstructive surgery: Numerous applications depending on the condition treated. Scar
treatments, Craniofacial Injuries, Chronic Wounds, Wartime injuries
 Cosmetic surgery: Stem cell and/or Exosome enriched fat grafts, Non-surgical hair
rejuvenation, mesotherapy and many other applications
This is just a limited presentation of some of the current use of stem cell and exosome
therapies. Their true application is a lot more extensive and the list will continue to grow
with time. This is merely a summary of important new developments. It is impossible to give
a detailed explanation in such a short format.
If you require additional information, we encourage you to schedule an office visit for a
detailed discussion.
Our treatments are free of commercial bias and are based on the most recent knowledge
of regenerative medicine.
Please call Dr. David Evdokimow at 908-221-1136 or send an email to
drevdokimow@gmail.com
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website:www.theplasticsurgeonofnj.com for updates