Alan Widgerow

University of California, Irvine, Plastic Surgery, Faculty Member

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Professor Alan D Widgerow

MBBCh (MD); FCS; MMed (MHS) ; FACS

Alan Widgerow is a Plastic Surgeon involved in full time Research and device innovations following a 20 year successful career in private practice in South Africa. He has held various positions in numerous academic and professional associations and is author of over 130 plastic surgical related publications and 2 books. He is currently Director of the Laboratory for Tissue Engineering at UCI and is actively involved in medical device innovations, tissue engineering and wound healing. He is also Chief Medical Officer for Alastin SkinCare, a start-up company based in Carlsbad, CA, where he is actively involved in R&D of new product development and lecturing physicians on the science related to the Alastin product range.
He has developed and licensed multiple products to the US and South African medical and cosmeceutical markets, and is consultant to various other companies Internationally and start-ups in the US (Allergan, SkinMedica, BurnShield, LITHA Health Care)
Address: Irvine, California, United States

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Papers by Alan Widgerow

A Split Body Evaluation of a Topical Body Product Applied Pre and Post Liposuction with Helium Plasma and Radio Frequency

Prospective, Randomized, Comparative Study of the Cutaneous Effects of a Topical Body Treatment Compared to a Bland Moisturizer

Aesthetic Surgery Journal, Apr 2, 2021

Background: Over time human skin thins and loses elasticity; topical treatments attempt to revers... more Background: Over time human skin thins and loses elasticity; topical treatments attempt to reverse this process. Objectives: The aim of this study was to assess the efficacy of TransFORM Body Treatment (TFB) in skin rejuvenation compared to a bland moisturizer on the extensor and volar forearms. Methods: Blinded participants were given 2 products to apply on the designated forearms with follow-up at 4, 8, and 12 weeks. Measurements included skin thickness, photography, dermatopathology, cutaneous elasticity determined by 2 different methods, and patient-reported outcomes. All were compared to baseline. Results: Changes between bland moisturizer and TFB were recorded for the following parameters. (1) Roughness: extensor-0.09 mm for bland moisturizer and-0.26 mm for TFB (P = 0.174); volar 0.01 mm for bland moisturizer and-0.23 mm for TFB (P = 0.004). (2) Recoil velocity: volar-56°/sec for bland moisturizer and-24°/sec for TFB (P = 0.61); extensor-95°/ sec for bland moisturizer and-63°/sec for TFB (P = 0.57). Retraction speed: volar-3.25 ms for bland moisturizer and-20.08 ms for TFB (P = 0.33); extensor-2.17 ms for bland moisturizer and-10.83 ms for TFB (P = 0.66). Histologically, TFB resulted in an increase in mucopolysaccharide content, new collagen, and number of elastin fibers in the papillary dermis. Changes in the Rao-Goldman score were also observed: volar-0.17 for bland moisturizer and-0.33 for TFB (P = 0.25); extensor-0.08 for bland moisturizer and-0.17 for TFB (P = 0.36). Conclusions: Histology showed production of new collagen and elastin. Quantification of changes in skin thickness, skin retraction speed, and skin recoil velocity showed trends that agree with the visual data.

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Microsurgical Needle Retention Does Not Cause Pain or Neurovascular Injury in a Rat Model

Plastic and Reconstructive Surgery - Global Open

Background: Approximately 20% of retained foreign bodies are surgical needles. Retained macro-nee... more Background: Approximately 20% of retained foreign bodies are surgical needles. Retained macro-needles may become symptomatic, but the effect of microsurgical needles is uncertain. We present the first animal model to simulate microsurgical needle retention. Given a lack of reported adverse outcomes associated with macro-needles and a smaller cutting area of microsurgical needles, we hypothesized that microsurgical needles in rats would not cause changes in health or neurovascular compromise. Methods: Male Sprague-Dawley rats (x̄ weight: 288.9 g) were implanted with a single, 9.0 needle (n = 8) or 8.0 needle (n = 8) orthogonal to the right femoral vessels and sutured in place. A control group (n = 8) underwent sham surgery. Weekly, a cumulative health score evaluating body weight, body condition score, physical appearance, and behavior for each rat was determined. Infrared thermography (°C, FLIR one) of each hindlimb and the difference was obtained on postoperative days 15, 30, 60, a...

Intraoperative Loss of a Microsurgical Needle: Assessing Potential Injury and Risks Through a Rat Model

Plastic and Reconstructive Surgery - Global Open

Biomechanical Characterization of Human Normal Auricular and Microtia Cartilage

Plastic and Reconstructive Surgery - Global Open

Patient-Reported Satisfaction After Autologous Auricular Reconstruction in Patients with Microtia: A Systematic Review

Facial Plastic Surgery & Aesthetic Medicine

Importance: In a patient-centered field such as plastic surgery, patient-reported satisfaction ca... more Importance: In a patient-centered field such as plastic surgery, patient-reported satisfaction can measure the success and value of surgery, since it is not uncommon for patient and surgeon assessments to differ. Currently, there is no standard for evaluating patient-reported satisfaction postauricular reconstruction. Objective: To systematically review the literature regarding patient-reported satisfaction postauricular reconstruction in microtia patients. Evidence Review: The databases MEDLINE, EMBASE, Cochrane, and Scopus were searched and preferred reporting items for systematic reviews and meta-analyses guidelines were followed. Studies documenting patient-reported satisfaction postauricular reconstruction in microtia patients were included. All techniques for ear reconstruction have been included in this review. Findings: Nineteen studies utilizing autologous reconstruction technique, comprising 3694 patients, met inclusion criteria. No standardized patient satisfaction assessment was used throughout the studies, indicating criteria variability to measure outcomes. Auricular substructure analysis highlighted lower patient satisfaction with the tragus and antitragus compared with the upper units. In addition, satisfaction depended on patient perception, not on a low surgical complication rate. Conclusions: There is a clear need to incorporate a standardized validated surgery-specific questionnaire related to patient satisfaction in the auricular reconstruction protocol.

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Fluidic Device System for Mechanical Processing and Filtering of Human Lipoaspirate Enhances Recovery of Mesenchymal Stem Cells

Plastic & Reconstructive Surgery

Background: Adipose tissue is an easily accessible source of stem and progenitor cells that offer... more Background: Adipose tissue is an easily accessible source of stem and progenitor cells that offers exciting promise as an injectable autologous therapeutic for regenerative applications. Mechanical processing is preferred over enzymatic digestion, and the most common method involves shuffling lipoaspirate between syringes and filtering to produce nanofat. Although nanofat has shown exciting clinical results, the authors hypothesized that new device designs could enhance recovery of stem/progenitor cells through optimization of fluid dynamics principles, integration, and automation. Methods: The authors designed and fabricated the emulsification and micronization device (EMD) and the filtration device (FD) to replace the manual nanofat procedures. Using human lipoaspirate samples, the EMD and the FD were optimized and compared to traditional nanofat using ex vivo measurements of cell number, viability, and percentage of mesenchymal stem cells and endothelial progenitor cells. Results...

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Effects of a Topical Anti-aging Formulation on Skin Aging Biomarkers

The Journal of clinical and aesthetic dermatology, Aug 1, 2022

Objective: Following previous clinical trials, an antiaging product (Restorative Skin complex [RS... more Objective: Following previous clinical trials, an antiaging product (Restorative Skin complex [RSC]; Alastin Skin Care Carlsbad, a Galderma company), was investigated for its effects on Klotho gene regulation, telomere length, and histological biopsy changes to provide a comprehensive picture of the mechanism and efficacy of its anti-aging effect. Methods: Neonatal human fibroblasts were used for telomere length studies to examine the effect of the full RSC formulation and the amino acid components Tripeptide-1 and Hexapeptide-12 (TriHex™) on these cellular aging mechanisms. In addition, RNA sequencing was conducted using human keratinocytes specifically investigating Klotho and related genes. This was supplemented by a clinical study using biopsy samples. Results: TriHex™ significantly upregulated the Klotho gene and related FGF23, FGFR1 and FOXO3B anti-aging genes. Significant telomere shortening reduction over control was demonstrated with the RSC formulation at four weeks and with TriHex™ at six weeks for all percentiles tested. Previous clinical studies demonstrated that the use of the antiaging regimen for 12 weeks produced a statistically significant improvement in scores for all evaluated parameters. Restaining of previous biopsy blocks from the clinical trial revealed positive ECM changes, stimulation of collagen, fibrillin, CD44 and elastin. Limitations: The study was limited by a relatively small numbers of patients in the clinical trial and the non-competitive nature of the trial. Conclusion: RSC anti-aging formulation and its TriHex™ components demonstrated significant reduction in telomere shortening, upregulation of Klotho and FOXO3 genes and biopsy validation of anti-aging efficacy. This new science supplements previous trials that demonstrated clinical efficacy of the formulation.

The Use of Micronanobubbles to Improve the Viability of Donor Corneal Tissue

Investigative Ophthalmology & Visual Science, Jul 22, 2019

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Journal of Cosmetic Dermatology, 2021

Scar management - marrying the practical with the science : review

Wound Healing Southern Africa, 2010

We have come a long way in our understanding of the mechanisms involved in producing an exaggerat... more We have come a long way in our understanding of the mechanisms involved in producing an exaggerated scar. One of the important factors to consider is that, as in so many other medical conditions, the answer lies in a multipronged approach. It serves no purpose targeting one area in a cascade of events that result in scarring. Thus we previously published a set of principles that govern the sequential areas of control that we have used to minimise scarring - support, hydration, collagen maturation and controlled inflammation. These principles will be elaborated on in respect of new scientific facts and with particular reference to the practical management of different wound sites.

A new look at venous ulceration : general review

Wound Healing Southern Africa, 2009

Chronic venous disease is a widespread problem that impacts greatly on the health care system bot... more Chronic venous disease is a widespread problem that impacts greatly on the health care system both in terms of time and costs involved. Varicose veins are extremely common among the general population (Figure 1). Of these hundreds of thousands of patients, it is estimated that one in every hundred will suffer from venous ulceration - out of these patients many endure ongoing ulceration for periods of 1-5 years (occasionally even longer) and recurrent ulceration after healing is not uncommon. Thus the magnitude of the problem associated with chronic venous disease is apparent.

The WHASA WHEEL - integrating multiple specialities in patient management with wound healing as the common basis : case study

Wound Healing Southern Africa, 2008

There is not a speciality in Medicine that I can think of today where Wound Healing does not impa... more There is not a speciality in Medicine that I can think of today where Wound Healing does not impact. The surgical specialities by their very nature involve the healing of wounds in one form or another, but it is not always appreciated that almost every chronic medical condition also has associated wound problems. This reality results in an unprecedented amalgamation of medical minds and basic scientists all contributing to a surge in knowledge related to this relatively new field. The WHASA (Wound Healing Association of Southern Africa) WHEEL is a concept that has been developed to demonstrate the impact of interspeciality co-operation for the ultimate benefit of the patient. This article, by means of a hypothetical case, attempts to demonstrate this co-operation and to highlight esoteric situations that arise when considering wound healing among the different fields. It is by no means exhaustive of surgical scenarios but merely representative of fairly common situations that any of...

Deconstructing the chronic wound : review

Chronic wounds have traditionally been defined as those that fail to progress through an orderly ... more Chronic wounds have traditionally been defined as those that fail to progress through an orderly and timely sequence of repair, such that healing does not take place in a predictable time frame. More objective definitions of chronic wounds are 'those that have failed to heal within three months'; 'a wound that has not decreased by 30% of its size within four weeks'; 'if a wound is not 30% smaller by week four, it will not heal by week twelve'; and so on. The crux of the matter is that these wounds reach an impasse in their healing progression which is not easily explained and has remained a mystery for decades. On 'deconstructing' the chronic wound phenomenon in recent years, two factors appear to play an increasingly important role in the evolution of chronicity - exaggerated inflammation and allied to that, infection, particularly involving biofilm.

Bioengineering and the diabetic foot ulcer : basic science review

Wound Healing Southern Africa, 2012

Diabetic disease is increasing exponentially on a global scale. Diabetic foot ulcers (DFUs) are t... more Diabetic disease is increasing exponentially on a global scale. Diabetic foot ulcers (DFUs) are the leading cause of non-traumatic lower limb amputations. The pathophysiological events need to be considered when designing new interventions. Bioengineered skin substitutes (BSS) are accepted in the therapeutic armamentarium for DFU treatment. However, newer designs are likely to offer more targeted approaches to the disease process. This relates to the stimulation of vasculogenesis in particular. This can be achieved by using interactive scaffolds that stimulate endothelial progenitor cells to increase vascular endothelial growth factor production and reverse some of the damage that is caused by glycation end-products that are characteristic of diabetes.

Pressure Ulcer Research : Current and Future Perspectives, ed. by D. Bader, C. Bouten, D. Colin, C. Oomens. : book review

South African Journal of Surgery, 2007

This book provides a comprehensive account of current research and management practices related t... more

WHASA consensus document on the management of acute burns

Wound Healing Southern Africa, 2015

Burns are among the most common and devastating forms of trauma. Increased morbidity and mortalit... more Burns are among the most common and devastating forms of trauma. Increased morbidity and mortality accompany thermal injury, and survival is dependent on the correct assessment and management. Although acute treatment regimens and dressing selection have evolved to improve outcomes, deep burn injuries often leave patients with considerable cosmetic and functional disabilities, which may lead to a lifetime of challenges. Patients with major burns should be referred to a burn unit or multidisciplinary centre where the primary objective is to care for burn patients and to optimise their outcomes. Such centres comprise teams of specialist burn surgeons, plastic and reconstructive surgeons, physiotherapists, occupational therapists, dietitians, social workers and nursing staff, as well as other consultants, who all strive to obtain rapid wound closure and return burn survivors to a functional and well adapted life.

Pain and the healing wound : controlling pain is more than just a compassionate need : wound care

Wound Healing Southern Africa, 2013

Breaching the skin surface causes pain. Pain evolves via central interpretation of signalling med... more Breaching the skin surface causes pain. Pain evolves via central interpretation of signalling mediators released following a peripheral stimulus. Short-term release of these mediators may aid in wound healing, but extended release may well have detrimental effects thereon. The longer the pain is endured, the more sensitive the patient becomes to the pain stimuli. Additionally, inflammation is increased which delays healing, and fibrosis can result in exaggerated scarring. Thus, while pain control is obviously sought based on compassionate grounds, its impact on healing and scarring may be added reasons to avoid protraction of its occurrence.

When healing stops... : general review

Wound Healing Southern Africa, 2011

The non-healing wound is encountered by practitioners in multiple clinical situations. It is char... more The non-healing wound is encountered by practitioners in multiple clinical situations. It is characterised by a stalled process in the healing trajectory. The non-healing wound is not necessarily a chronic wound, although the two conditions have many similarities. With the advent of improved molecular biological understanding, many cellular events can be recognised as patterns for non-healing, and possible interventions may become evident. Thus, once obvious host disease problems have been excluded, exaggerated inflammation with high matrix metalloproteinase levels and the presence of biofilm are causative factors in many cases of non-healing wounds. Intervention may range from a simple change of dressing type and debridement to more sophisticated wound bed interventions. A systematic approach to the non-healing wound is presented.

Manual of Aesthetic Surgery, vol 2. Werner L. Mang : book review

Extracted from text ... Manual of Aesthetic Surgery. Vol 2. Werner L. Mang. Pp. XLIII + 272. 206 ... more Extracted from text ... Manual of Aesthetic Surgery. Vol 2. Werner L. Mang. Pp. XLIII + 272. 206 colour illus, 20 plates, 66 photographs, DVD video. Hardcover. US$249.00. Heidelberg: Springer-Verlag, 2005. ISBN 3-540-66553-6. This book is the second in a series of instructive manuals on aesthetic surgery. The author makes clear in his introduction that the book is not aimed at professionals who have practised the specialty for a long time; rather it is intended for the novice starting out in the field. Where volume one is related to the basic operative procedures in the head and neck, this volume concentrates on the torso. In his introduction Mang describes aesthetic surgery as the most difficult ..