[Opening]
Thank you. It’s a pleasure to be here with the Solongevity team and friends of Image Regenerative Clinic Milano.
I’m Carlo Tremolada, plastic and maxillofacial surgeon. My background is surgery, but my passion has always been research—
especially the kind that helps the body repair itself. Today I’ll walk you through a practical, already-available regenerative
approach that we developed and patented: Lipogems—micro‑fragmented adipose tissue (MFAT).
[Why adipose tissue]
For centuries we’ve known that fat is not just “filler.” Adipose tissue is richly vascularized; along the tiny blood vessels live
perivascular cells that can act as mesenchymal stromal cell (MSC) precursors. If we can concentrate and present that microenvironment
to damaged tissues in a safe, minimally invasive way, we consistently see better pain control, improved function, and better-quality
healing across multiple indications.
[What Lipogems is]
Lipogems is a sterile, single‑use, closed system that gently reduces small clusters of adipose tissue from roughly 3 mm down to
around three‑tenths of a millimeter, without enzymes and without additives. The device is air‑free and fluid‑perfused, protecting
the fragile capillary niche while removing oils, blood residues, and inflammatory debris. The output is micro‑fragmented adipose
tissue that can be injected with fine cannulas directly where it’s needed.
[The harvest—simple and aesthetic-friendly]
We harvest a small amount of fat—typically from abdomen or flanks—using tiny incisions and tumescent local anesthesia. Patients
usually appreciate the aesthetic “bonus” and the fact that it’s a quick outpatient procedure with a short recovery. Because the
system is closed and gentle, complications are rare; in our experience, infection is extremely uncommon, and pain is limited.
[What the micro‑fragments do]
Think of each micro‑fragment as a living, physiological “bioreactor.” It brings not only adipocytes but, crucially, the perivascular
stromal niche with a cocktail of cytokines, growth factors, extracellular‑matrix signals, and the ability to modulate inflammation.
Instead of forcing cells outside of their natural habitat, we preserve their architecture so they can talk to the host tissue the
way biology expects.
[Clinical applications we use every day]
• Orthopedics and sports medicine: knee osteoarthritis (especially with degenerative meniscal pathology), tendinopathies of the
shoulder and elbow, ankle injuries, and cartilage degeneration. We routinely observe pain reduction and functional gains.
• Plastic‑aesthetic and reconstructive: facial volumization with a regenerative angle (skin texture, scars), breast soft‑tissue
quality after radiotherapy, post‑traumatic or post‑surgical contour defects.
• Pelvic and perineal medicine: complex fistulas and continence support (in multidisciplinary pathways).
• Dermatology and scar medicine: chronic wounds, atrophic scars, post‑acne texture improvement (always combined with proper wound
care and energy‑based devices where indicated).
[Evidence and validation]
Over the past decade, multicenter studies, registry data, and peer‑reviewed papers have documented safety and consistent clinical
benefit of micro‑fragmented adipose tissue in joints and soft tissues. No enzymes, no culture expansion, no added drugs—just the
patient’s own tissue, processed to optimize its biological effect. Regulatory frameworks vary by country, but the procedure is
already in routine use in orthopedics, plastic surgery, and rehabilitation settings. In some health systems, parts of the pathway
are reimbursed; private pay models are common.
[Longevity strategy: ‘Regenerative boosters’]
At Image Milano, we integrate Lipogems into a broader longevity strategy: lifestyle and nutrition, biomarkers, endocrine balance,
and targeted supplementation—then we add a “regenerative booster” when the tissue needs a nudge. The goal is not to promise
miracles; it’s to create measurable, patient‑relevant improvements—less pain, more function, higher‑quality tissue—using what the
body already offers, intelligently prepared.
[Patient selection and workflow]
We start with a careful assessment: history, imaging, function, and expectations. If a joint shows advanced bone‑on‑bone collapse,
we discuss realistic outcomes or surgical pathways. If there’s inflammatory overload, we calm it first. For MFAT cases:
1) micro‑harvest (outpatient), 2) in‑line processing in the closed device, 3) targeted injection guided by anatomy and, where needed,
ultrasound, and 4) rehabilitation to consolidate gains. Most patients are back to routine activities in days; sport loads are
reintroduced progressively with physio oversight.
[Safety]
Across thousands of cases worldwide, the safety profile is excellent when performed in sterile conditions by trained teams.
Because we keep the stromal architecture, we avoid the cell‑manipulation risks seen with enzymatic approaches; and the closed,
air‑free device minimizes contamination. Typical side effects are localized soreness or swelling that settles over days.
[Results you can expect]
In knee OA, we often see a clinically meaningful reduction in pain and improved walking distance within weeks, with durability
over months and, in many reports, beyond a year. In aesthetics, the skin looks and behaves more “healthy”—not just filled, but
better texture, elasticity, and scar quality. In tendinopathies, pain on provocative tests reduces and load tolerance increases.
We document outcomes with PROMs and imaging where relevant.
[Why micro‑fragmented beats ‘cells in a tube’]
Cells outside of their micro‑environment are fragile. Enzymatic isolation and expansion remove the very matrix and paracrine
neighbors that instruct MSC behavior. Micro‑fragmentation preserves the perivascular niche and avoids over‑processing. It’s a
“functional tissue transplant,” not a cell product.
[Where this is going next]
We are pushing research on standardized dosing by anatomical site, better patient stratification by phenotype and biomarkers,
and combined protocols (e.g., MFAT plus mechanical stimulation, or staged with orthobiologic scaffolds). In longevity medicine,
the aim is to time the regenerative intervention to the biologic “window” when it gives maximum signal with minimum burden.
[Take‑home]
Regeneration is not science fiction or a vague promise for the future. With Lipogems micro‑fragmented adipose tissue, we can apply
a safe, simple, and biologically intelligent booster today—complementary to lifestyle, endocrine balance, and physical medicine.
That’s how we convert long‑term healthspan ideas into concrete, patient‑level benefits.
[Closing]
Thank you. I’m happy to take questions and dive deeper into protocols, indications, and data.