Healing Like a Child

Host: Welcome to Pronto Telenova. I'd like to welcome and thank Professor Carlo Tremolada, Scientific Director of IMAGE REGENERATIVE. Today we're discussing regenerative medicine — a term that's become quite fashionable. But between trends and health lies what matters most: practice, and our own wellbeing. So what is it, and what is it used for?

Carlo: Everyone's talking about longevity and regeneration these days — very overused terms. When it comes to longevity, what we really need is physical exercise, proper nutrition, and a healthy lifestyle. Those are the pillars. Regeneration is different. We need to demonstrate that the things we talk about actually work.

What is regeneration? It's fundamentally harnessing our body's own healing mechanisms to restore lost health. Take a very simple example: what happens when we're children. As kids, we take terrible falls, we get seriously hurt — and after a little while, we recover very well. Part of it is psychological — the brain helps enormously when you have trust in the people treating you — but it also helps that the vascular density of a child's tissues is completely different from an adult's.

Here's an example orthopaedists know well. If you tear a meniscus at six or seven years old playing football — even a complete tear — it heals entirely on its own. After three or four months, the child is perfectly fine. In adults, even young athletes, that doesn't happen. A twenty-year-old with a torn meniscus usually can't spontaneously regain perfect health, especially if they're an athlete.

With the techniques we have now — of which Lipogems® is one of the most important because it enables long-term healing — we can achieve meniscus reconstruction even in people aged 50, 60, or 70. We can regenerate it exactly as it would regenerate in a child.

Host: Without surgery?

Carlo: Without surgery, in certain cases where, for example, the joint isn't locked. It's no longer necessary to perform meniscus debridement in those situations.

Host: That sounds extraordinary.

Carlo: There are now over 200 peer-reviewed scientific publications demonstrating, for example, that fingertips can regrow — a regeneration normally only seen in newborns — and that severe injuries can be repaired with near-zero scarring.

Host: So what exactly is Lipogems®?

Carlo: It's your own adipose tissue, microfractured into very small pieces — about 300 microns — but perfectly identical to native adipose tissue. These pieces are well-vascularised, with capillaries covered by tiny cells called pericytes, the precursors of mesenchymal stem cells — the cells that carry out daily maintenance of our body.

Think of it as an "Egg of Columbus" — a system to increase the vascular density of your tissues and return to healing as you did when you were a child.

In practice: a small amount of fat is harvested with very thin cannulas. It's not liposuction — it's a fat harvest. A coffee-cupful is enough to treat two knees. This tissue is then processed inside the Lipogems® device, which is approved by the U.S. FDA and European medical agencies, backed by extensive scientific literature demonstrating safety and efficacy. The device microfractures and thoroughly cleanses the adipose tissue. The resulting micro-fragments are then injected with a needle or cannula wherever needed — a torn meniscus, an arthritic knee, an ankle that won't heal, or hallux rigidus, for example, which is common among dancers at La Scala. Several famous dancers have undergone this procedure and fully recovered without invasive surgery.

This has also been demonstrated by Professor Primorac in Zagreb, who showed that cartilage actually regrows after the procedure.

Host: Where on the body is the fat taken from?

Carlo: Wherever you like — that's the wonderful thing. You can even gain an aesthetic benefit at the same time, combining the harvest with a micro-liposuction. The small amount of tissue is processed inside the device, and what comes out are these microfractured fragments — 300 microns, perfectly alive, covered by their capillary network. When reinjected where needed, they revascularise the tissue as if you were a small child.

Host: Even for someone over 50 or 60?

Carlo: Of course. Here's a simple way to think about it. Imagine a cube, one metre on each side. If you reduce it into smaller cubes of 10 centimetres without destroying them, you get 1,000 cubes, each with six faces. A simple microfracture increases the contact surface area by 6,000 times. Between the ages of 7 and 70, you lose roughly 90% of your capillaries. But if you add 6,000 times more where you need them, you heal exactly as if you were seven years old.

Host: Who invented this?

Carlo: I did. It's an international patent, present in 50 countries. I'm a plastic and reconstructive surgeon; I was director of plastic surgery at San Paolo Hospital in Milano for many years. I've always been interested in biology and tissue healing. We've known that adipose tissue has regenerative properties — even normal liposuction fat improves tissue quality. But those particles are too large and struggle to take root. Lipogems® solves this: the fragments are much smaller, they implant more easily and with less trauma, and they remain alive in place for a very long time, performing their regenerative function.

Viewer questions

Chiara: Is it painful?

Carlo: It's done under local anaesthesia, so it's not painful at all. But it is a procedure — not a simple injection. It lasts about an hour, depending on what needs to be done.

Host: Has this been adopted by the public health system in any regions?

Carlo: Yes — in Veneto, Emilia-Romagna, Liguria, and soon in Lombardia as well. But it's not just about orthopaedics. In Emilia-Romagna, Professor Poggioli at Bellaria di Bologna uses Lipogems® for extremely difficult conditions that have nothing to do with orthopaedics or aesthetics — perianal fistulas, Crohn's disease, ulcers that are extremely difficult to heal. With Lipogems®, healing rates are much higher than with the best technologies currently available. They've completed a clinical trial on hundreds of patients with exceptional results. The same applies to diabetic foot ulcers, where the re-amputation rate is significantly lower.

I also use it extensively in surgery — for example, after a facelift, recovery periods typically require up to a month at home. With Lipogems®, recovery times can be reduced to a quarter of that, because the cells release powerful anti-inflammatory factors that suppress inflammation and increase regenerative capacity.

Pasquale: Could this method have been used for the kids at Cran?

Carlo: When I was in the United States presenting the method, I visited two major burn centres — in Birmingham and in Boston. It was used primarily for burn outcomes. For acute cases, further studies are needed, but in theory it's ideal: it drastically reduces inflammation, reduces pathological scarring, and has an anti-infective effect. From a clinical practice standpoint, it will likely be used most in the healing of scars that unfortunately, in some cases, are inevitable.

Viewer: How long does the effect last?

Carlo: That's the revolutionary aspect. This system is truly stable — it's the best way to use your own mesenchymal stem cells for long-term healing. The microfractured adipose tissue takes root where you place it and remains for months or years, producing a progressive healing process. It's also the only system proven to regenerate cartilage. Children regenerate cartilage because they have the time to do so. PRP — platelet-rich plasma from a blood draw — is the most commonly used method to aid regeneration. It works well, but it can't do more than a limited amount because it doesn't have the time to work. PRP contains growth factors that trigger stem cells to detach and begin regenerating, but the process must continue on its own — there must be sufficient microvascular density in the tissue. PRP doesn't change that. Lipogems® is completely different: you're introducing tissue — a microvessel transplant. You permanently change the local conditions, and the tissue continues to improve for weeks, months, years.

Paolo: When my grandson was born, they collected cord blood stem cells and said it wouldn't be possible later. But now I see that's not the case?

Carlo: Cord blood donation is something parents should absolutely do when a baby is born — but in Italy it's public, meaning anyone can use it. You can send it to Switzerland for private storage, but the whole thing doesn't make much sense. The umbilical cord is rich in mesenchymal stem cells, but no more so than fat. In reality, we carry this bank inside us our whole lives. Even at 60 or 70, with microfracturing, although you no longer have the same potent stem cells as a child, they don't change that much with age — what changes dramatically is the number. But with microfracturing, you increase the bioavailable number by up to 6,000 times. People over 80, even over 90, have benefited enormously — especially in the shoulders, which cause terrible pain.

Marco: I have a microfracture in my shoulder. If I undergo the procedure and get another MRI, will I see that it's healed?

Carlo: Certainly. Over 300 scientific studies frequently show improvement on imaging — on X-rays and MRI. But what matters most is the clinical improvement. With Lipogems®, you see improvement across all the tissues of a joint — not just cartilage, but also ligaments, synovium, and other structures.

Host: What about back pain without a diagnosis?

Carlo: This really needs to be done properly, by highly competent people. The injection must be performed under ultrasound or CT guidance. It's also reimbursed by most insurance plans. Allianz, through IMAGE REGENERATIVE, even has a direct billing agreement — insured patients don't pay a penny, because the insurance covers it. That's one of Europe's largest insurers placing full trust in this method.

Domenico (phone call): I have a torn ligament in my right knee. I've been told hyaluronic acid might help. Is it a permanent solution?

Carlo: Let's not confuse things. Hyaluronic acid is the most commonly used treatment for knee osteoarthritis. Your torn ligament is probably the cause of your osteoarthritis. Hyaluronic acid has a dual function: it's like putting oil in an engine — it makes the joint glide more smoothly and prevents damage. But it doesn't heal. It's a mechanical aid. Lipogems® is completely different — it provides the joint with the cells that actually carry out repair. One is applying oil; the other is repairing. Two completely different things.

Valerio: I was a cancer patient but I'm not anymore. Are there risks or contraindications?

Carlo: That's a very smart question. One of the extraordinary things Lipogems® does — and why I use it extensively — is addressing radiation therapy damage. Radiation can save your life, but it can leave significant damage to mucous membranes and skin. Lipogems® can restore irradiated tissues to normal. I have quite a few patients coming from the United States specifically for this. It can address issues with the oral mucosa, rectal mucosa, or vaginal tissue following radiation treatment. There are no contraindications — and keep in mind that normal adipose tissue transplantation has been used for at least fifty years in post-mastectomy breast reconstruction, proving there are no oncological issues.

Host: Thank you to Professor Carlo Tremolada, Scientific Director of IMAGE REGENERATIVE.

Carlo: Thank you all. And congratulations.