Mario Goisis - Outpatient Regenerative Medicine: Fat Injection and PRP as Minor Office-based Procedures

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The gradual aging of the population and improved living conditions in many geographical areas have made regenerative medicine more and more relevant over the last few decades. Besides their traditional areas of application (e.g., reconstruction after trauma or injury), regenerative approaches have become increasingly more pertinent in antiaging or simply aesthetic medicine. The branches that avail themselves of regenerative approaches are numerous and include plastic surgery, odontostomatology, otolaryngology, orthopedics, dermatology, gynecology, and many others besides. The exponential increase of professionals, meetings, and training centers, together with strong links with the industrial world, has meant that the scientific level too of regenerative approaches has progressively reached high levels of excellence. The most advanced regenerative techniques emerging from research centers and supported by a wealth of first-class technologies are now being widely used in medicine. Regenerative techniques are based on three main pillars: stem-cells, growth factors, and scaffolds. The development of these, which may also be used in combination, is by no means simple and requires optimization by means of recourse to technologies that must be, at once, effective and safe while also being simple to carry out. Only the simplicity of the procedures involved can actually ensure their widespread use outside of operating theaters. Finally, we must remember that it is mandatory that all operators have a thorough and correct knowledge of the macroscopic and microscopic anatomy of the areas of the body which they intend treating. This aspect, above all, appears to be one of the prerequisites essential for correct treatment and achieving lasting results. All these considerations lead us to stress the need for the development of appropriate training courses capable of meeting the growing demands of a technologically highly advanced and rapidly evolving sector that is also making a huge contribution to the knowledge of the regenerative mechanisms of tissue.

Surgery has always made use of fat grafts for reconstructive and aesthetic purposes. Starting from the early 1980s, the introduction of standardized techniques, like Colemans, led to the achievement of excellent results reported in numerous scientific publications. So, today, many years after its first introduction, adipose tissue may be considered, without a shadow of doubt, the safest filler and the scientifically most validated medium of tissue regeneration. Today, the real challenge is to simplify and make harvesting and injection techniques more and more efficient. The future of lipofilling, by means of microfat and nanofat techniques, will most probably involve the integration and progressive replacement of injection techniques by hyaluronic acid and fillers.