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Objectives: Using video, new concepts in facial contouring and rejuvenation will be presented. The audience should be stimulated to apply these ideas and develop their own to better treat their patients.

Introduction: Major facial contouring for reconstructive and aesthetic concerns has generally carried out with implants and osteotomies. The introduction of synthetic soft tissue fillers for facial contouring has introduced a less invasive means of facial contouring, but are temporary and when larger volumes are needed, cost prohibitive. Autogenous and allogeneic materials are readily available options for facial contouring and combinations of various scaffolds with biologically active cells, growth factors and other pharmaceuticals opens up a new, minimally invasive means of improving facial contours.

Materials / method: Over the past 16 years an approach to facial contouring that has been termed injectable tissue engineering (ITE) has evolved. The materials used in ITE have included millifat, microfat and nanofat, allogeneic fat, calcium hydroxyapatite (CH), poly-l-lactic acid (PLA), autogenous cartilage, allogeneic de-cellurized cartilage and bone matrix (DBM). Autogenous fat grafts have been used as the “cell source”, providing a rich stromal vascular fraction, while allogenic fat, cartilage and/or bone have served along with poly-l-lactic acid and calcium hydroxyapatite as scaffolds.

Results: Thirteen patients (3 men and 9 females) ages 22-68 years old underwent ITE. In two patients, PLA was diluted in 20 ml of saline and mixed one to one with 20 ml of microfat (parcel size, 1 mm); in 6 patients, 1.5 ml of CH was mixed with 10 ml of millifat (2 mm); in 4 patients, DBM was combined with PRP (n=2) or with nanofat (n=2) and in one patient, liquid allogeneic cartilage was combined with nanofat. All grafts were delivered through cannulas ranging from 14 gauge to 19 gauge diameters inserted through a 14-18 gauge needle incision. DBM was injected sub-periosteally with a 14 Gauge cannula.

Conclusion: Injectable tissue engineering where composites are constructed with scaffolds and biologically active materials and/or tissues may eliminate the need for complex implants or osteotomies in patients desiring facial contour improvements. Further studies are underway evaluating the use of DBM for chin augmentation.
 

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请注明名称（个人，公司，学会等等）: Musculoskeletal foundation, Mage Group UK

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Objectives: Stromal and Vascular Cells are a group of cells which are fixed and settled in the adipose tissue, are in the vascular walls and are adhered to the ExtraCellularMatrix (ECM). Usually, lipoaspiration procedure is performed to harvest the adipose tissue which Stromal and Vascular Cells are to be isolated from the tissue matrix. Due to tightly adhered presence of the cells to the matrix; we aim to isolate or bring the adipose tissue in different & desired viscosity.

Introduction: In order to make precise injections, we shall aim to parcel the fat tissue in sizes for desired consistency and viscosity. Different viscosity and consistency of the fat tissue is able to be prepared using Microlyzer within the frame of 2400-1200& 600 microns with different numbers of back&forth movement between the syringes. Considering anatomical site layers, from deep fat compartments injections to superficial topical injections for regenerative purposes, we need different prepared fat tissue with different viscosity and consistency.

Materials / method: Generally, manually harvested lipoaspirate is recommended for this method in order to keep the cells viable. We demonstrated with Microlyzer device and its protocol to obtain different fat tissue viscosity and consistency for different fat grafting choices. The parcel size of the prepared fat tissue is from 2400 microns for deep fat compartments or lifting effects to 600 microns processed topical microneedling applications for regeneration purposes of the skin. we used variety of needles from 18G to 30G for demonstration.

Results: Our protocol offers different numbers of cutting & sizing of fat tissue using Microlyzer's 2400, 1200 and 600 micron blades. From 2400, 1200 and 600 micron blade filters, respectively, there are 438, 936 and 3354 units of blades are present. 2400 micron blade filter, from 5-11 times of back&forth movement; the processed fat can pass through 18G to 21G. We demonstrated with Microlyzer processed adipose tissue is precisely injectable with up to 30G needle. Also, SVF preparation protocol is injectable even using 33G needle as the final product becomes very liquid.

Conclusion: These findings have shown that the Microlyzer device and protocols offer vast benefit of fat grafting material preparation in the desired viscosity and consistency for the injection from deep-fat compartment layers to very superficial and liquid form of injections with great viability of the processed fat cells.

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请注明名称（个人，公司，学会等等）: T-LAB

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请注明日期: patent pending
和审阅情况: 2018

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Objectives: To compare effectiveness and subjective satisfaction of two protocols to execute mini invasive lipofilling (microfat) to restore vulvar age related volume loss. During a period of time of 12 months, one group of patient underwent a single stage microfat session on the vulva and vaginal great lips , while a second group underwent a second microfat session at least 3 months after the first, furthermore undergoing once a month a session of vulvar biorevitalization.

Materials / method: Between 1/1/2014 and 11/30/2016 23 patients underwent microfat to restore vulvar age related volume loss; 12 of them underwent a single stage microfat under local anesthesia; the remaining 11 patients underwent a second session of microfat at least 3 months after the first session; furthermore the patients of the second group underwent every month a session of vulvar biorevitalization. Both the groups underwent the lipofilling by means of a new conception closed system, with a patented cannula. The following vulvar area have been treated: mons pubis and labia majora.

Results: The patients of the multiple session lipofilling and biorevitalization group expressed a significant bigger satisfaction about the treatment, in particular 6 months after the treatment (86% against 42%). Photographic and echographic exams showed a bigger and more stable on the mid-long term correction of the age related vulvar volume loss on the group of patient who underwent the multiple lipofilling sessions.

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Objectives: In the rhinoplasty to rebuild the hard tissue of the nose the first choice is the autologous cartilage. The hardest part it is a careful remodelling of the cartilage grafts, especially in noses with thinner soft tissues, where the edges of the grafts can not be camouflaged. So it would be possible to obtain a good results using a more malleable crushed, or diced cartilage. But to implant them, it is necessary incise and dissect the nose tissues, as classic rhinoplasty.

Introduction: To avoid these invasive procedure, especially when we do not need of large quantities of implant, an easier procedure it was the use of more fluid cartilage.

Materials / method: Derived by shaving with scalpel n. 15,the cartilage strongly held firm by forceps. That we can manipulate as a filler with injection by needles between 18 to 21 gauge, or equivalent size cannulas. We used the fluid cartilage alone or mixing with microfat when we need to increase the thickness of the soft tissues, improving also the tissue’s quality. used in 14 patientes

Results: To have this autologous cartilage we must expect a surgical step of harvesting of septum cartilage, or rib, descarted ear cartilage.

Conclusion: The advantages of the cartilage fluid are that it fits exactly the desired shape, molding to distribute correctly the graft, in the same way as a filler. But contrary to the filler which remains fluid, the paste solidifies in autologous cartilaginous tissue. On the other hand a solid graft implanted after larger dissections, it could have moved. An other advantages is the permanent survival of the graft, as observed with at least one year of follow up.
We did not have complications such as infections. We have had few cases of undercorrection.
We can not be able to determine the percentage

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Objectives: MEST: MEchanical SVF Transfer technique is the new way of producing SVF from fat tissue without enzyme in high amount of cells and viability. We are going to present our patented protocol for producing mechanical SVF with special device named as Adinizer. This device consisted of ultra sharp blade system and cuts the bond and bridges between adipocytes and mesechymal tissues under minimal pressure. Participants will learn how to mechanical SVF can be done with high amount of cells and viability with using Adinizer without causing to kill adipocytes.

Introduction: SVF can be isolated from adipose tissue either by means of enzymatic dissociation or by means of mechanical dissociation. Most enzymatic techniques used thus far for isolating the SVF from adipose tissue use collagenase. Main disadvantage of all these enzymatic techniques is that they are rather time consuming and expensive, but also that enzymatic treatment disrupts all communicative connections that exist between the cells as well as between the cells and ECM. Moreover, regulations in several countries does not allow to clinically apply cell-based products that are derived with collagenase.

Materials / method: 91 patients have been treated with Mechanical SVF Treatment (MEST) technique by using Adinizer in different indication. Patients have been followed minimum 6 months postoperatively. Cell count and viability have been evaluated by using dual florescence cell counter. Also our technique has been compared with enzyme technique in same patients in cGMP, cGLP laboratory with flow cytometry.

Results: All patients has been treated successfully with MEST technique. In flow flow cytometric analysis total cells were 2,5 X 10(6) viability was 96.68% in MEST group and respectively 3.5 X 10(6) and 98.23% in enzyme group. Also, cell count has been calculated up to 9.2 X 10(6) and viability up tom 99 % in dual florescence cell counter.

Conclusion: MEST might be more suitable as compared to enzymatic dissociation, because mechanical dissociation of adipose tissue is a fast time sparing inexpensive method and keeps the cell connections . Last 3 years there is shift form enzyme to mechanic SVF production. Since the adipose tissue is the most fragile tissue in the body, we believe that to get best results we should behave the fat tissue "gently".We developed and got patent a new approach as "Gentle Touch System". We cut the fat tissue with ultra sharp blades (Adinizer) to break bond and bridges between the adipocyte and mesenchymal cells .

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Objectives: To practically demonstrate the application of Rigenera® micrografting technology in the treatment of patients affected by androgenetic alopecia providing the guidelines for a correct diagnosis to reach good clinical outocomes.

Introduction: The micrografting technique is based on the concept that by enlarging the skin graft with a ten fold skin expansion, it is possible to cover wide lesions starting from a small sample of donor site. The Rigenera® micrografting technology is a promising approach allowing to obtain a suspension of autologous micrografts derived by the mechanical disaggregation of a small pieces of dermal tissue and immediately available in the clinical practice.

Materials / method: The diagnosis was performed by TrichoLab instrument. Micrografts was obtained by Rigeneracons medical device. To make this, collect a small piece of dermal tissue by a biopsy punch and mechanically disaggregate it by insertion into the Rigeneracons device and add 1 ml of saline solution. After disaggregation, collect the micrografts suspension by a syring without needle. Make intradermal injections directly on the region to be treat.

Results: Clinical evaluation was performed taking photos before and after treatment showing an improvement of hair growth and density due to an increase of total hair count and density accomplished by an increase and reduction of anagen and telogen phases, respectively, as confirmed by scalp dermoscopic.

Conclusion: Collectively, the obtained results suggest that micrografts can be considered a novel therapeutic option in the management of androgenetic alopecia.

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请注明名称（个人，公司，学会等等）: Regenera Activa SL and Human Brain Wave Srl

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请注明名称（个人，公司，学会等等）: Regenera Activa SL and Human Brain Wave Srl

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请注明名称（个人，公司，学会等等）: Regenera Activa SL and Human Brain Wave Srl

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请注明日期: approved
和审阅情况: 12/2015

这项工作的完成感谢以下机构的支持： Regenera Activa SL and Human Brain Wave Srl

Objectives: Our goal is to show that microfat, nanofat grafting can be effective in theses indications. This presentation aims to present our technique, analyzing effectiveness, patient satisfaction, and complications.

Introduction: We aimed to show that our novel microfat nanofat procedure improves skin quality, while yielding a regenerative effect.
This novel technique can also achieve good results in neck, decolletage, hands, and genital area with improvement of vaginal dryness, mucosa trophicity, genito-urinary symptoms of menaupose (GSM), loss of elasticity and volume of external genitalia, but also in hair loss.

Materials / method: Patients presenting vaginal trophic disorders, atrophy of labia majora, GSM, or hair loss, or requested for skin rejuvenation were enrolled. Fat was aspirated from inner face of the knee. Following aspiration and flushing, microfat was obtained after washing with saline.
This microfat was emulsified to obtain nanofat suspension.
A microfat and nanofat grafting was performed in the genital area.
Nanofat was injected into the subcutneous layer at all part of the face, neck, decolletage, hands and scalp.
Biological analysis, histological analysis was done.

Results: 500 patients were included. A significative improvement of the Fridmann score, and FSD scale was found for all patients of genital area, with particular benefit on dryness and dyspareunia.
All patients for skin rejuvenation confirmed an improvement in texture, elasticity, firmness, fine wrinkles and skin hydration with a lifting effect.
All patients with hair loss found an increase hair density, the growth of thicker hair and a reduction of inflammatory component
No complication was found in our study.

Conclusion: This demonstrate that functional disorders of intimate sphere, hair loss and skin rejuvenation can be treated by microfat, nanofat grafting.
This autologous procedure is able to provide a very good improvement in all this indications. This method was effective in all patients and required a single session for long lasting results.

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