A new filling technique with vital micrograft from adipose tissue: a Lipo-Stem-Exos method. A case report

A new filling technique with vital micrograft from adipose tissue: a Lipo-Stem-Exos method. A case report

Authors

  • Fabiano Svolacchia Department of Sense Organs, University of Rome “La Sapienza”, Italy
  • lorenzo svolacchia Department of General Surgery, University of Rome “La Sapienza”, Italy

Keywords:

Vital micrografts, microfiltration, side population, ADSCa, exosomes, lipo-stem-exos

Abstract

Aim: Through this clinical case report, we have demonstrated that the periocular area can be effectively corrected using a single filling session with vital micrografts derived from microfiltrated, fragmented adipose tissue. Over time, vital micrografts have allowed us to maintain a high correction capacity. The technique that we have defined Lipo-Stem-Exos has allowed us to obtain an excellent correction of the volume and the improvement of the Dark Circle, improving the general appearance of the gaze with excellent patient compliance.

Background: The eyelid tissue is very thin and during aging, in addition to the loss of elasticity, the eye can experience a depression due to a decrease in periocular volumes with an exposure of the bones that make up the anatomical area and a deficit in the tear trough area. This phenomenon appears to be physiological in all individuals; however, in some cases, it may constitute a genuine cosmetic concern.

Method: We subjected a patient to a nasolacrimal sulcus filling treatment with a technique that we defined Lipo-Stem-Exos. After the collection of adipose tissue, we fragmented it and selected viable micrografts with a size between 20 and 40 microns. Filtration of adipose tissue through 20–40 µm filters enabled the isolation of tissue progenitor cells from the side population under hypoxic conditions, while effectively excluding inflammatory contaminants.

Results: With this technique we observed and reported excellent long-lasting results. The Lipo-Stem-Exos technique took us about 45 minutes with complete compliance from the patient.

Conclusion: We observed the improvement of the periocular area with a clinical maintenance of the results even beyond 240 days from the session. These results suggest that micrografts extracted at 20–40 µm under hypoxic conditions retain viability and contribute to the improvement of the treated anatomical area.

References

1. Markey JD, White WM. Advances in nonsurgical periocular rejuvenation. Facial Plast Surg Clin North Am. 2022; 30(3):321-329.

2. Tonnard P, Verpaele A, Peeters G, Hamdi M, Cornelissen M, Declercq H. Nanofat grafting: basic research and clinical applications. Plast Reconstr Surg. 2013; 132(4):1017-1026.

3. Svolacchia F, Svolacchia L. Microfiltered vs only disaggregated mesenchymal stem cells from adipose tissue in regenerative medicine. Scr Med. 2020; 51(3):152-157.

4. Cittadini E, Brucculieri AM, Quartararo F, Vaglica R, Miceli V, Conaldi PG. Stem cell therapy in the treatment of organic and dysfunctional endometrial pathology. Minerva Obstet Gynecol. 2022; 74(6):504-515.

5. Jackson WM, Nesti LJ, Tuan RS. Mesenchymal stem cell therapy for attenuation of scar formation during wound healing. Stem Cell Res Ther. 2012; 3(3):20.

6. Moseley TA, Zhu M, Hedrick MH. Adipose-derived stem and progenitor cells as fillers in plastic and reconstructive surgery. Plast Reconstr Surg. 2006; 118(3 Suppl):121S-128S.

7. Rehman A, Nigam A, Laino L et al. Mesenchymal stem cells in soft tissue regenerative medicine: a comprehensive review. Medicina (Kaunas). 2023; 59(8):1449.

8. Svolacchia F, Svolacchia L, Falabella P et al. Exosomes and signaling nanovesicles from the nanofiltration of preconditioned adipose tissue with Skin-B® in tissue regeneration and antiaging: a clinical study and case report. Medicina (Kaunas). 2024; 60(4):670.

9. Li N , Hua J. Interactions between mesenchymal stem cells and the immune system. Cell Mol Life Sci. 2017; 74(13):2345-2360.

10. Sánchez-Sánchez R, Brena-Molina A, Martínez-López V et al. Generation of two biological wound dressings as a potential delivery system of human adipose-derived mesenchymal stem cells. ASAIO J. 2015; 61(6):718-725.

11. Salahat M A et al. Autologous adipose stem cells use for skin regeneration and treatment in humans. J of Biol Agric Healthc. 2013; 3(1):ISSN2224-3208.

12. Hilfiker A, Kasper C, Haveric A. Mesenchymal stem cells and progenitor cells in connective tissue engineering and regenerative medicine: is there a future for transplantation? Langenbecks Arch Surg. 2011; 396(4):489-497.

13. Bourin P, Gadelorge M, Peyrafitte J-A et al. Mesenchymal progenitor cells: tissue origin, isolation and culture. Transfus Med Hemother. 2008; 35(3):160–167.

14. Lee RH, Kim B, Choi I et al. Characterization and expression analysis of mesenchymal stem cells from human bone marrow and adipose tissue. Cell Physiol Biochem. 2004; 14(4-6):311–324.

15. Fraser JK, Wulur I, Alfonso Z, Hedrick MH. Fat tissue: an underappreciated source of stem cells for biotechnology. Trends Biotechnol. 2006; 24(4):150-154.

16. Kirby GT, Mills SJ, Cowin AJ, Smith LE. Stem cells for cutaneous wound healing. Biomed Res Int. 2015; 2015:285869.

17. Lo Furno D, Tamburino S, Mannino G et al. Nanofat 2.0: experimental evidence for a fat grafting rich in mesenchymal stem cells. Physiol Res. 2017; 66(4):663-671.

18. Molteni M, Gemma S, Rossetti C. The role of toll-like receptor 4 in infectious and noninfectious inflammation. Mediators Inflamm. 2016; 2016:6978936.

19. Tambasco D, Arena V, Grussu F, Cervelli D. Adipocyte damage in relation to different pressures generated during manual lipoaspiration with a syringe. Plast Reconstr Surg. 2013; 131(4):645e-646e.

20. Svolacchia F, De Francesco F, Trovato L, Graziano A, Ferraro GA. An innovative regenerative treatment of scars with dermal micrografts. J Cosmet Dermatol. 2016; 15(3):245-253.

21. Bi HS, Zhang C, Nie FF, Pan BL, Xiao E. Basic and clinical evidence of an alternative method to produce vivo nanofat. Chin Med J (Engl). 2018; 131(5):588-593.

22. Han YD, Bai Y, Yan XL et al. Co-transplantation of exosomes derived from hypoxia-preconditioned adipose mesenchymal stem cells promotes neovascularization and graft survival in fat grafting. Biochem Biophys Res Commun. 2018; 497(1):305–312.

23. Berardesca E, Distante F, Anthoine P, Rabbiosi G, Aubert L. Clinical and instrumental evaluation of the activity of an anti-wrinkle product on cutaneous relief and photoaged skin. J Appl Cosmetol. 1997; 15:69–75.

24. Karina K, Rosadi I, Sobariah S, Afini I, Widiastuti T, Rosliana I. Comparable effect of adipose-derived stromal vascular fraction and mesenchymal stem cells for wound healing: an in vivo study. Biomed Res Ther. 2019; 6(10):3412-3421.

Downloads

Published

22-12-2025

How to Cite

1.
Svolacchia F, svolacchia lorenzo. A new filling technique with vital micrograft from adipose tissue: a Lipo-Stem-Exos method. A case report. Aesthetic Medicine [Internet]. 2025 Dec. 22 [cited 2026 Jan. 22];11(4):16858. Available from: https://mail.mattioli1885journals.com/index.php/aestheticmedicine/article/view/16858