A.R.T. Autologous Regenerative Therapy in Aesthetic Medicine

Standardized Protocols in Tissue Rejuvenation

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Adipose tissue (also known as fat tissue) is a human tissue with a high concentration of adult mesenchymal stem cells (ADSCs), the proven regenerative capacities of which have now applications in various medical fields as reconstructive surgery, dermatology, scar therapy, orthopedics, vascular surgery, cardiology, gynecology, otolaryngology, proctology, as well as in antiaging therapies in cosmetic surgery or aesthetic medicine. Regenerative therapy has proven very promising in face rejuvenation, where skin atrophy and volume loss, the main factors beyond facial aging, cause facial rhytids, laxity, skeletonization, and pseudo-descent of the midface.
This handy guide offers a new standardized, guided procedure, the Superficial Enhanced Fluid Fat Injection (or S.E.F.F.I.), that will enable professionals dealing in an outpatient setting to perform safe, effective tissue rejuvenation, increasing the patient s compliance, guaranteeing effectiveness, reducing risks and costs. Harvesting subcutaneous adipose tissue is a critical process without a specific training, exposing the patient to possible complications related to incorrect harvesting maneuvers. The guided SEFFI procedure allows to perform harvesting at a safe plane and 15mm depth, explains how to restore volume and regenerate the skin injecting viable adipocytes, by adhering to a rigorous clinical protocol, following steps in images and videos.
In particular, chapters deal with making tissue harvesting less traumatic, collecting cells in the most superficial plane to gain a richer tissue in terms of Stromal Vascular Fraction Cells (SVFCs) and mesenchymal stem cells (ADSCs), and harvesting the cell clusters containing adipocytes, SVFCs and ADSCs of reduced size, avoiding fragmentation devices and unnecessary manipulation.
Associated treatments (Calcium Hydroxyapatite, Energy Based Device, Bio-Photostimulation) for combination with the SEFFI procedure, and it application in reconstructive hair transplantation and remodeling after injury. This guide to safe and effective rejuvenation treatments through the SEFFI protocol will enable dermatologists and aesthetic medicine practitioners to offer safe, simple, effective, and standardized regenerative therapy to their patients.

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Domenico Piccolo, MD, is a Dermatologist and Head of Dermoaesthetic Laser Centers “Novea” in Avezzano, Pescara, and L'Aquila, Italy. His expertise includes videodermoscopy, melanoma prevention, scar treatment, and laser applications in dermatology and aesthetic medicine, for which he holds a patent. After specializing in Dermatology in 2000, he focused on pigmented lesions, photodynamic therapy, skin surgery, and lasers. He was a resident with Prof. Peter H. Soyer (1997–99, Graz, Austria) and registered with the UK’s General Medical Council (GMC) in 2009, working at Skinfinity Cosmetic Clinic, Leeds. He is currently Adjunct Professor at the Dermatology Clinics of the Universities of Trieste, Florence, and Pavia, and a lecturer in the Laser Master’s program at Sapienza University, Rome. Dr. Piccolo is President of the Italian Association of Ambulatory Dermatologists (AIDA) and former Vice President of the Italian Society of Laser Dermatology (SILD). He has authored 180 papers, 5 books, numerous book chapters, and has spoken at over 500 national and international congresses. Alessandro Gennai, MD, is a Reconstructive and Aesthetic Plastic Surgeon based in Bologna and Milan. He graduated with honors in Medicine and Surgery in 1988 and specialized in General Surgery in 1993 (University of Modena). In 1994, he completed the International School of Aesthetic Medicine (Fatebenefratelli Foundation, Rome), followed by a 1999 fellowship at the ISSE Institute, Los Angeles, with Prof. Nicanor Isse. Dr. Gennai developed and standardized three original surgical techniques: MIVEL (Minimal Incisions Vertical Endoscopic Lifting), SEFFI (Superficial Enhanced Fluid Fat Injection), and NAL (Neck Artificial Ligament), all published in major journals. His work focuses on facial rejuvenation and regenerative medicine using adipose-derived stem cells. He has authored over 40 papers and 12 books, and lectures widely. He is a member of AICPE, SICPRE, and SIME, and teaches in several Italian second-level university master’s programs. Since 2017, he has served on the Educational Board of the European Academy of Facial Plastic Surgery (EAFPS). Fabrizio Melfa, MD, graduated in Medicine and Surgery from the University of Palermo in 1994. He specialized in Nutritional Sciences (2000) and Aesthetic Medicine (2002) at SIME-FIF in Rome and the University of Pavia. In 2005, he earned a Master’s in Phlebolymphology (University of Siena), and in 2013 completed a course in Skin Health Restoration with Dr. Zein Obagi in Beverly Hills. Dr. Melfa is founder and director of the MediAging medical-scientific program, and Adjunct Professor at the Universities of Pavia and Genoa, teaching in the Master’s program in Aesthetic Medicine. He has co-authored national and international publications and organized numerous events in phlebology and aesthetic medicine. Bruno Bovani, MD, specialized in General Surgery and earned a PhD in Experimental Surgery (University of Perugia). He worked as a plastic surgeon at the University of Perugia until 2002, then continued in private practice. He founded the Esculapio Ambulatory Surgery Center (Perugia, 2005) and the San Marino Aesthetic Medicine Studio. He speaks at major national and international congresses, teaches at various courses, and is a Contract Professor at the Universities of Naples, Genoa, and Modena for their Aesthetic Medicine Master’s programs. He is a member of SICPRE and AICPE. Piero Tesauro, MD, PhD, graduated with honors in Medicine and Surgery (1990, University of Naples) and specialized with honors in Plastic Surgery (1995, University of Milan). That same year, he was Senior House Officer at Queen Victoria Hospital, London. He earned a PhD in Experimental Surgery and Hair Transplantation (1998, University of Milan). Dr. Tesauro is a Board Member of SITri (Italian Society of Trichology) and ISHRS (International Society of Hair Restoration Surgery), and a member of AICPE. He is a Past President of both SITri and ISHR (Italian Society of Hair Restoration).