In-depth Analysis

    CLINICAL SHEET
    Use of Micro - and Nano - Fragmented Adipose Tissue in:

    SEVERE AND REFRACTORY
    VULVO - VAGINAL ATROPHY

    Treatment Description

    The treatment involves subcutaneous and submucosal infiltration of autologous micro- or nano-fragmented adipose tissue, mechanically processed without enzymes. This tissue is rich in stromal vascular fraction (SVF), growth factors, cytokines, and bioactive molecules with regenerative potential.

    Biological and Pathophysiological Effects

    → Stimulation of angiogenesis and tissue trophism via VEGF, FGF, and PDGF.
    → Modulation of local inflammation through down-regulation of IL-1β, TNF-α.
    → Regeneration of extracellular matrix and improvement in mucosal elasticity
    → Indirect trophic effect on epithelial cells through the regenerative microenvironment.

    Specific Clinical Indications

    → Severe vulvo-vaginal atrophy (thin, fragile, hypoelastic mucosa).
    → Persistent symptoms unresponsive to local/systemic estrogen therapy.
    → Dyspareunia, vulvar burning, chronic itching, pronounced dryness.

    Documented Clinical Benefits

    → Increased thickness and vascularization of vulvo-vaginal mucosa.
    → Significant reduction in dryness and pain symptoms.
    → Improved lubrication and sexual function (FSFI score).
    → High safety profile, including in patients contraindicated for hormone therapy.

    Conclusions

    The use of micro/nano-fragmented adipose tissue is a safe and effective regenerative strategy for treating severe and refractory vulvo-vaginal atrophy, with sustained benefits on genital function and quality of life.

    LICHEN SCLEROSUS

    Treatment Description

    NanoFat is infiltrated perilesionally and subepidermally, delivering bioactive mediators capable of modulating chronic inflammation and tissue fibrosis.

    Biological and Pathophysiological Effects

    → Inhibition of fibrotic mediators (TGF-β1) and proinflammatory cytokines.
    Remodeling of dermal architecture     and improved skin elasticity.
    Immunomodulation of local autoimmune responses.

    Clinical Indications

    → Vulvar lichen sclerosus refractory to topical therapy.
    → Patients with anatomical distortion, stenosis, or chronic pain.

    Documented Clinical Benefits

    → Improvement of symptoms (itching, pain, burning).
    → Functional and sexual recovery.
    → Macroscopic and histologic enhancement of tissue quality.

    Conclusions

    Autologous adipose tissue therapy offers an innovative regenerative approach to chronic lichen sclerosus, countering inflammation and fibrosis.

    POSTPARTUM OR POST-SURGICAL
    VULVO-PERINEAL SCARS

    Treatment Description

    Adipose tissue is injected into the subcutaneous plane of retractile or painful scars, providing both mechanical release and regenerative stimulation.

    Biological and Pathophysiological Effects

    → Local anti-inflammatory and antifibrotic effects.
    → Enhanced vascularization and dermal repair.
    → Reduced adhesions and improved tissue mobility.

    Clinical Indications

    → Retraction after episiotomy, vulvar surgery, or Bartholin excision.
    → Chronic perineal pain or dyspareunia.

    Documented Clinical Benefits

    → Softening and release of scar contracture.
    → Disappearance of chronic pain.
    → Aesthetic and functional improvement of the treated area.

    Conclusions

    Adipose-derived regenerative therapy is effective for vulvo-perineal scars, improving symptoms and tissue pliability.

    WIDE VAGINA SYNDROME

    Treatment Description

    NanoFat suspension is injected into the vaginal mucosa and submucosal tissue to improve tone, trophism, and sensitivity through regenerative mechanisms.

    Biological and Pathophysiological Effects

    → Enhanced submucosal vascularization.
    → Fibroblast stimulation and collagen production.
    → Improved tissue consistency and neurosensitivity

    Specific Clinical Indications

    → Vaginal laxity post-delivery or post-menopause.
    → Hypo-sensitivity and sexual dysfunction.

    Documented Clinical Benefits

    → Improved vaginal tone and thickness.
    → Enhanced sexual satisfaction and tactile response.
    → Synergistic effect with physical or minimally invasive therapies.

    Conclusions

    Autologous adipose tissue offers a natural and effective approach for treating vaginal laxity, restoring tone and sexual perception.

    STRESS URINARY INCONTINENCE

    Treatment Description

    Autologous AD-MSCs are isolated via liposuction and injected into the periurethral or intraurethral region. This procedure aims to regenerate pelvic floor tissues and improve urethral sphincter function.

    Biological and Pathophysiological Effects

    → Stimulation of collagen production and extracellular matrix remodeling .
    → Regeneration of sphincter muscle and enhancement of continence.
    → Modulation of local inflammation and promotion of angiogenesis.

    Specific Clinical Indications

    → Women with SUI unresponsive to conventional treatments.
    → Patients with intrinsic sphincter deficiency.

    Documented Clinical Benefits

    → Subjective improvement of 70–80% and objective reduction in urine leakage >50% in over 40% of treated patients .
    → Increased maximum urinary flow and reduced residual volume.
    → No significant adverse events reported in phase I/II clinical trials.

    Conclusions

    AD-MSC therapy is a promising option for treating SUI, with evidence of safety and significant clinical improvements. However, further randomized studies are needed to confirm long-term.