by Domenico Piccolo, Alessandro Gennai, Fabrizio Melfa, Bruno Bovani, Piero Tesauro
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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