Regenerative Treatments
Regenerating tissues is our goal, and we rely on the most modern and safe techniques. The treatment philosophy lies in identifying the appropriate regenerative product and establishing the exact quantity to be implanted (dose/effect), just as one would do with a medication.
Regeneration of Genital Tissues
Injective regenerative techniques use preparations derived from blood and adipose tissue derived from blood.
Not all PRP (platelet-rich plasma) is the same, and Lichen Hub has selected only high biological value kits whose regenerative factors can be tailored.
PRP
It is a blood derivative obtained from a blood draw of about 20 cc, just like any blood test. Once the sample is collected, it is placed in centrifuges. PRP contains platelets, which contain growth factors that reduce inflammation and promote regeneration.
PRP can come in different types: simple PRP or activated PRP, with platelets that immediately release their growth factor content.
There are PRP types rich in monocytes, cells that fight inflammation.
Monocytes
These are cells found in the blood that possess strong anti-inflammatory properties. They are obtained in exactly the same way as PRP, through a blood draw.
Exosomes
They are particles released by blood cells when appropriately stimulated. They have a pronounced anti-inflammatory capacity.
Adipose Tissue Derivatives
Adipose tissue contains multiple cells with regenerative, anti-inflammatory, immunomodulatory, and analgesic capacities.
The cells that make up adipose tissue include mature adipose cells, which are large cells, immature adipose cells, which are smaller cells that will develop into mature adipose cells, and stromal component cells, which are small cells with high regenerative capacity. Among these are fibroblasts, endothelial cells, and stem cells.
Depending on the type of extraction, adipose preparations of different sizes and cellular content can be obtained:
- Fat graft: Large-sized cell preparation that allows for the implantation of mature adipose cells. Requires implantation with 16-gauge cannulas.
- Microfat graft: Medium-sized cell preparation that can be injected with medium-small diameter cannulas (18/21 gauge). Has volumizing, regenerative, and anti-inflammatory properties.
- Millifat graft: Small-sized preparation that does not contain mature adipose cells and can be implanted with small-diameter cannulas (21 gauge). Has regenerative and anti-inflammatory properties.
- Nanofat graft: Does not contain mature adipose cells but only stromal components. Can be injected with thin needles. Has regenerative and anti-inflammatory properties.
- Ultrananofat graft: Extremely thin preparation containing stromal components, vesicles, and exosomes. Can be obtained with thin filters and implanted with extremely thin needles. Primarily has anti-inflammatory properties.
- Exosomes: Contains vesicles and exosomes without cellular content. Can be injected with extremely thin needles. Primarily has anti-inflammatory properties.
- SVF (Stromal Vascular Fraction): Pure stromal fraction containing maximally regenerative cells. In Europe, only mechanical methods are permitted to obtain it. There are now extraction methods that allow for high-quality stromal fractions to be obtained without resorting to complex laboratory procedures, as the high cost may not always be justified.
The Importance of the Injection Technique
Injecting a regenerative preparation with a needle or a cannula is very different. The same applies to the choice of size. Some layers—the extremely fragile superficial ones—need to be injected with very fine needles, while the deeper layers can be treated with larger needles and cannulas.
Over the course of twenty years of experience, Dr. Brambilla has developed two important implantation techniques.
The first is a deep injection technique, known as “percutaneous lysis,” in which a needle is used that, while injecting the adipose tissue, simultaneously breaks up the sclerotic fibers.
The second is a technique known as the “hat trick” or “triple play,” in which three different preparations are injected at three different depths using three needles of different gauges.
Technology: A Great Ally If You Know How to Recognize It
Technology has greatly aided in improving the quality of the biological products we inject, making them increasingly pure and precise in their composition.
Filtration systems for adipose tissue, various methods for preparing PRP, and technologies that enhance the quality of the extraction process have all advanced significantly.
However, caution must be exercised with technologies whose efficacy is not proven. The tissue affected by lichen sclerosus is delicate and unforgiving.