Micro-fragmented adipose tissue is your own fat, harvested through a small skin incision under local anesthesia and then reduced mechanically into much smaller clusters before it is injected back. The Lipogems system is the device most associated with that approach.
What makes it different from ordinary fat grafting is the size of what comes out and the fact that no enzymes are used to get there. What it is not is a way to rebuild cartilage that has already been lost.
What micro-fragmentation is
Adipose processing has historically relied on enzymatic hydrolysis to release individual cells or cell clusters. Because of the cost and the safety and efficacy questions attached to enzyme use, research groups developed non-enzymatic separation techniques using shear, centrifugal, radiation and pressure forces instead. Mechanical processing replaces the enzymes [1].
The Lipogems system, initially developed by Dr. Carlo Tremolada, is one of those systems. Its stated primary goal was to improve on the traditional Coleman fat grafting technique by producing transplantable fat clusters of reduced size [1].
How the processing works
In the published description of the procedure, a minor skin incision is made under local anesthesia and Klein solution is injected into the subcutaneous adipose tissue. The fat is harvested and then processed inside the device, where it is subjected only to mild mechanical forces that gradually reduce the clusters, while oil and blood residues are eliminated through a drain bag. The entire procedure is carried out in a fully submerged system to minimize manipulation of the tissue [1].
The size change is the point. Clusters are reduced from spherical fragments of roughly 1 to 3.5 mm in diameter down to clusters of 0.2 to 0.8 mm. Approximately 100 to 130 mL of fat aspirate can be processed to yield about 60 to 100 mL of final tissue product using the standard 225 mL kit [1].
Why adipose tissue is used as the source
Adipose tissue is studied as a source of mesenchymal stromal cells because the yield is high and access is straightforward. A 2025 narrative review reports that one gram of adipose tissue can provide approximately 5,000 stem cells, roughly 500 times the yield attributed to bone marrow [1].
That is a statement about laboratory yield from tissue samples, not about clinical outcome in patients. A larger cell count in the vial is not the same as a better result in the joint, and it should not be read that way.
What is and is not being claimed
Micro-fragmented adipose tissue is a tissue-processing method with a well-described mechanical procedure. Beyond that description, the clinical picture is less settled than the marketing around adipose products usually suggests.
At Regen.MD, no orthobiologic is presented as a way to rebuild lost cartilage. For advanced knee osteoarthritis, an orthobiologic is framed as a bridge therapy prior to joint replacement — something that may buy function and time in a considered pathway, not a substitute for the operation when the operation is what the joint needs.
How it compares with the other orthobiologics we offer
The starting material is the distinction that matters. Platelet-rich plasma comes from your blood; bone marrow aspirate concentrate comes from your marrow; micro-fragmented adipose tissue comes from your fat. They are prepared differently, delivered differently, and suited to different targets.
Our orthobiologics service page sets out the full range: intra-articular and tendon platelet-rich plasma in leukocyte-poor and leukocyte-rich variants, intraosseous and subchondral platelet-rich plasma, bone marrow aspirate concentrate, Lipogems, and intradiscal orthobiologics. Which one is discussed for you follows from the diagnosis, not from which one you read about first.
Where this fits in care at Regen.MD
At Regen.MD in St. Louis, nothing is scheduled from a phone call. Our conservative-first evaluation starts with your history, symptom timeline, examination findings and existing imaging, and then establishes whether an orthobiologic has a defensible role at all.
When conservative measures have been exhausted, surgery is part of the pathway rather than a failure of it. Dr. Gurpreet Singh Padda, MD, MBA, MHP is a surgeon, and the practice provides surgery at that stage. It is not where we start.
Find out whether an orthobiologic has a role in your case
Regen.MD begins with a paid, physician-led Clinical Evaluation — a review of your history, imaging, and metabolic data, and a written roadmap for what to do next. Evaluation is contingent upon review of your data.
Questions? Call (314) 295-3000 or text (314) 886-5902.
Regen.MD, 4477 Woodson Rd, Suite 103, St. Louis, MO 63134, next to St. Louis Lambert International Airport.
Frequently asked questions
Is micro-fragmented adipose tissue the same as platelet-rich plasma?
No. Micro-fragmented adipose tissue is prepared from your own fat and delivered as small tissue clusters; platelet-rich plasma is prepared from your own blood. They are different starting materials with different handling, and which one fits depends on the tissue being treated. We compare them against your diagnosis when we evaluate the conditions we treat.
What does ‘micro-fragmented’ actually mean?
It refers to the size of the fat clusters after processing. In the published description, mild mechanical forces gradually reduce the tissue from spherical clusters of 1 to 3.5 mm in diameter down to clusters of 0.2 to 0.8 mm. Our education library covers how that compares with older fat grafting technique.
Will this rebuild the cartilage in my knee?
No. Nothing offered here is claimed to rebuild lost cartilage. For advanced knee osteoarthritis, orthobiologics are discussed as a bridge therapy before joint replacement, and that framing is set out on our orthobiologics page.
How do I find out whether I am a candidate?
Through a paid, physician-led Clinical Evaluation, where your history, examination and imaging are reviewed before any procedure is discussed as an option. That review is done by Dr. Gurpreet Singh Padda, MD, MBA, MHP, who is also a surgeon and will say plainly when surgery is the better answer.
Sources
- Fu H, Wang C. “Micro-fragmented adipose tissue — An innovative therapeutic approach: A narrative review.” Medicine, 2025. https://pmc.ncbi.nlm.nih.gov/articles/PMC11875617/ — referenced for the shift from enzymatic to non-enzymatic mechanical separation, the origin and stated goal of the Lipogems system, the procedural description (minor skin incision under local anesthesia, Klein solution, mild mechanical forces, drain bag, fully submerged system), the cluster size reduction from 1 to 3.5 mm down to 0.2 to 0.8 mm, the 100 to 130 mL input and 60 to 100 mL output using the 225 mL kit, and the approximately 5,000 stem cells per gram of adipose tissue figure.