Osteopathic Evaluation

In-depth article by Dr. Fabrizio David , regenerative medicine specialist at Image Regenerative Clinic. Supporting NAD (Nicotinamide Adenine Dinucleotide) levels through targeted IV therapies is now considered one of the most promising strategies in the field of longevity. This isn’t a passing trend, but a clinical approach backed by growing scientific evidence, capable of enhancing cellular energy, mitochondrial function, DNA repair, and oxidative stress response—key processes in slowing biological aging. Like any truly effective therapy, NAD requires careful medical assessment, personalized protocols, and a structured clinical setting to ensure real, safe, and lasting results. Not a Miracle Cure, But a Powerful Tool NAD is not an over-the-counter supplement or a one-size-fits-all solution. It’s a vital molecule for cellular metabolism that naturally declines with age and in the presence of chronic conditions. Restoring or supplementing its levels can translate into increased vitality, improved stress management, faster recovery, and enhanced cognitive and physical performance. But timing, dosage, and method of administration are crucial—and must always be determined under expert medical guidance. At Image Regenerative Clinic, every treatment begins with a comprehensive analysis of the patient’s metabolic and inflammatory status, including: Complete hematochemical and metabolic panel; Evaluation of key micronutrients involved in NAD synthesis (vitamin B3, B12, folic acid, vitamin D, zinc); Markers of oxidative stress and inflammation; Indicators of mitochondrial function; Only through this detailed workup can we determine whether NAD IV therapy is appropriate and set up a protocol that is truly effective. NAD IV Therapy and an Integrated Approach When indicated, intravenous NAD therapy allows for rapid and direct absorption, with noticeable effects often after just a few sessions. Depending on individual needs, it may be combined with custom infusions of vitamins, minerals, amino acids, and antioxidants, all tailored to the patient’s specific metabolic profile. This therapeutic strategy is part of a broader, holistic program that may include: Nutritional optimization Targeted physical activity Stress management strategies Continuous long-term monitoring Why Choose a Clinical Setting In a world where everything seems readily available, what makes the difference is the context. NAD IV therapies are not treatments to be improvised. They require medical expertise, structured protocols, and meticulous follow-up. Only in a specialized clinic like Image can patients receive the level of care needed to ensure safety, efficacy, and true personalization. Longevity is about making informed choices—not chasing miracles. Investing in your long-term health means relying on structured, science-based programs guided by clinical insight. When used consciously and under expert supervision, NAD can become an extraordinary ally .

Reading time: 5 minutes From unhealthy longevity to healthy longevity: a guided path, not a miracle How new therapeutic tools, lifestyle habits, and medical monitoring can help us live better and longer In recent years, the concept of healthy longevity has taken center stage in medical and societal conversations. It's no longer just about adding years to life: the challenge is to add life to years—by preventing chronic diseases, slowing degenerative processes, and maintaining mental and physical balance. But what can we do when the body begins to slide toward a condition of unhealthy longevity? The answer is not a shortcut, but a multidisciplinary path. That’s exactly the premise behind the Weight Loss Body Program developed by Image Regenerative Clinic —a structured approach to regaining health and vitality through a personalized, integrated program under strict medical supervision. Healthy longevity: a daily construction As explained in the “Code of Healthy Longevity” , aging can be modulated. Proper nutrition, physical activity—especially strength training—restorative sleep, stress management, and targeted supplementation (vitamin D, Omega-3s) are essential to slow the inflammatory processes that underlie many chronic and degenerative diseases. A study published in Nature Aging showed that combining vitamin D, Omega-3s, and physical exercise can slow biological aging, even influencing epigenetic markers ( Nutrienti e Supplementi, 2023 ). Similarly, Omega-3 supplementation has proven useful in preventing autoimmune diseases and low-grade silent inflammation ( Nutrienti e Supplementi, 2022 ). When lifestyle is not enough: the role of new molecules In some cases, despite best efforts, the body can no longer respond effectively. You enter a grey area marked by excess weight, sleep apnea, muscle loss (sarcopenia), and rising inflammation markers . Here, advanced pharmacological tools—under strict medical supervision—can be helpful. Drugs like semaglutide (Ozempic®) and tirzepatide (Mounjaro®) , originally developed for type 2 diabetes, have shown revolutionary potential for healthy longevity , thanks to their ability to: Significantly and sustainably reduce body weight Improve insulin sensitivity Regulate appetite and reduce caloric intake Improve inflammation markers Act on multiple target organs (liver, kidneys, central nervous system) According to a study published in the New England Journal of Medicine , tirzepatide led to a 22.5% reduction in body weight in people with obesity—greater than the reduction seen with semaglutide ( NEJM, 2022 ). Moreover, an analysis published by Quotidiano Sanità shows that, when used appropriately, these molecules also provide added benefits for cardiovascular, hepatic, and neurodegenerative health , as well as improved sleep quality in people suffering from obstructive sleep apnea ( Quotidiano Sanità, 2024 ). Real limits, avoidable risks These drugs are not miracle pills. Used outside a structured framework, they can lead to rapid weight regain—often at the expense of muscle mass . This is especially risky in older adults, where sarcopenia is one of the key threats to healthy aging. A study published by SIO Obesità emphasizes the importance of combining these therapies with resistance training to preserve muscle tissue and support metabolic health ( SIO Obesità, 2023 ). Image Regenerative Clinic: an integrated protocol for conscious longevity To prevent misuses and risks, Image Regenerative Clinic has developed a personalized Weight Loss Body Program that includes: Comprehensive medical evaluation Tailored nutritional support Targeted physical training (especially strength exercises) Innovative therapies only when needed and always under medical supervision Regular follow-ups to ensure stability, safety, and long-term results The goal is not simply to “lose weight” but to restore health , slow aging , and prevent chronic diseases associated with unhealthy longevity. Each intervention is part of a larger, individualized framework designed for long-term balance and well-being. No miracles, just conscious choices Ozempic® and Mounjaro® are powerful tools, but only become truly effective when integrated into a structured, medically guided journey. Used in isolation, without a complete lifestyle reset, the risk of relapse is high. True healthy longevity does not come from a single drug. It stems from the smart combination of prevention, science, and an integrated vision of health . https://www.youtube.com/watch?v=f2pSXS7ArtY And this is exactly where the real transformation begins.

From March 21 to 29, 2025, Milan reaffirms its role as an international hub of science and innovation by hosting the Milan Longevity Summit. For ten days, Nobel Prize winners, world-renowned scientists, and pioneers in regenerative medicine will share their research on the most advanced strategies for living longer and healthier lives. Among the event’s key speakers are Shinya Yamanaka, 2012 Nobel Prize winner in Medicine for his discoveries on stem cells, and Venkatraman Ramakrishnan, 2009 Nobel Prize winner in Chemistry for his research on ribosome structure. Also attending is Prof. Camillo Ricordi, Emeritus Director of the Diabetes Research Institute (DRI) in Miami, known for his groundbreaking studies on cellular transplants and co-founder of Lipogems alongside Prof. Carlo Tremolada. The Summit benefits from the organizational and scientific contribution of Prof. Alberto Beretta, a world-renowned immunologist and co-founder of SoLongevity. Milan: Capital of Longevity and Economic Growth Milan is not only an international cultural and scientific center but is increasingly becoming a leading hub for longevity research. Attending events like the Milan Longevity Summit provides access to cutting-edge knowledge and insights into how science is redefining our future. Longevity is not just a biological challenge but also a powerful economic driver: living longer and healthier means reducing healthcare costs, keeping the population active for longer, and creating new investment opportunities in biotechnology, wellness, and regenerative medicine. Two Must-Attend Talks on March 29 The final day, March 29, will feature two high-value keynote speeches: Prof. Camillo Ricordi – "Longevity for All: The Interplay of Epigenetics and Environment" A deep dive into how epigenetics and the environment influence longevity and which strategies can help maximize our biological potential. Prof. Carlo Tremolada – "Regenerative And Enhancing Medicine: Advancing Health And Longevity" A focus on the latest technologies in regenerative medicine, particularly the role of mesenchymal stem cells in improving quality of life. Why Attend? Gain access to the latest scientific discoveries through world-class conferences and workshops. Understand the connection between science, economy, and well-being, and how longevity is reshaping the future of society. Experience Milan as a capital of innovation and health, a unique opportunity to engage with world-class experts. Participate in Longevity Labs, hands-on experiences in nutrition, exercise, and anti-aging strategies. Participation in the Milan Longevity Summit is free, but some events require registration. For more information and to register, visit the official website: www.milanlongevitysummit.org Don’t miss the chance to be part of an event that will change the way we think about health, longevity, and our future!

From Harpers Bazaar Italy Article Harpers Bazaar Italy recently published an article exploring how today's wellness and beauty treatments are looking further ahead, toward a horizon where "well aging" is increasingly tech-driven. The article examines the evolution of biohacking from science fiction concept to mainstream practice, embraced by celebrities and cutting-edge facilities alike. The Evolution of Biohacking in Beauty and Wellness Though only recently popularized, biohacking was already present in the early 2000s in discussions among biologists and hackers who made experimentation their profession. These pioneers laid the foundations for a movement where biology, technology, and science combine to improve human body and mind through practices ranging from genetic modifications to simple lifestyle changes. In beauty and wellness, the most widespread biohacking methods include specialized nutrition and supplements, thermotherapy sessions (like cold plunges and infrared sauna blankets), DNA-personalized skincare treatments for targeted cellular repair, devices that monitor circadian rhythms, and customized nutrition and training plans based on genetic and biometric analyses. Recent industry evolutions focus on exosomes in professional aesthetic practices, biostimulating treatments using microwaves and ultrasound, fillers enriched with biorevitalizing substances, and advanced liposuction and lipofiller procedures. From a wellness perspective, the latest biohacking frontiers emphasize the revitalizing power of massages and bioenergetic treatments. Image Regenerative Centre As Italy's first regenerative clinic , Image offers a wide range of regenerative medicine services, from reconstructive surgery to cutting-edge aesthetic treatments. Lipogems® is the facility's flagship treatment: a patented multifunctional procedure involving the injection of micro-fractured adipose tissue, representing an evolution of both traditional lipofilling and techniques for extracting mesenchymal stem cells. Source: Harper's Bazaar Italia, 20.5.2024

The debate between acceptance and health In recent years, the concept of Body Positivity has gained popularity, promoting acceptance of all bodies and countering weight-related stigma. It's a positive principle that has helped valorize diversity and combat discrimination. However, in some cases, the evolution of this movement has led to an extreme view, where any discussion about health related to weight is perceived as an attack on individual freedom. This leads us to reflect on the importance of a balanced approach, where respect for oneself and others combines with awareness of health risks. It is therefore fundamental to distinguish between acceptance and well-being, understanding how body weight influences our overall health. Health cannot be sacrificed in the name of inclusivity. Obesity is not just an aesthetic issue, but a concrete risk factor for longevity and quality of life. Several studies have shown that being overweight increases the risk of chronic diseases such as type 2 diabetes, hypertension, cardiovascular diseases, and some types of cancer. The New England Journal of Medicine has highlighted that obesity can reduce life expectancy by up to ten years, depending on the severity of the case. These data help us understand how essential it is to address the issue of weight with a perspective based on science and long-term well-being, rather than on superficial judgments or radical ideologies. The role of science in weight management Within this complex discussion lies the Body Positivity movement, born with the intent to promote self-acceptance, fight discrimination, and value the diversity of bodies. However, in recent years, it has become radicalized to the point of challenging anyone who talks about weight loss, spreading the idea that promoting a healthy lifestyle equates to "fatphobia." This attitude risks dissuading people from making informed decisions for their health, leaving them trapped in conditions that compromise their quality of life. Accepting one's body doesn't mean ignoring the risks associated with obesity: true awareness comes from balance, that is, appreciating oneself without neglecting the impact that body weight has on metabolism, internal organs, and the ability to maintain optimal energy over time. Faced with this complexity, scientific research has developed solutions for weight control, aimed at improving quality of life without falling into extremism. Innovation has led to the creation of drugs such as Mounjaro (tirzepatide) and Wegovy (semaglutide), which have demonstrated their ability to promote weight loss in a safe and sustainable way, improving vital parameters such as blood glucose, cholesterol, and blood pressure. These solutions open new perspectives for those struggling with overweight and obesity, but they are not exempt from criticism. Some commentators have contested them, arguing that they contribute to reinforcing the stigma of obesity. However, it is essential to understand that these treatments are not an aesthetic solution, but medical tools that can significantly improve the health of those suffering from pathological obesity. The importance of a balanced approach Looking at the longest-lived societies in the world, we discover an interesting fact: weight management should not be seen as an imposition, but as an opportunity to live better and longer. Research on longevity shows that the populations of Blue Zones share a common aspect: maintaining a balanced body weight through healthy eating and constant physical activity. The benefits of an optimal BMI include better blood glucose control and diabetes prevention, reduced risk of cardiovascular diseases, lower levels of inflammation and oxidative stress, and increased vitality and quality of life. The discussion on weight and health cannot be reduced to an ideological clash between "skinny versus fat." The real goal must be well-being, based on informed choices supported by science. It's not about adhering to aesthetic standards imposed by society, but about living longer and better. Instead of fueling sterile debates, we should focus on what truly matters: a healthy, active life full of energy. At Image Regenerative Clinic, we adopt a scientific and personalized approach to help our patients achieve their maximum potential for well-being and longevity. We are ready to support you on this journey with advanced medical solutions and personalized strategies for your well-being.

The human body consists of cells, small functional units tasked with collaborating and performing various functions to ensure proper organism functioning. Every human action produces an 'adaptive' bodily response to the received stimulus, from basic activities like eating, moving, and sleeping, to more complex actions like sports, working, and healing from trauma. The Self-Healing Principle From birth, the human organism possesses all biochemical-physiological prerequisites for self-healing and tissue regeneration following tissue damage. It must first ensure individual growth and subsequently maintain health, being ready to respond to both positive and negative stimuli. Osteopathy incorporates this concept as one of its foundational pillars: through precise assessment of movement, signs, symptoms, and general body signals, it employs techniques on all directly and indirectly accessible tissues to communicate with the nervous system and enable optimal physiological healing conditions. Osteopathic therapy, combined with strengthening/maintenance/neuromotor reprogramming exercises, can modify an individual's posture, optimally aligning body segments for improved general and specific function. Lipogems Sustaining damage during developmental years (0-20 years), when healing factors and regenerative capabilities are at peak efficiency, differs significantly from injury in adult or advanced age, particularly regarding recovery time, healing quality, restorative tissue quality, and healing capacity. Additionally, certain body tissues are poorly vascularized or lack blood vessels entirely, such as articular cartilage, menisci, specific bones like the scaphoid or talus, and ligaments in knees, shoulders, and ankles. This creates conditions where damage to these structures may be irreversible and prone to continuous degeneration. Lipogems technology stimulates natural regenerative processes through autologous mesenchymal cells derived from adipose tissue, enabling affected tissues to regenerate and heal. When is Manual Therapy Combined with Lipogems Indicated? This combination is indicated for degenerative tissue pathologies with progressive prognosis, chronic inflammatory conditions, post-surgical complications, and cases requiring prevention of significant degeneration or improvement of body tissue quality. Primary indicated conditions include: osteoarthritis, meniscal disorders, tendinopathies, calcifications, fibrosis, partial ligament injuries, musculotendinous lesions, impingement (shoulder, hip), arthritis, and TMJ degenerative pathologies. The Synergistic Mechanism Osteopathy addresses dysfunction, restores correct biomechanics and function by interacting with the nervous and proprioceptive systems, effective when target tissues can respond positively and heal. When pathology develops and degenerative factors emerge, Lipogems provides an innovative solution to halt and often reverse this process, enabling even severely damaged tissues with limited healing capacity to regenerate efficiently and systematically. The therapeutic approach is individually tailored, combining osteopathy and Lipogems to achieve and maintain optimal function. The physiological mechanisms underlying healing stimulation are supported by scientific and clinical evidence, while the synergy and efficacy of the combined therapeutic approaches are validated by our clinical experience.

What is posture? Posture can be simply defined as the position of our body in an upright position and can be considered at both static and dynamic levels. Our central nervous system, which manages postural mechanisms, must always be able to: maintain various body districts in position and arranged in space in such a way that there is minimal energy expenditure in counteracting the continuous compression force we are subject to during static and dynamic activities; ensure absence of pain in achieving ideal posture; maintain excellent perception and feedback from receptor structures; manage external forces correctly while preserving function; and guarantee balance and motor control. Incorrect posture directly disturbs static positioning and indirectly affects dynamic movement. When maintained over time, it establishes neural circuits that register incorrect posture as correct (because it becomes habitual), resulting in compensatory bodily adaptations. Through the activity of receptors, endoceptors, and exteroceptors, whose function is to inform the CNS, the body receives information about its position in space. Osteopathic Assessment Medical history combined with physical examination allows the osteopath to identify the patient's primary problem: if the most significant dysfunction is not within osteopathic scope, the patient is referred to the appropriate specialist for the specific condition. Everything related to maintaining optimal functionality falls within osteopathic competence. The osteopath carefully evaluates movement biomechanics, postural patterns, and musculoskeletal compensations to develop a personalized treatment plan. Diego Stancanelli - Osteopath D.O., MCB Massage Therapist, Doctor of Motor Sciences

Dozens of articles are published annually in the USA discussing the remarkable results of Lipogems. The authors of these publications are surgeons who have often been personally trained by Prof. Tremolada in the use of Lipogems technology, which he invented and patented. A notable example is this article by physicians Jay Panchal, Gerard Malanga, and Mitchell Sheinkop, published in the American Journal of Orthopedics and featured in several authoritative online publications. Here is a brief excerpt: Key Study Concepts Knee osteoarthritis is a chronic condition affecting all races, genders, and ages, but predominantly presents in overweight and elderly individuals. Globally, arthritis is considered the fourth leading cause of disability. In both developing and developed countries, knee osteoarthritis can cause significant quality of life decline in individuals over 65 years due to pain and disability. Conservative, non-surgical treatments can be successful in patients with mild to moderate arthritic pain. Lipogems Mechanism of Action in Osteoarthritic Knees The FDA-approved Lipogems device is used to harvest adipose tissue, cleanse it of blood and oil components, and micro-fracture it while maintaining the intact vasculo-stromal niche containing pericytes. This study aimed to evaluate the safety and efficacy of minimally manipulated, micro-fractured autologous adipose tissue in patients with severe refractory knee osteoarthritis. Conclusions The injection of minimally manipulated, micro-fractured autologous adipose tissue represents a safe and effective treatment option for patients with severe refractory osteoarthritis (grade 3 or 4) of the knee. This study demonstrated significant improvements in pain, quality of life, and functionality for at least 12 months in the study cohort. Lipogems intervention may represent a non-surgical treatment option to avoid knee joint replacement in this population. Prof. Tremolada's Commentary "Lipogems is a method now used in over 20 countries with a growing success history of over 36,000 cases. To make its function comprehensible to everyone, I will simply say that it is currently the best technique used for adipose tissue transplantation."