In regenerative medicine we hear the term stem cells, cells, cells, cells. What if most of the benefits we see with fat graft in treating orthopedic pain isnt about cells? But instead tiny packages filled with signaling elements that jump start repair and regeneration? These little powerhouses are called extracellular vesicles, exosomes. Lipogems fat graft not only cushions and fills defects, but is packed with these bioactive powerhouses.