Stromal cells obtained mechanically from adipose tissue have many advantages over those extracted with enzymatic methods. Beyond being faster, easier, and cheaper, the lack of restrictive regulations imposed by organizations has contributed to increasing interest in developing new methods and devices in this regard [
1]. The goal of collecting stromal cells mechanically is to obtain “nanofat”–a semi-solid product in the form of emulsified fat–but the “stromal cell cocktail” obtained as the final product of the standard enzymatic method, called the stromal vascular fraction (SVF), is in liquid form. Although variations of nanofat are defined with different terms, such as cell aggregate or SVF gel, they are generally solid products in a very thin fat format. Today, nanofat, the “veteran” of mechanical methods, is applied clinically for many different indications, and with such a wide range of applications, there is a need for an end product available in various physical forms [
2,
3]. Copcu and Oztan defined a new technique and achieved high viability and cell count in stromal cell recovery by separating the bonds between parenchymal and stromal cells mechanically instead of with enzymes, using especially sharp blades [
1]. Adinizing is the name given to cutting fat tissue using ultra-sharp blades. Copcu and Oztan [
1] obtained the stromal cell with high viability and cell number from the adipose tissue mechanically with the adinizing process and named this process MEST (mechanical stromal-cell transfer). These authors, with the indication-based protocols (IPs) they defined, ensured that the final product stromal cells were in the desired physical structure in liquid or solid form (
Table 1). The stromal cell can be obtained in liquid form when the condensed fat tissue is mixed with saline or similar liquid before adinizing (pre-adinizing) and then cut with ultra-sharp blades. Since the SVF term belongs to the final product in liquid form obtained with enzymatic products, and extracellular matrix and stromal cells are protected in mechanical methods, they call it total stromal cells (TOST) [
4]. Stromal cells are generally applied to target tissue at the time of injection. However, this use is in the form of an emulsified fat graft. Different from all these, Verpaele et al. [
5] presented the application of nanofat to the skin by needling as a new application technique. The stromal cell preparation used was in a semi-solid, emulsified fat state. In the same publication, they also reported the application of a “nanofat cream” they produced after the process [
5]. Similarly, Cohen et al. [
6] applied millifat as biocream. In this study, three application methods are presented as new innovative approaches (
Fig. 1), all of which are obtained mechanically and have not been reported before.