Volume Retention After Facial Fat Grafting and Relevant Factors: A Systematic Review and Meta-analysis

• Published in: Aesthetic plastic surgery Vol. 45; no. 2; pp. 506 - 520
• Main Authors: Lv, Qianwen, Li, Xin, Qi, Yue, Gu, Yunpeng, Liu, Zhenjun, Ma, Gui-e
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-04-2021; Springer Nature B.V
• Subjects: Adipose Tissue - transplantation; Autografts; Cosmetic surgery; Evidence-based medicine; Face - surgery; Humans; Medicine; Medicine & Public Health; Meta-analysis; Otorhinolaryngology; Patients; Plastic Surgery; Reconstructive Surgical Procedures; Retention; Review; Skin & tissue grafts; Surgery, Plastic; Systematic review; Treatment Outcome; Systematic review; Facial fat grafting; Volume retention rate; Meta-analysis
• ISSN: 0364-216X; 1432-5241
• DOI: 10.1007/s00266-020-01612-6

Background
Autologous fat grafting is common in facial reconstructive and cosmetic surgeries; the most important drawbacks are the high absorption rate and unpredictable volume retention rate. Surgeons usually make clinical judgements based on their own experience. Therefore, this study aimed to systematically and quantitatively review the volume retention rate of facial autologous fat grafting and analyse the relevant influencing factors.
Methods
A systematic literature review was performed using the Medline, EMBASE, Cochrane Library, and Web of Science databases in October 2019 for articles that reported objectively measured volume retention rates of facial fat grafting. Patient characteristics, fat graft volumetric data, and complications were collected. A meta-analysis using a random-effects model was conducted to pool the estimated fat retention rate. Relevant factors were analysed and reviewed on the basis of subgroups.
Results
We included 27 studies involving 1011 patients with facial fat grafting. The volume retention rate varied from 26 to 83%, with a mean follow-up of 3–24 months. The overall pooled retention rate was 47% (95% CI 41–53%). The volume measurement method significantly influenced the reported retention rate. A trend towards better retention was found for secondary fat grafting procedures and patients with congenital deformities. Only 2.8% of all patients had complications.
Conclusion
The exact percentage of facial fat grafts retained is currently unpredictable; the reported rate varies with different estimation methods. This review analysed studies that provided objectively measured volume retention rates, the pooled average percentage of facial fat graft retention (47%, 95% CI 41–53%), and relevant factors.
Level of Evidence III
This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of Contents or the online Instructions to Authors
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