Autologous fat grafting in breast augmentation: A systematic review highlighting the need for clinical caution.
Academic Article
Overview
abstract
BACKGROUND: Autologous fat grafting (AFG) is a breast augmentation method for treating volume and contour abnormalities. This systematic review aims to summarize complications, radiological safety, volume retention, and patient satisfaction associated with AFG. METHODS: PubMed, EMBASE, Google Scholar, Cochrane CENTRAL, Wiley library, clinical key/Elsevier, and EBSCO databases were searched for relevant studies from January 2009 to March 2022. Articles describing AFG for breast augmentation were selected based on pre-determined inclusion and exclusion criteria. PRISMA guidelines were adhered to, and the study was registered on PROSPERO. The ROBINS-I assessment was used to assess the quality of studies and the risk of bias was measured using the ACROBAT- NRSI. RESULTS: Total of 35 studies comprising 3757 women were included. The average follow-up duration was 24.5 months (range, 1-372 months). The overall complication rate was 27.8%, with fat necrosis making up 43.7% of all complications. Average fat volume injected was 300mls (range: 134-610ml) and average volume retention was 58% (range: 44-83%). Volume retention was greater with supplementation of fat with plasma-rich-protein (PRP) and stromal vascular fractioning (SVF). The most common radiological changes were fat necrosis (9.4%) and calcification (1.2%). After follow-up of one year, patient satisfaction was on average 92% (range; 83.2-97.5%). The included studies were of good quality and consisted of a moderate risk of bias. CONCLUSIONS: AFG was associated with an overall complication rate of 27.8%, and additional supplementation of fat with PRP and SVF may improve graft survival. Despite poor volume retention being a persistent drawback patient satisfaction remains high.
