Optimizing Autologous Fat Grafting: A Systematic Review of Enhancement Strategies and Graft Survival.

In 30 seconds

This systematic review assessed strategies for enriching autologous fat grafts to improve graft survival, drawing on animal and clinical studies published through February 2025. Twenty-seven studies met the criteria: 15 animal studies and 12 clinical studies, most involving breast reconstruction or augmentation. Stromal vascular fraction and adipose-derived stem cell enrichment were the most frequently studied approaches; platelet-rich plasma and other agents were also examined. Many studies reported favourable results, although statistical significance was inconsistent. Overall, enrichment appeared to improve survival, but substantial variation in methods and outcomes limits comparison and certainty.

Key findings

• The review included 27 studies: 15 animal studies and 12 clinical studies.
• Stromal vascular fraction and adipose-derived stem cell enrichment were the most frequently investigated strategies, with favourable results in many trials.
• Platelet-rich plasma was among the approaches identified as promising, alongside stromal vascular fraction- and stem cell-based methods.
• Protocols and outcome measures varied substantially, and statistical significance was not consistently achieved.

Why it matters

Fat graft survival remains unpredictable, and enrichment strategies may help address this challenge in reconstructive and aesthetic procedures. However, the evidence spans heterogeneous animal and clinical studies, making it difficult to compare approaches or establish reliable expectations. The review highlights the need for standardized methods and stronger clinical evidence before the relative benefits of these strategies can be determined.

What to keep in mind

The included studies varied substantially in enhancement protocols, case numbers, follow-up duration, and outcome measures, limiting comparability.