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Updated: Dec 27, 2025
Stromal Vascular Fraction-enriched Fat Grafting for the Treatment of Symptomatic End-neuromata
Published on: November 23, 2017
Fat Graft Enrichment Strategies: A Systematic Review
Krishna S Vyas1, Henry C Vasconez1, Shane Morrison1
1From the Division of Plastic Surgery, Department of Surgery, Mayo Clinic; University of Kentucky College of Medicine; Division of Plastic Surgery, Department of Surgery, University of Washington; Division of Plastic Surgery, University of Wisconsin; and Mayo Medical School, Mayo Clinic.
Background:
Autologous fat grafting is a dynamic modality used in plastic surgery as an adjunct to improve functional and aesthetic form. However, current practices in fat grafting for soft-tissue augmentation are plagued by tremendous variability in long-term graft retention, resulting in suboptimal outcomes and repetitive procedures. This systematic review identifies and critically appraises the evidence for various enrichment strategies that can be used to augment and improve the viability of fat grafts.
Methods:
A comprehensive literature search of the Medline and PubMed databases was conducted for animal and human studies published through October of 2017 with multiple search terms related to adipose graft enrichment agents encompassing growth factors, platelet-rich plasma, adipose-derived and bone marrow stem cells, gene therapy, tissue engineering, and other strategies. Data on level of evidence, techniques, complications, and outcomes were collected.
Results:
A total of 1382 articles were identified, of which 147 met inclusion criteria. The majority of enrichment strategies demonstrated positive benefit for fat graft survival, particularly with growth factors and adipose-derived stem cell enrichment. Platelet-rich plasma and adipose-derived stem cells had the strongest evidence to support efficacy in human studies and may demonstrate a dose-dependent effect.
Conclusions:
Improved understanding of enrichment strategies contributing to fat graft survival can help to optimize safety and outcomes. Controlled clinical studies are lacking, and future studies should examine factors influencing graft survival through controlled clinical trials in order to establish safety and to obtain consistent outcomes.
