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Updated: May 30, 2025

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Fat Grafting Versus Implants: Who's Happier? A Systematic Review and Meta-analysis.

Khalifa AlGhanim1,2, Kathryn Minkhorst1,2, Katrina M Jaszkul3

  • 1Schulich School of Medicine, Western University, London, Canada.

Plastic Surgery (Oakville, Ont.)
|January 29, 2025
PubMed
Summary

Breast implants offer higher overall patient satisfaction compared to fat grafting for breast augmentation. However, fat grafting is a desirable alternative, emphasizing the need for careful patient selection based on individual goals.

Keywords:
BREAST-Qbreast augmentationbreast implantsfat graftingquality of life

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Area of Science:

  • Plastic Surgery
  • Regenerative Medicine

Background:

  • Breast augmentation techniques have evolved from implants to include fat grafting.
  • Fat grafting offers a natural outcome and avoids implant-related complications.
  • Patient-reported outcomes are crucial for evaluating augmentation methods.

Purpose of the Study:

  • To systematically review and compare patient-reported outcomes between fat grafting and implant-based breast augmentation.
  • To utilize the validated BREAST-Q questionnaire for outcome assessment.
  • To conduct a meta-analysis of existing studies.

Main Methods:

  • Systematic literature review following PRISMA guidelines across major databases (PubMed, Cochrane, EMBASE, MEDLINE, Scopus).
  • Screening by two independent blinded reviewers.
  • Quality assessment using MINORS criteria.
  • Meta-analysis of 14 studies (81 fat grafting, 1535 implant cases).

Main Results:

  • Implant-based augmentation showed significantly higher overall patient satisfaction scores (13.0 points higher, P=.016).
  • No significant differences were found in post-operative sexual well-being, psychosocial well-being, or physical well-being scores.
  • Meta-regression analysis informed the satisfaction score comparison.

Conclusions:

  • Implant augmentation yields higher overall satisfaction, but fat grafting is a viable alternative.
  • Careful patient selection and goal assessment are critical for choosing the optimal augmentation method.
  • Fat grafting remains a highly desirable option for select patients.