Rectus Abdominis Fat Grafting: Outcomes and Safety

Area of Science:

• Plastic Surgery
• Aesthetic Medicine
• Body Contouring

Background:

• Rectus abdominis fat grafting (RAFG) is increasingly used with liposuction and abdominoplasty.
• Limited evidence exists on RAFG safety, standardization, and outcomes.
• A standardized protocol for ultrasound-guided or direct-vision RAFG was developed.

Purpose of the Study:

• To describe a standardized protocol for rectus abdominis fat grafting (RAFG).
• To evaluate the clinical results, complications, and patient satisfaction of RAFG.
• To assess the safety and reproducibility of ultrasound-guided or direct-vision RAFG.

Main Methods:

• Retrospective review of 182 patients undergoing liposuction or abdominoplasty with RAFG (2022-2024).
• Fat injected via high-frequency ultrasound guidance or direct vision.
• Analysis of demographics, operative time, graft volumes, complications, and BODY-Q scores.

Main Results:

• 182 patients (mean age 37.2 years, BMI 26.4 kg/m²).
• Average graft volume 85 mL across 4 metameres.
• Low complication rate (1.09%) including 1 surgical-site infection and 1 fat necrosis; no fat embolism.
• Mean BODY-Q satisfaction scores improved from 12.5 to 26.2.

Conclusions:

• Standardized, metameric, small-volume RAFG is safe and reproducible.
• Ultrasound guidance or direct visualization enhances abdominal definition.
• Low complication rates and high patient satisfaction support RAFG in body contouring.