Research Advances in Cell-Assisted Lipotransfer for Facial and Breast Surgery

Cell-assisted lipotransfer (CAL) is an advanced fat grafting technique in which adipose tissue is enriched with regenerative cellular components, most frequently stromal vascular fraction (SVF) or adipose-derived stem cells (ADSCs). This approach is intended to enhance the survival and structural stability of conventional fat grafts, thereby improving outcomes in soft-tissue augmentation and regeneration. By supporting early vascularization, reducing postoperative resorption, and enhancing long-term volume retention, CAL may also improve skin quality and local tissue remodeling. Nevertheless, key challenges remain, including the lack of standardized processing protocols, uncertainty about long-term safety, inadequate consensus on optimal cell dosing, and the need for clear regulatory guidelines. This review outlines the technical basis of CAL, presents the preparation and proposed mechanisms of its key bioactive components, including SVF, ADSCs, and platelet-rich plasma (PRP), and systematically examines recent clinical evidence for its application in facial rejuvenation and contour enhancement, as well as breast reconstruction and augmentation. Overall, the aim is to provide a foundation for developing standardized clinical protocols for CAL.