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Autologous Fat Grafting Versus Facial Fillers in Facial Cosmesis: A Systematic review and Meta-analysis
Ali Hassan1, Ameer Hamza2, Safa Javed3
1Queen Elizabeth Hospital, Birmingham, UK. alijaved3693@gmail.com.
Introduction:
Autologous fat grafting (AFG) and facial fillers specially Hyaluronic acid fillers (HA) are widely used for facial rejuvenation, yet their comparative benefits for patient satisfaction remain uncertain.
Objective:
To compare AFG and facial fillers, using patient satisfaction as the primary outcome.
Design:
Systematic review and meta-analysis (PRISMA-aligned).
Methods:
Nine comparative studies (n = 805) were pooled with random-effects models (standardized mean difference, SMD). Heterogeneity (Q, I2) and small-study effects (Egger's) were assessed.
Results:
AFG showed higher patient satisfaction than HA (SMD 0.91, 95% CI - 0.32 to 2.14), but results varied across studies (I2=97%); subgroup analyses were directionally consistent but did not explain variability. Egger's test suggested possible small-study effects (p = 0.15), though interpretation is limited with <10 studies.
Conclusions:
On average, AFG provides higher satisfaction, likely due to its greater durability, while HA remains valuable for convenience and reversibility. Findings should be interpreted in light of between-study variability. Well-designed, standardized RCTs are needed.
Level Of Evidence I:
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine Ratings, please refer to Table of Contents or online Instructions to Authors www.springer.com/00266 .
