Abstract
Background
Autologous fat transfer (AFT) has already become a part of clinical practice for aesthetic breast augmentation, even though evidence regarding its efficacy is still lacking.
Objectives
To determine the current worldwide status and efficacy, techniques, and oncologic safety on this subject.
Methods
PubMed, EMBASE, and Cochrane Library databases were searched to identify all relevant studies.
Results
Eighty-four articles published between 1987 and April 2020, consisting of 6468 patients, were included, and 64 studies consisting of 5162 unique patients were included in the meta-analysis. Most studies had a low level of evidence (levels 2b–5); In this meta-analysis, there were 17 prospective cohort studies, four retrospective cohort studies, six case-control studies, and 38 case series. The publications were from 21 countries. Indications for autologous fat transplantation were aesthetic augmentation (93.2%) and congenital malformation (6.8%). Among the 5162 patients, two cases (0.04%) of cancer were reported. The meta-analysis revealed very high overall patient and surgeon satisfaction rates of 93% and 87%, respectively. Overall, only 1.56 sessions were needed to achieve the desired result. Long-term survival was calculated to be about 60–70% at 1-year follow-up. Only 8% of procedures resulted in clinical complications, and 5% of patients required biopsy because of abnormal clinical or radiological findings.
Conclusions
Autologous fat transplantation seems to be a major tool in aesthetic breast augmentation. Preoperative patient selection is essential but under-reported. Future research should focus on evaluating the technical and patient factors influencing the rate of fat survival and its oncological safety.
Better clinical outcome for autologous fat transplant combined with silicone gel prosthesis for breast augmentation: Evidence from meta-analysis
