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A systemic review of autologous fat grafting survival rate and related severe complications.

Abstract：

OBJECTIVE:Clinical application of autologous fat grafting (AFG) is quickly expanding. Despite the widely acceptance, long-term survival rate (SR) of AFG remains a question not yet solved. Meanwhile, although rare, severe complications related to AFG including vision loss, stroke even death could be seen in the literature. DATA SOURCES:A comprehensive research of PubMed database to June 2013 was performed according to guidelines of the American Society of Plastic Surgeons Fat Graft Task Force Assessment Methodology. Articles were screened using predetermined inclusion and exclusion criteria. STUDY SELECTION:Data collected included patient characteristics, surgical technique, donor site, recipient site, graft amount, and quantified measurement methods. Patient cohorts were pooled, and SR was calculated. All the severe complications were also summarized according to the different clinical characteristics. RESULTS:Of 550 articles, 16 clinical articles and 10 animal studies met the inclusion criteria and provided quantified measurement methods. Totally, 596 patients were included. SR varied from 34% to 82% in breast and 30-83% in the facial area. Nude mice were applied to investigate human fat grafting SR (38.3-52.5% after 15 weeks). Rabbits were commonly used to study animal AFG SR (14.00-14.56% after 1-year). Totally, 21 severe complications were reported, including death (2), stroke (10), vision loss (11, 8 of which accompanied with stroke), sepsis (3), multiple abscess (1) and giant fat necrotic cyst (2). Ten of these complications happened within 10 years. CONCLUSIONS:There is no unified measurement method to evaluate fat graft SR until now and no clinical evidence to show better SR according to different donor and recipient cite. Body mass index change between pre- and postoperation may be the bias factor in evaluating fat SR. Fat embolisms of the ophthalmic artery and the middle cerebral artery are the most severe complication of AFG and still lack of effective treatment.

journal_name

Chin Med J (Engl)

journal_title

Chinese medical journal

authors

Yu NZ,Huang JZ,Zhang H,Wang Y,Wang XJ,Zhao R,Bai M,Long X

doi

10.4103/0366-6999.156142

subject

Has Abstract

pub_date

2015-05-05 00:00:00

pages

1245-51

issue

eissn

0366-6999

issn

2542-5641

pii

ChinMedJ_2015_128_9_1245_156142

journal_volume

128

pub_type

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A systemic review of autologous fat grafting survival rate and related severe complications.