Cosmetic Fat Transplantation: A Review

Aim: To review current techniques used in fat grafting to optimise graft persistence and achieve optimal cosmetic outcomes. Background: Fat transplantation has been used extensively in the reconstruction and cosmetic industry for many years. However, there is significant adipocyte loss and reabsorption rates, leading to the loss of external cosmetic volume and the need for repeat procedures. Adipocyte loss can occur at all four stages of transplantation and this review discusses each of these methods with the aim being to optimise graft outcome. Results: Several new techniques have been discussed including liposuction techniques, fat processing, and assisted fat grafting which show an improvement in adipocyte survival, revasculisation and graft outcomes. Conclusion: There have been many improvements in fat grafting and the implementation of these will optimise surgical outcomes but there are still strategies to improve further. However, there is still a lack of standardised techniques and training. More research is needed in the areas of fat processing and the use of additives to the fat graft. More clinical research is needed in the fat placement technique, which has very little published evidence and current techniques are mostly anecdotal by cosmetic surgeons.