A systematic review published in Frontiers in Medicine reported that augmenting autologous fat transfers with adipose-derived stromal cells significantly improved graft survival in facial rejuvenation procedures, promising more durable results.
Traditional fat transfers typically demonstrate volume retention rates of 50% to 60% after 1 year, often necessitating multiple procedures. In contrast, cell-assisted fat transfers, enhanced by adipose-derived stromal cells (ADSCs), showed statistically significant improvements in volume retention, with certain studies indicating up to 81% retention rates in enriched grafts compared with 16% in conventional grafts.
Researchers attributed these improvements to ADSCs’ ability to support graft viability through several mechanisms, including modulation of inflammatory responses and promotion of new blood vessel formation. Specifically, pathways such as TLR4 and Nrf2 were noted to be involved, creating conditions conducive to graft integration and survival.
Complication rates varied between techniques. In traditional fat grafting, complications occurred at a rate of 27.8%, with 10.9% classified as major, including hematoma/seroma (2.5%), dermatitis/cellulitis (3.3%), and infection (1.8%). Severe complications were more common in certain areas, with the temporal region accounting for 53% of such cases.
The cell-assisted technique showed promise in specific clinical contexts. For example, in cases of radiation-induced tissue damage, 4 of the 11 patients with irreversible functional impairment experienced complete symptom resolution. Additionally, in comparative studies for facial lipoatrophy, ADSC-enriched grafts demonstrated ≥ 60% volumetric improvement, surpassing the 40% to 60% seen with conventional methods.
However, the researchers emphasized that the current evidence is limited by small sample sizes and variability in ADSC preparation techniques. They advocated for larger, standardized trials to confirm these findings and support broader clinical application.
The authors disclosed no commercial or financial conflicts of interest in conducting this research.
