Zhang Kaiwei, Wang Wanzhe, Hua Kaifang, Han Xuefeng
Plastic Surgery Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
Aesthetic Plast Surg. 2025 Sep 19. doi: 10.1007/s00266-025-05269-x.
Autologous fat grafting (AFG), which has been utilized in the clinical realm for more than a century, was first introduced to address facial contour deformities stemming from tuberculosis. Subsequently, it has emerged as a prominent approach for rectifying facial defects associated with congenital and acquired diseases, traumas, or postoperative conditions. AFG is widely used in treating various facial soft tissue defects. It features convenience, simplicity, effectiveness, and safety, making it a preferred option for minimally invasive facial defect reconstruction.
A comprehensive literature search was systematically performed in the PubMed, Embase, and Scopus databases, retrieving studies published up until February 2025.
Recent progress and innovations have been achieved in multiple areas, including clinical application, operative techniques, fat products, additives, assessment methods, and interdisciplinary cooperation, leading to significant improvements and ushering in a new era of diversification and refinement. However, challenges remain in applying AFG to facial soft tissue defects. The volume retention of the grafted fat varies greatly. Investigating the survival mechanism of the grafted fat, preventing and managing severe complications, and determining the optimal surgical timing for progressive diseases are still controversial and challenging.
This review comprehensively summarizes the current application status, existing controversies, and future directions of AFG, aiming to provide a valuable reference for clinical practice and future research.
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 the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
自体脂肪移植（AFG）已在临床领域应用了一个多世纪，最初是为解决因结核病导致的面部轮廓畸形而引入的。随后，它已成为矫正与先天性和后天性疾病、创伤或术后情况相关的面部缺陷的一种重要方法。AFG被广泛用于治疗各种面部软组织缺陷。它具有方便、简单、有效和安全的特点，使其成为微创面部缺陷重建的首选方案。
在PubMed、Embase和Scopus数据库中系统地进行了全面的文献检索，检索截至2025年2月发表的研究。
在临床应用、手术技术、脂肪制品、添加剂、评估方法和跨学科合作等多个领域取得了最新进展和创新，带来了显著改善，并开启了一个多样化和精细化的新时代。然而，将AFG应用于面部软组织缺陷仍存在挑战。移植脂肪的体积保留差异很大。研究移植脂肪的存活机制、预防和处理严重并发症以及确定进行性疾病的最佳手术时机仍存在争议且具有挑战性。
本综述全面总结了AFG的当前应用状况、现有争议和未来方向，旨在为临床实践和未来研究提供有价值的参考。
证据水平V：本刊要求作者为每篇文章指定一个证据水平。有关这些循证医学评级的完整描述，请参阅目录或在线作者指南www.springer.com/00266 。
