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Efficacy and Safety of Autologous Fat Transfer in Facial Reconstructive Surgery A Systematic Review and Meta-analysis
- Source :
- Jama Facial Plastic Surgery, 20(5), 351-360. American Medical Association
- Publication Year :
- 2018
- Publisher :
- American Medical Association, 2018.
-
Abstract
- IMPORTANCE: The use of autologous fat transfer (AFT) or lipofilling for correcting contour deformities is seen as one of the major breakthroughs in reconstructive plastic surgery. Its applications in facial reconstructive surgery have been of particular interest owing to the prospect of achieving autologous reconstruction by a minimally invasive approach. However, its unpredictability and variable degree of resorption have limited its utility and much skepticism still exists regarding its efficacy. Furthermore, more than 2 decades of clinical research have produced a highly fragmented body of evidence that has not been able to provide definite answers. OBJECTIVE: To investigate the safety and efficacy of AFT in facial reconstruction through a systematic review and meta-analysis. DATA SOURCES: A literature search was performed in PubMed, Embase, and the Cochrane Library from inception to October 11, 2017. STUDY SELECTION: All published studies investigating the efficacy and safety of AFT in facial reconstructive surgery. DATA EXTRACTION AND SYNTHESIS: Two independent reviewers performed data extraction systematically, adhering to the PRISMA guidelines. Summary measures were pooled in a random-effects model meta-analysis. MAIN OUTCOMES AND MEASURES: The patient and surgeon satisfaction, graft survival, number of AFT sessions, and the incidence of AFT-related complications were the main outcomes of interest in this meta-analysis. RESULTS: This systematic review resulted in the inclusion 52 relevant studies consisting of 1568 unique patients. These included 4 randomized clinical trials, 11 cohort studies, and 37 case series. The overall follow-up averaged 1.3 years after AFT. Meta-analysis revealed a very high overall patient satisfaction rate of 91.1% (95% CI, 85.1%-94.8%) and overall surgeon satisfaction rate of 88.6% (95% CI, 83.4%-92.4%). The number of AFT sessions required to achieve the desired result was 1.5 (95% CI, 1.3-1.7) and 50% to 60% of the injected volume was retained at 1 year. Only 4.8% (95% CI, 3.3%-6.9%) of procedures resulted in clinical complications. CONCLUSIONS AND RELEVANCE: To our knowledge, this study provides the first overview of the current knowledge about AFT in facial reconstructive surgery. Our results confirm that AFT is an effective technique for treating soft-tissue deformities in the head and neck, with low rate of minor complications. LEVEL OF EVIDENCE: NA.
- Subjects :
- REHABILITATION
medicine.medical_specialty
Visual Analog Scale
Treatment outcome
Cosmetic Techniques
030230 surgery
CRANIOFACIAL MICROSOMIA
Transplantation, Autologous
MESENCHYMAL STEM-CELLS
Autologous Fat Transfer
PROGRESSIVE HEMIFACIAL ATROPHY
03 medical and health sciences
Imaging, Three-Dimensional
Postoperative Complications
0302 clinical medicine
VOLUMETRIC-ANALYSIS
Humans
Minimally Invasive Surgical Procedures
Medicine
030223 otorhinolaryngology
Original Investigation
LIPODYSTROPHY
TRANSPLANTATION
business.industry
Graft Survival
Soft tissue
Plastic Surgery Procedures
LIPOATROPHY
PARRY-ROMBERG SYNDROME
Surgery
Transplantation
Facial reconstructive surgery
Plastic surgery
Fat transplantation
Treatment Outcome
Adipose Tissue
Patient Satisfaction
Face
Meta-analysis
HUMAN-IMMUNODEFICIENCY-VIRUS
Tomography, X-Ray Computed
business
Subjects
Details
- ISSN :
- 15383660 and 21686076
- Volume :
- 20
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- Archives of Facial Plastic Surgery
- Accession number :
- edsair.doi.dedup.....7fc8947c3a943f14de6e501a49b8ae15