Abstract
BackgroundCell-assisted lipotransfer is a novel technique for fat grafting. This study aimed to investigate the clinical efficacy of cell-assisted lipotransfer technology compared with conventional fat grafting.MethodsAccording to PRISMA guidelines, related articles in PubMed, Embase and Cochrane library were systematically searched. Studies focusing on fat survival rate and/or patient satisfaction rate for fat grafting alone versus cell-assisted lipotransfer were retrieved. Estimated fat survival and patient satisfaction rates were pooled. Subgroup analysis was stratified by the transplant site. Publication bias was conducted. Furthermore, the stability of results was assessed by sensitivity analysis.ResultsNine articles were included in the meta-analysis. Significant heterogeneity was observed among individual studies for fat survival rate assessment (I2 = 98.3%, P < 0.001). The fat survival rate was significantly higher in the cell-assisted lipotransfer group than in the control group [weighted mean difference = 25.85, 95% confidence interval 5.39–46.31; P = 0.013]. Notably, results remained unchanged in the sensitivity analyses. No significant difference was found in the patient satisfaction rate between the cell-assisted lipotransfer and control groups [odds ratio = 3.69, 95% confidence interval 0.73–18.53; P = 0.113]. In subgroup analysis, a significantly higher patient satisfaction rate was found in cell-assisted lipotransfer fat graft group in the face (odds ratio = 18.85, 95% confidence interval 9.03, 28.68; P < 0.001) and arm (odds ratio = 64.60, 95% confidence interval 58.79, 70.41; P < 0.001) than in the controls. Finally, no significant publication bias was found (P = 0.371).ConclusionThis study suggests that cell-assisted lipotransfer is superior to conventional lipoinjection with improved fat survival rate. However, the long-term efficacy should be evaluated in further studies.
Highlights
IntroductionThis study aimed to investigate the clinical efficacy of cell-assisted lipotransfer technology compared with conventional fat grafting
Cell-assisted lipotransfer is a novel technique for fat grafting
Study selection The eligibility of each study was independently assessed by two investigators following the inclusion criteria: (1) the study subjects were patients who had undergone soft tissue reconstruction or filling, (2) studies assessed the clinical efficacy of autologous cell-assisted lipotransfer (CAL), (3) patients in the control group were treated with fat grafting alone and (4) fat survival rate and/or patient satisfaction rate were assessed in the studies
Summary
This study aimed to investigate the clinical efficacy of cell-assisted lipotransfer technology compared with conventional fat grafting. Fat grafting was first reported in 1989, but the use of this technology was restricted due to its unpredictability and low graft survival rate [1, 2]. Several clinical studies with favourable and unfavourable results using CAL compared with conventional lipoinjection have been reported. A meta-analysis that supported the superior clinical efficacy of CAL has been reported [7]. No study has discussed this issue, the transplant site may be one of the factors influencing the efficacy of fat grafting [10, 11]. We conducted a meta-analysis to investigate whether CAL could improve fat survival and patient satisfaction rates. We performed a subgroup analysis stratified by the transplant site
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