Fat Grafting In Breast Reconstruction Research Articles

Integrated RNA Sequencing Analysis Revealed Early Gene Expression Shifts Associated with Cancer Progression in MCF-7 Breast Cancer Cells Cocultured with Adipose-Derived Stem Cells

Breast cancer remains a prevalent global health challenge, with tumor-removal surgeries being among the most common treatments but often leading to aesthetic defects. Adipose-derived stem cell (ADSC)-enriched fat grafting in breast reconstruction offers promising therapeutic benefits. However, concerns about its oncological safety persist, particularly regarding the potential risks of promoting cancer recurrence. This study investigated the effects of ADSCs on breast cancer progression by coculturing ADSCs with the MCF-7 breast cancer cell line for a short cell cultivation period of 3 days. We performed an RNA-seq analysis to identify significant transcriptomic changes in cocultured MCF-7 cells and carried out functional enrichment analyses to uncover key biological pathways influenced by ADSCs. Our findings revealed that transcriptomic alterations in MCF-7 cells are linked to aggressive cancer traits, including the upregulation of epithelial–mesenchymal transition (EMT) and the HIF-1 signaling pathway, which indicate a shift toward aerobic glycolysis. Some of the observed gene expression changes also correlated with relapse risk and mortality. These findings underscore the need for further research to explore the implications of these genes and pathways in driving aggressive cancer phenotypes and assess the safety of ADSCs in clinical settings.

The Landscape of Research on Autologous Fat Grafting for Breast Reconstruction

The Landscape of Research on Autologous Fat Grafting for Breast Reconstruction

Endoscopic latissimus dorsi muscle flap and fat grafting in breast reconstruction.

Endoscopic latissimus dorsi muscle flap and fat grafting in breast reconstruction.

Efficacy of Exclusive Fat Grafting for Breast Reconstruction: An Updated Systematic Review and Meta-analysis.

Exclusive fat grafting is an alternative method to implant- or flap- based reconstruction techniques following mastectomies or breast conservation therapies. Its efficacy has been explored before but new data has come to light, resulting in previous results becoming outdated. Concerns have also been raised about the oncological safety of this procedure which must be evaluated alongside the efficacy to gain a comprehensive understanding of the merits of this alternative technique. We queried the PubMed electronic database from its inception until August 2023 for studies evaluating the efficacy and oncological safety of exclusive fat grafting breast reconstruction following cancer-related mastectomy or breast conservation therapy. Results of the analysis were pooled and presented as means or valid proportions. Results of the analysis were pooled using a random-effects model and presented with 95% confidence intervals (95% CIs) where appropriate. 41 studies were included in our analysis. Pooled results show that on average, 1.7 sessions of exclusive fat grafting were required to complete reconstruction in Breast Conservation Therapy (BCT) patients, with an average volume of 114.2 ml being injected. For mastectomy patients with irradiated breasts, 4.7 sessions were needed on average with 556.8 ml being required to complete reconstruction, compared to their non-irradiated Counterparts requiring only 2.6 sessions and 207.2 ml to complete reconstruction. Oncological recurrence events were found in 29/583 non-irradiated mastectomy patients (p = 0.014) and in 41/517 BCT patients (p = 0.301) CONCLUSION: Exclusive fat grafting is an oncologically safe and reasonably efficacious alternative to more common methods of breast reconstruction. More data is needed to fully characterize the oncological safety of this procedure in irradiated and non-irradiated mastectomy patients. 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 .

Oncological Safety of Autologous Fat Grafting for Breast Reconstruction.

Autologous fat grafting has become a vital component of breast reconstruction. However, concerns remain regarding the safety of fat grafting after oncological resection and breast reconstruction. The purpose of the study was to evaluate the association of fat grafting after breast reconstruction with metastasis and death in breast cancer patients. A retrospective, population-based cohort study was conducted using deidentified claims data from 2001 to 2018 and included privately insured patients with breast cancer who underwent breast reconstruction after surgical resection. Breast reconstruction patients who underwent fat grafting were compared with those not undergoing fat grafting, evaluating metastasis and death up to 15 years after reconstruction. One-to-one propensity score matching was used to account for selection bias on patient risk factors comparing those with and without fat grafting. A total of 4709 patients were identified who underwent breast reconstruction after lumpectomy or mastectomy, of which 368 subsequently underwent fat grafting. In the propensity score-matched patients, fat grafting was not associated with an increased risk of lymph node metastasis (9.7% fat-grafted vs 11.4% in non-fat-grafted, P = 0.47) or distant metastasis (9.1% fat-grafted vs 10.5% in non-fat-grafted, P = 0.53). There was no increased risk of all-cause mortality after fat grafting for breast reconstruction (3.9% fat-grafted vs 6.6% non-fat-grafted, P = 0.10). Among breast cancer patients who subsequently underwent fat grafting, compared with no fat grafting, no significant increase was observed in distant metastasis or all-cause mortality. These findings suggest that autologous fat grafting after oncologic resection and reconstruction was not associated with an increased risk of future metastasis or death.

Cryopreservation of adipose tissue-derived mesenchymal stem cells: An alternative to serial fat grafting in breast reconstruction

Cryopreservation of adipose tissue-derived mesenchymal stem cells: An alternative to serial fat grafting in breast reconstruction

Are We Speaking the Same Language? A Systematic Review on the Use of Consistent Language in Reporting Fat Necrosis in Autologous Fat Grafting of the Breast.

Autologous fat grafting is a widely adopted approach to optimize outcomes in breast reconstruction and augmentation. Although fat necrosis is a well-known consequence of autologous fat grafting, it remains inconsistently defined in the literature. In late 2014, the Food and Drug Administration released a draft guidance to restrict future autologous fat grafting-a statement that was permissively modified in late 2017. In the context of evolving guidelines and autologous fat grafting outcome data, the language and descriptions of fat necrosis are inconsistent in the literature. Five databases were queried for studies reporting fat necrosis following autologous fat grafting for breast reconstruction or augmentation from inception to August 11, 2022. Studies were temporally stratified according to released FDA guidelines: pre-2015, 2015-2017, and 2018-2022. Sixty-one articles met inclusion criteria. Prior to 2015, 6 of 21 studies (28.6%) offered clear definitions of fat necrosis. In contrast, the 2015-2017 period demonstrated an absence of clear fat necrosis definitions (0/13 studies, p = 0.03). Though the 2018-2022 period exhibited a rise in annual publications compared with the pre-2015 period (5.4 vs. 1.9, respectively, p = 0.04), this was not matched by a rise in clear fat necrosis reporting (14.8% studies, p = 0.45). Across all periods, only 16.4% of articles offered clear definitions, which exhibited wide heterogeneity. Despite the increasing popularity of autologous fat grafting, fat necrosis remains inconsistently defined and described, especially in the context of changing FDA guidelines. This limits the reliable interpretation and application of the current literature reporting fat necrosis outcomes. 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 .

Comment on "Oncological Safety of Autologous Fat Grafting in Breast Reconstruction: A Meta-analysis Based on Matched Cohort Studies".

Comment on "Oncological Safety of Autologous Fat Grafting in Breast Reconstruction: A Meta-analysis Based on Matched Cohort Studies".

D70. Suspicious or Safe? A Systematic Review on the Impact of FDA Guidance on Reporting of Fat Necrosis in Autologous Fat Grafting of the Breast

PURPOSE: Autologous fat grafting (AFG), increasingly popular in breast reconstruction and augmentation, often causes fat necrosis. In late-2014, the FDA draft guidance recommended cessation of all AFG. In late-2017, the final guidance was updated to allow AFG with restrictions. The landscape of clinically relevant fat necrosis reporting remains undescribed in the context of these changing guidelines. METHODS: PubMed, Embase, Cochrane, Web of Science, and Scopus were queried for studies mentioning fat necrosis and fat grafting in breast reconstruction or augmentation from inception to August 11, 2022. Of the 1359 articles identified, 62 met inclusion criteria. Studies were temporally stratified according to released FDA guidelines. RESULTS: 7 of 22 (31.8%) studies pre-2014 FDA draft guidance used clear fat necrosis definitions. There is an absence of defining fat necrosis in the 13 studies between 2015 and the late-2017 FDA guidance (p=0.023). After the 2017 guidance, only 3 of 27 (11.1%) studies clearly followed FDA recommendations to define fat necrosis. Among the 10 studies defining fat necrosis, none used identical definitions. 52 (83.9%) of all studies did not define what constituted fat necrosis. CONCLUSION: Clear fat necrosis definitions are not consistently utilized in literature describing autologous fat transfer of the breast, despite FDA recommendations. Given the rise of non-PRS-performed fat grafting procedures, we call on the PRS community to commit to uniformly reporting clinically distinct fat necrosis complications.

Autologous fat grafting: current state of clinical practice in the Australian setting

**Objective**: This study aimed to gather and present systemic data about current fat grafting practice in Australia. We knew prior to the study that data for Australian fat grafting is limited, so we sought information from distinct sources. Part 1 aimed to present fat grafting data available from the Australian Breast Device Registry (ABDR). Part 2 aimed to present the details of current fat grafting practice by Australian plastic and reconstructive surgeons. **Methods**: In part 1, fat grafting data from the ABDR from its inception in 2012 to 2020 was collected and summarised. In part 2, a comprehensive survey about all aspects of fat grafting practice was distributed to surgeon members of the Australian Society of Plastic Surgeons (ASPS). **Results**: Part 1. The ABDR recorded an 8.4 per cent and 6.0 per cent increase in fat grafting at the time of breast device insertion surgery from 2012 to 2020 for reconstructive and aesthetic procedures respectively. Fat grafting with breast device insertion, in previously irradiated breast tissue, increased from 0 per cent to 17.4 per cent in the same period. Part 2. One in five of all surgeons of the Australian Society of Plastic Surgeons completed the survey. Our survey demonstrated that fat grafting is highly heterogeneous with respect to donor site selection, harvest technique, processing technique, number of sessions required and volumetric follow-up. **Conclusion**: Our study is the first attempt to present national data on fat grafting. It demonstrates clearly that uptake of autologous fat grafting for breast reconstruction and aesthetic procedures is rapidly increasing Australia-wide. It demonstrates that procedural variables of fat grafting are not standardised among Australian plastic surgeons. This indicates that further clinical data relating to patient demographics, procedural variables and outcomes are vital to ensure patient safety, health resource management and to inform best practice guidelines.

A Cross-Sectional Analysis of Breast Reconstruction with Fat Grafting Content on TikTok

Objective: As of November 2021, TikTok has one billion monthly active users, and content creators have utilized the app to advocate for social reforms, education, and other uses that were not previously considered. Breast cancer is the most commonly diagnosed cancer in women, and as more individuals with breast cancer choose to undergo resection, the demand for autologous fat grafting in breast reconstruction has increased. The purpose of this study is to analyze content related to breast reconstruction with fat grafting found on TikTok and recommend methods to improve patient education, care, and outcomes. Methods: We searched TikTok on November 1, 2021, for videos using the phrase “breast reconstruction with fat grafting.” The top 200 videos retrieved from the TikTok search algorithm were analyzed, and all commentaries, duplicates, and non-relevant videos were removed. Video characteristics were collected, and two independent reviewers generated a DISCERN score. Results: A total of 131 videos were included in the study. They were found to have a combined 1,871,980 likes, 41,113 comments, and 58,662 shares. The videos had an average DISCERN score of 2.16. Content creators had an overall low DISCERN score in items involving the use of references, disclosure of risks for not obtaining treatment, and support for shared decision making. When stratified, the DISCERN score was higher for videos created by physicians (DISCERN average 2.48) than for videos created by non-physicians (DISCERN average 1.99) (p < 0.001). Conclusion: Content creators can improve the quality of their videos by disclosing treatment risks, benefits, discussing risks for not obtaining treatment, and advocating for shared decision-making. Furthermore, including citations and academic references may offer increased credibility and promote evidence-based practice. Furthermore, although DISCERN is a reliable source to assess patient information, it has not been tested for its reliability with videos such as on TikTok. Corresponding Author: Kongkrit Chaiyasate, 3555 W 13 Mile Rd #120, Royal Oak, MI, 48073, [email protected], 248-890-2515

Fat grafting in autologous breast reconstruction: applications, outcomes, safety, and complications

Autologous fat grafting is an important surgical technique in aesthetic and reconstructive procedures. Fat grafting for breast reconstruction is now an established procedure for adding volume and improving cutaneous pliability; it can be used independently to replace more invasive flap procedures or implants, or as an adjunct for smaller volume supplementation. The breadth of applications in the breast necessitates diversity in technique and approach, and while there is no universally agreed-upon protocol, basic principles have guided the evolution of some commonly adopted tenets. Broadly, fat grafting outcomes are highly favorable but dependent on patient and procedure factors, requiring learned patient selection and expertise in recipient site assessment. Common complications from fat grafting, such as fat necrosis and the development of nodules, are particularly troublesome for post-oncologic patients, requiring considerable pre-surgical consultation for patient education and managing expectations. In addition to volume and contour augmentation, fat grafting has additional beneficial effects that have recently drawn increased attention including pain reduction from implant capsular contracture or post-mastectomy pain syndrome, improved skin quality and reduced fibrosis following radiation, and possible anti-tumorigenic effects. New developments in clinical fat grafting research that are promising include the use of adipose progenitor cells admixed with lipoaspirate for improved volume retention or alternative biologics such as platelet-rich plasma. Preclinically, research towards safe and effective regenerative medicine approaches is actively underway, with the ultimate goal of achieving predictable and increased graft retention, reducing the number of required surgical procedures and enabling on-table results to reflect procedure outcomes.

Condensing of Low-Density Fat by Mechanical Process Improves Fat Retention and Reduces Oil Cyst Formation in Breast Reconstruction.

Although autologous fat grafting is a useful adjunct for breast reconstruction, its indications remain limited as large-volume fat grafting results in high absorption and complication rates. Low-density fat includes small numbers of viable cells and considerable oil, resulting in nodules and oil cysts. This study evaluated the volumization effect and complications with combined fat grafting of condense low-density fat and high-density fat. This retrospective, single-center study included 25 patients who underwent combined grafting of condensed low-density fat and high-density fat (CLDF + HDF) and 20 patients who underwent conventional Coleman fat grafting for breast reconstruction from December 2017 to January 2022. Retention rates and complications were evaluated by magnetic resonance imaging and ultrasound rates. Patient satisfaction was evaluated using a typical Likert scale. Photographs were taken and imageological examinations were performed before and after treatment. Graft retention rate was higher in patients who underwent CLDF + HDF than Coleman fat grafting for breast reconstruction (38.40 ± 4.41% vs. 31.43 ± 5.43%, p <0.05). One patient in the CLDF + HDF grafting group, compared with twelve in the Coleman fat grafting group, developed oil cysts exceeding 1 cm. Patient satisfaction rate was higher in the CLDF + HDF grafting group. Mechanical processes can concentrate the cellular content of LDF and remove oil, condensing LDF to the level of HDF. Combined grafting of CLDF optimized by mechanical processing and HDF is effective for breast reconstruction, with a higher retention rate and a lower incidence of complications than conventional Coleman fat grafting. 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 .

A Cross-Sectional Analysis of Breast Reconstruction with Fat Grafting Content on TikTok.

As of November 2021, TikTok has one billion monthly active users and is recognized as the most engaging social media platform. TikTok has seen a surge in users and content creators, ranging from athletes to medical professionals. In the past year, content creators have utilized the app to advocate for social reforms, education, and other uses that were not previously considered. Breast cancer is the most commonly diagnosed cancer in women, with an expected 281,550 new cases of invasive breast cancer in 2021. As more individuals with breast cancer choose to undergo resection, the demand for autologous fat grafting in breast reconstruction has increased due to the natural look and feel of breast tissue. The purpose of this article is to analyze content related to breast reconstruction with fat grafting found on TikTok and recommend methods to improve patient education, care, and outcomes.We searched TikTok on November 1, 2021, for videos using the phrase “breast reconstruction with fat grafting.” The top 200 videos retrieved from the TikTok search algorithm were analyzed, and all commentaries, duplicates, and nonrelevant videos were removed. Video characteristics were collected, and two independent reviewers generated a DISCERN score A total of 131 videos were included in the study. They were found to have a combined 1,871,980 likes, 41,113 comments, and 58,662 shares. The videos had an average DISCERN score of 2.16. Content creators had an overall low DISCERN score in items involving the use of references, disclosure of risks for not obtaining treatment, and support for shared decision-making. When stratified, the DISCERN score was higher for videos created by physicians (DISCERN average 2.48) than for videos created by nonphysicians (DISCERN average 1.99; p < 0.001). Content creators can improve the quality of their videos by disclosing treatment risks, benefits and risks, discussing risks for not obtaining treatment, and advocating for shared decision-making. Furthermore, including citations and academic references may offer increased credibility and promote evidence practice. This article is limited by the variability seen on the TikTok platform that is influenced by algorithmic trends. The top 200 search results vary, making each compilation of videos selected for analysis unique. Furthermore, although DISCERN is a reliable source to assess patient information, it has not been tested for its reliability with videos such as on TikTok. Despite TikTok being developed as a social media platform, it has shown to be a medium for patient outreach and an educational tool.

The Palpable Nodule after Autologous Fat Grafting: Distinguishing Benign versus Malignant Lesions in Breast Reconstruction.

Nodule formation after autologous fat grafting to the breast is the most common complication. In the reconstructive population, this generates significant patient anxiety and presents a diagnostic challenge. The authors characterized palpable nodule occurrence after autologous fat grafting in breast reconstruction and compared benign versus malignant nodule characteristics. Chart review of the senior author's experience with breast fat grafting was performed. Data extracted included demographics, intraoperative details, nodule data, radiographic characteristics, and biopsy results. Logistic regression identified risk factors for nodule formation. Unpaired t tests and Fisher exact tests compared characteristics of benign versus malignant nodules. In total, 775 breasts were identified that underwent 1158 fat grafting procedures, of which 67 (8.6 percent) developed palpable nodules. Sonographic characterization of nodules included presumed fat necrosis (38.2 percent), benign lesions (27.6 percent), presumed oil cysts (17.1 percent), indeterminate (8.9 percent), and concerning for malignancy (8.1 percent). Lesions concerning for malignancy were more often irregular (10.0 percent versus 0 to 2.9 percent of benign nodules) and more often larger than 0.8 cm in greatest dimension (80 percent versus 42.9 to 61.8 percent of benign nodules). Six patients developed a palpable local recurrence. Malignant nodules tended to be larger (1.45 cm versus 0.70 cm; p = 0.03), were more often vascular (50 percent versus 3.8 percent; p = 0.03), and tended to occur later (17.5 months versus 10.0 months; p = 0.60). Benign nodules occurred in the setting of larger fat graft volumes (64.2 cc versus 40.0 cc; p = 0.008). This study provides the first comparison of radiographic and clinical characteristics between benign and malignant palpable nodules after autologous fat grafting in breast reconstruction. Risk, III.

Research progress of external volume expansion assisted autologous fat grafting for breast reconstruction

To review the application progress, mechanism, application points, limitations, and oncological safety of external volume expansion (EVE) assisted autologous fat grafting for breast reconstruction and provide a reference for optimizing the design of EVE. Based on the latest relevant articles, the basic experiments and clinical applications of EVE were summarized. EVE can reduce interstitial fluid pressure, increase blood supply, and promote adipogenic differentiation, thereby benefiting the survival of transplanted fat. EVE assisted autologous fat grafting in clinical practice can improve the retention rate of breast volume and the outcome of breast reconstruction, meanwhile it doesn't increase the risk of local recurrence. But there is no standard parameters for application, and there are many complications and limitations. EVE improves the survival of transplanted fat, but its complications and poor compliance are obvious, so it is urgent to further investigate customized products for breast reconstruction after breast cancer and establish relevant application guidelines.

Oncological Safety of Autologous Fat Grafting in Breast Reconstruction: A Meta-analysis Based on Matched Cohort Studies.

Autologous fat grafting has become a commonly used procedure for breast reconstruction after breast cancer surgical treatment. Nevertheless, oncological considerations remain concerning autologous fat grafting after breast cancer surgery. This meta-analysis aimed to summarize the current matched cohort studies and provide high-quality evidence-based conclusions on the oncological safety of fat grafting in breast reconstruction. The Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines were followed. A literature search was performed on August 1, 2021, using PubMed. All relevant matched cohort studies of patients undergoing autologous fat grafting after breast cancer surgery were included. After independently screening the studies and extracting the data, pooled estimates for local and regional recurrence as well as distant metastases were conducted using Review Manager software (RevMan, version 5.3). Outcomes were expressed as odds ratios and 95% confidence intervals. Seventeen studies involving 7494 patients were included. The observed outcomes indicated that no significant differences existed in the risks of local and regional recurrence or distant metastases between autologous fat grafting and control groups. Also, there was no significant heterogeneity among the studies. This study provided evidence-based conclusions that support the use of autologous fat grafting in breast reconstruction. 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 .

Oncological Safety of Autologous Fat Grafting in Breast Reconstruction after Mastectomy for cancer: A case-control study

The use of autologous fat grafting in the context of breast reconstruction is still a matter of controversy. The objective of this study was to compare the local relapse rate in women who had a fat grafting session in the context of breast reconstruction after breast cancer management, to those who had breast reconstruction without fat grafting. We performed a retrospective, monocentric, case-control study from January 2007 to December 2017 in our hospital. The cases included women who underwent breast reconstruction with autologous fat grafting and controls, undergoing breast reconstruction without fat grafting. We compared survival and local recurrence between the two groups. 412 women were included: 109 (26.5%) in the lipofilling group and 303 women (73.5%) in the "no lipofilling" group. In the overall study population, lipofilling did not appear to be a predictive factor for recurrence, HR=1.39 [0.63 - 3.06], p=0.41; or a predictive factor for overall survival, HR=0.84 [0.23 - 3.02], p=0.79, or for distant metastases, HR=1.10 [0.43 - 2.79], p=0.84. In contrast, in the subgroup of women treated for invasive cancer, the multivariate analysis showed that lipofilling in this context was an independent predictive factor for local recurrence (HR= 5.06 [1.97- 10.6], p=0.04). we found an increased risk of local recurrence after lipofilling in women who were managed for invasive breast cancer. This suggests that special consideration should be given to women who have had invasive breast cancer before lipofilling.

Autologous fat grafting for breast reconstruction after breast cancer: a 12-year experience

PurposeThe aim of our study was to examine the surgical outcome and complications (efficiency) as well as the incidence of locoregional recurrence and distant metastases (oncological safety) in patients who underwent autologous fat grafting (AFG) of the breast following breast cancer surgery.MethodsIn our monocentric cohort study, retrospective and prospective data were collected from all consecutive patients who underwent AFG after breast cancer between 2008 and 2020; a total of 93 patients met the inclusion criteria.ResultsOur long-term results showed no increase in tumor recurrence and distant metastases in the studied collective when compared to the available literature. We observed 1 local recurrence (1.1%), 2 distant metastases (2.2%), and 1 tumor-related death (1.1%). There was a high degree of patient satisfaction; 67.12% of patients reported adequate satisfaction with autologous fat grafting.ConclusionCurrently, to our knowledge, this is the study with the longest follow-up time (mean 6.7 years after AFG and 11.5 years after tumor resection). The results of our clinical study will contribute to improve evidence in the broad field of AFG, adipose stem cell and tumor research. Consistent with our study, the literature review shows a clear tendency of clinical trial results with a low incidence rate of tumor recurrence and metastasis following the use of AFG. AFG seems to be a safe procedure also after breast cancer treatment.

QS11: Does the Processing System Matter? A Comparison of Two Filtration Devices in Autologous Fat Grafting for Breast Reconstruction

Purpose:The use of autologous fat grafting (AFG) is becoming increasingly common as an adjunct to breast reconstruction. However, there is a paucity of data comparing the varying processing devices. The goal of this study is to compare the outcomes of two commercially available AFG processing devices.Methods:The authors conducted a retrospective review of patients who underwent AFG using dual filter (Puregraft®) or single filter (RevolveTM) processing systems between 2016 and 2019. Propensity score matching was utilized to adjust for confounding. A total of 38 breasts from the Puregraft® group were matched with 38 breasts from the RevolveTM system.Results:Matching was successful in achieving a similar distribution of baseline characteristics between the two groups. The mean number of AFG sessions was comparable between the two groups (p=0.37) with a similar median total volume (Puregraft®, 159 ml vs. RevolveTM, 130 ml, p=0.23). Complication rates were similar between the two devices (Puregraft®, 26%; RevolveTM,18%; p=0.47). Patients with at least one complication had higher overall AFG volume (median, 200 vs.130 ml, p=0.03) and number of sessions (mean, 2.4 vs.1.8, p=0.009) compared to those without any postoperative complication.Conclusion:The decision for which processing system to use for autologous fat grafting should be based on surgeon preference as overall complication rates were comparable between two commonly used commercially available systems. Future studies are underway to decipher whether either system has superior graft retention, cosmetic or patient reported outcomes.