Trending Fat Grafting Across the World: Analysis of Three Annual Major Plastic Surgery Meetings
Farrah C. Liu, BS1, Juan Pablo Arbelaez, MD2, Zachary S. Gala, BME1, Samir Janne Hasbun, MD2, Alvaro Luiz Cansancao, MD2, Alexandra Condé-Green, MD1.
1Rutgers New Jersey Medical School, Newark, NJ, USA, 2Ivo Pitanguy Institute, Rio de Janeiro, Brazil.
Background: Fat grafting has seen a recent surge in both reconstructive and aesthetic endeavours. Clinical research has explored the applicability of adipose regenerative cells in all areas of the body. Despite rising international interest in the regenerative outcomes, no methodological and technical standardization exists. This study analyzes the literature on fat grafting techniques during the experimental and clinical stages to show that even with a rise in both clinical practice and basic science research, more funding and emphasis on fat-grafting can unlock its true potential in reconstructive and regenerative medicine. Methods: Systematic review of the program presentations at the annual plastic surgery conferences from the (ISAPS, ASAPS, ASPS) for the years 2006 to 2016 was performed. The programs were obtained on the official websites or via hard copy archives. Independent reviewers manually classified each program itinerary listed, and filtered for relevant fat-grafting presentations. The data was further divided by congress, year, country of publication, subject, and results. Results: The review yielded a total of 628 presentations, with 218 (34.7%) from ISAPS, 213 (33.9%) from ASAPS, and 197 (31.4%) from ASPS. Abstracts with corresponding podium presentations consisted of 29.9% of the total itinerary, while big session presentations consisted of 41.1%, and 28.8% were master classes. Basic science research projects made up 21.1%, while the rest were human studies (78.9%). Pre-operative assessment was studied in 6.4%, and the majority (61.9%) addressed clinical outcomes. Complications, harvesting and processing techniques, and future uses made up the remaining investigations. Aesthetic presentations made up 59.7% while reconstructive were 5.6%, and the remaining projects addressed both aesthetic and reconstructive uses. For area of the body where fat-grafting was implemented, facial regions were the most common, closely followed by breast, and then gluteal region, body contouring, and then extremities. Conclusion: To our knowledge, this is the first study of this magnitude to inclusively analyze prior trends in fat grafting, current research, and future implications. Once purely aesthetic, it is now performed worldwide for various plastic, reconstructive, and regenerative purposes. Fat grafting is expanding across surgical subspecialties and revolutionizing multidisciplinary research, becoming increasingly widespread in clinical practice. However, a lack of methodological standardization and an absence of basic science and clinical evidence in certain aspects of the procedure prevents the reveal of its vast potential. We hope that this review will provide some insight in the evolution of fat grafting, and emphasize the facets that can undergo further investigation.
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