Comparative Efficacy and Safety of Different Assisted–Fat Transplantation Methods: A Network Meta-analysis of Randomized Controlled Trials

To compare the outcomes of different supplements to autologous fat grafting for volume augmentation in plastic and reconstructive area, the mainstream databases were searched for qualified randomized controlled trails, with the terms of "fat transplantation", "lipotransfer", "platelet-rich plasma", "platelet-rich fibrin", "stromal vascular fraction", "mesenchymal stem cells", "growth factor" and "Botox". The primary outcome assessed the volume retention rate of various assisted-fat transplantation methods, and second outcomes of incidence of complications, effective rate, secondary operation rate and postoperative patient satisfaction were also calculated. A total of 47 articles with 2244 participants were incorporated. It is important to note that not all assisted fat grafting techniques were superior to placebo in increasing fat volume retention. Significant improvements were observed only in the Stem Cells, PRP, and SVF groups. Among these, Stem Cell-enriched grafts demonstrated the highest likelihood of being the most effective intervention, suggesting considerable clinical potential. Subgroup analyses based on recipient sites and sensitivity analysis revealed the consistent conclusion, which enhanced the robustness of the conclusion. Assisted-fat transplantation methods also exhibited various impacts on secondary outcomes. The CGF procedure presented the fewest surgical complications, and SVF, PRP and PRF-enriched fats outperformed the control group in terms of effectiveness. CGF and SVF-enriched fat were associated with the lowest reoperation rate, with the GF group showing the highest likelihood of achieving patient satisfaction. Assisted-fat transplantation methods demonstrated superior efficacy and safety, and stem cells-based products showed certain potential for clinical application. The selection of specific therapy should be guided by overall considerations in clinical settings.