Nanofat Grafting: The Future of Regenerative Medicine? A Bibliometric Analysis and Systematic Review of Clinical Applications

BACKGROUND: Nanofat grafting has evolved from a mechanically emulsified adipose-derived product into a regenerative platform used across aesthetic, reconstructive, and functional indications. However, terminology, processing methods, and clinical applications remain heterogeneous. This study combined bibliometric mapping with a systematic review to characterize the evolution, evidence base, and limitations of nanofat research. METHODS: A bibliometric analysis was performed using the Web of Science Core Collection to identify nanofat-related publications relevant to plastic, reconstructive, aesthetic, and regenerative surgery. Publication trends, citation metrics, leading contributors, and keyword networks were analyzed using Bibliometrix and VOSviewer. A separate PRISMA-based systematic review was conducted in PubMed/MEDLINE, Embase, Scopus, and Web of Science to identify human clinical studies evaluating nanofat-based interventions. RESULTS: The bibliometric search identified 286 publications, including 241 after the introduction of nanofat in 2013. Output increased markedly after 2019 and peaked in 2025 with 45 publications. The corpus accumulated 4,320 citations and had an H-index of 37. China, the United States, Italy, Switzerland, and Germany were the leading contributors. The systematic review included 77 clinical studies comprising 2,737 patients, of whom 2,304 received nanofat-based or mechanically emulsified adipose-derived interventions. Clinical applications were grouped into eight domains, with scar remodeling, facial/skin rejuvenation, wound healing, and periorbital rejuvenation representing the most frequent indications. CONCLUSIONS: Nanofat research has expanded rapidly into a heterogeneous adipose-derived regenerative field. Current evidence supports broad translational interest but remains limited by variability in processing methods, adjunctive therapies, outcomes, and study design. Standardized terminology, product characterization, and indication-specific controlled trials are needed.