• Todor K Krastev, Ghufran A H Alshaikh, Juliette Hommes, Andrzej Piatkowski, and van der HulstRene R W JRRWJDepartment of Plastic, Reconstructive and Hand surgery, Maastricht University Medical Centre (MUMC+), P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands..
• Department of Plastic, Reconstructive and Hand surgery, Maastricht University Medical Centre (MUMC+), P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands. Electronic address: dr.todor.krastev@gmail.com.
• J Plast Reconstr Aesthet Surg. 2018 Oct 1; 71 (10): 1392-1409.

BackgroundAutologous fat transfer (AFT), also known as fat grafting or lipofilling, has already become a part of clinical practice for treating contour deformities of the breast, even though evidence regarding its efficacy is still lacking. This is the first meta-analysis on this subject, aimed to facilitate intuitive interpretation of the available data by clinicians, guideline committees and policy makers.MethodsA literature search was performed on 1 September 2017 in PubMed, EMBASE and the Cochrane Library to identify all relevant studies. A rigorous data extraction and standardisation process allowed pooling of clinical outcome data into a meta-analysis.ResultsEighty-nine studies consisting of 5350 unique patients were included. The mean follow-up was 1.9 years. Meta-analysis revealed a very high overall patient and surgeon satisfaction rate of 94.3% and 95.7%, respectively, which was also confirmed by high satisfaction scores and Breast-Q scores. Overall, only 1.5 sessions were needed to achieve the desired result. Though evidence on the long-term volume retention is lacking, based on the current data it was calculated to be 52.4% at one year. Only 5.0% of procedures resulted in clinical complications and 8.6% of breasts required biopsy due to abnormal clinical or radiological findings.ConclusionsAFT seems to be an effective procedure in breast reconstruction, reflected by the high patient and surgeon satisfaction and low incidence of clinical and radiological complications. Future research should focus on evaluating the technical and patient factors influencing the rate of fat resorption as well as its oncological safety.Copyright © 2018 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

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