title: Efficacy and Safety of Cell-Assisted Lipotransfer: A Systematic Review and Meta-Analysis.
abstract: BACKGROUND
  The main drawback of autologous fat grafting, which is commonly used for soft-tissue augmentation, is the high resorption rate. Cell-assisted lipotransfer has been used to improve fat graft survival; however, evidence for its efficacy and safety is still lacking.
  
  
  METHODS
  The authors searched PubMed, Cochrane Library, EBSCO, and EMBASE for clinical studies on cell-assisted lipotransfer published from 2008 through 2014. A meta-analysis was conducted to pool the estimated fat survival rate. Incidence of complications and incidence of multiple operations were calculated.
  
  
  RESULTS
  Seventeen articles involving 387 cases were included in the systematic review. The pooled fat survival rate was significantly higher in the cell-assisted lipotransfer group than in the nonlipotransfer group (60 percent versus 45 percent, p = 0.0096). Complication incidence was similar in the two groups. Cell-assisted lipotransfer significantly improved fat survival in the face (by 19 percent) and reduced the incidence of multiple operations (by 13.6 percent). In breast fat grafting, however, fat survival was improved by only 9 percent, which was not statistically significant. Meanwhile, lipotransfer in breast cases was associated with a higher complication incidence compared with face cases (p < 0.001).
  
  
  CONCLUSIONS
  This study demonstrates that cell-assisted lipotransfer has better efficacy than conventional fat grafting (non-cell-assisted lipotransfer). It is more applicable to face cases than to breast cases. Until now, there has not been enough evidence of the superiority of cell-assisted lipotransfer over conventional fat grafting for reducing complications.
  
  
  METHODS
  Therapeutic, III.
authors.affiliation: Shanghai, People's Republic of China From the Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine.
authors.forename: Yiwen
authors.initials: Y
authors.lastname: Zhou
authors.forename: Jing
authors.initials: J
authors.lastname: Wang
authors.forename: Haizhou
authors.initials: H
authors.lastname: Li
authors.forename: Xiao
authors.initials: X
authors.lastname: Liang
authors.forename: Jinhong
authors.initials: J
authors.lastname: Bae
authors.forename: Xiaolu
authors.initials: X
authors.lastname: Huang
authors.forename: Qingfeng
authors.initials: Q
authors.lastname: Li
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation*; D005260:Female; D006085:Graft Survival; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D016378:Tissue Transplantation / Q000379:methods* / Q000592:standards; D014182:Transplantation, Autologous; D016896:Treatment Outcome