Volume retention rate after breast autogenous fat grafting and related influencing factors: A systematic review and meta-analysis

The volume retention of breast autologous fat grafting is unpredictable, and the volume retention rate and related influencing factors have not been systematically reviewed. Therefore, this systematic review and meta-analysis aimed at evaluating the volume retention rate and related influencing factors of breast autologous fat grafting which is for reconstructive or aesthetic purposes. Literature search was conducted in the PubMed, Embase, Cochrane Library, and Web of Science databases from inception to December, 2022. Sensitivity analysis was performed for all outcomes. Begg’s test was performed to test publication bias. Subgroup analysis was performed based on population, fat preparation method, volume measurement method, number of fat grafting, and injected fat grafting volume. A total of 25 studies were finally included in this systematic review and meta-analysis. The follow-up time ranged from 3 months to 36 months. Results showed that the pooled volume retention rate at the latest follow-up point was 54% [95% confidence interval (CI): 48.5%-59.5%]. Based on fat preparation methods, the pooled rate was 51.5% (95%CI: 41.5%-61.5%) for centrifugation, which was higher than that of sedimentation [38.7% (95%CI: 30.9%-46.5%)]. In addition, the enrichment of stromal vascular fraction (SVF) obtained after centrifugation was found to be associated with higher volume retention rate (WMD: 17.36, 95%CI: 8.84-25.87). Our findings may provide a guidance for the volume retention rate of breast autologous fat grafting in the clinic. Further studies are needed to verify our findings.