Assessment of the clinical efficacy of cell-assisted lipotransfer and conventional fat graft: a meta-analysis based on case-control studies

BACKGROUND Cell-assisted lipotransfer is a novel technique for fat grafting. This study aimed to investigate the clinical efficacy of cell-assisted lipotransfer technology compared with conventional fat grafting. METHODS According to PRISMA guidelines, related articles in PubMed, Embase and Cochrane library were systematically searched. Studies focusing on fat survival rate and/or patient satisfaction rate for fat grafting alone versus cell-assisted lipotransfer were retrieved. Estimated fat survival and patient satisfaction rates were pooled. Subgroup analysis was stratified by the transplant site. Publication bias was conducted. Furthermore, the stability of results was assessed by sensitivity analysis. RESULTS Nine articles were included in the meta-analysis. Significant heterogeneity was observed among individual studies for fat survival rate assessment (I 2 = 98.3%, P < 0.001). The fat survival rate was significantly higher in the cell-assisted lipotransfer group than in the control group [weighted mean difference = 25.85, 95% confidence interval 5.39-46.31; P = 0.013]. Notably, results remained unchanged in the sensitivity analyses. No significant difference was found in the patient satisfaction rate between the cell-assisted lipotransfer and control groups [odds ratio = 3.69, 95% confidence interval 0.73-18.53; P = 0.113]. In subgroup analysis, a significantly higher patient satisfaction rate was found in cell-assisted lipotransfer fat graft group in the face (odds ratio = 18.85, 95% confidence interval 9.03, 28.68; P < 0.001) and arm (odds ratio = 64.60, 95% confidence interval 58.79, 70.41; P < 0.001) than in the controls. Finally, no significant publication bias was found (P = 0.371). CONCLUSION This study suggests that cell-assisted lipotransfer is superior to conventional lipoinjection with improved fat survival rate. However, the long-term efficacy should be evaluated in further studies.