Autologous Fat Graft Enriched with Stem Cells: Evidence on Tissue Regeneration and Applications in Plastic Surgery
Abstract
Mateus Soares Santos Araujo, Victor Rodrigues de Paula, Landwanadan Fonteneles Lucena, Rodrigo dos Santos Oliveira Alves, Joao Marcelo Vieira Morais, Lorrane S. Ribeiro Silveira, Nathalia do Prado Dutra Santos, Maria do Socorro Morais da Silva, Thiago Augusto Rochetti Bezerra*, Filipe JL Garcia, Milena Gabriele Coelho Freitas, Eliane Moreira Da Silva, Carlos Henrique B Figueiredo De Mendonça, Amanda Batista Ferreira da Silva, Maria Beatriz Mendonça Ventura, Andréa Pereira da Silva, Giovana Casarini Yamashiro and Nathalia de Castro Fraga
Introduction: Autologous fat grafting enriched with adipose-derived stem cells (ADSCs) represents one of the main strategies in regenerative medicine applied to plastic surgery. In addition to volumetric restoration, this technique aims to enhance biological processes related to angiogenesis, inflammatory modulation, extracellular matrix remodeling, and tissue repair, thereby expanding its applications in aesthetic and reconstructive procedures.
Objective: To analyze, through a systematic literature review, the scientific evidence regarding the regenerative mechanisms, clinical efficacy, safety, and main applications of autologous fat grafts enriched with ADSCs in plastic surgery.
Methods: A systematic review conducted in accordance with the PRISMA 2020 guidelines, including studies published between 2021 and 2026 in major international databases. A total of 132 articles were selected that addressed experimental and clinical aspects, as well as reviews on enriched lipografting, vascular stromal fraction, cell-assisted lipotransfer, nanofat, and regenerative medicine applied to plastic surgery.
Results: The studies demonstrated that ADSCs play an important role in neovascularization, graft survival, immunomodulation, and wound healing. The main clinical applications involved breast reconstruction, facial rejuvenation, and the treatment of scars, burns, and complex wounds. Despite the promising results, heterogeneity was observed among cell processing protocols, surgical techniques, and the outcomes analyzed, making direct comparisons between studies difficult.
Conclusion: The enrichment of adipose grafts with ADSCs offers high regenerative potential and growing clinical applications in plastic surgery; however, methodological standardization and long-term clinical studies remain necessary to consolidate their incorporation into clinical practice.