A Systematic Review of the Literature and Meta-Analysis of Autologous Fat Transfer: Fat Transfer Confers a 4.2% Incidence of Complications.

Reporting of complications such as infection, necrosis, oil cysts and haematoma after fat transfer varies widely in the literature. Numerous variations in techniques (for example, cannula size, infiltration solution and fat-processing methods) have been described across a heterogeneous patient population for age, fat harvest location and recipient site. To date, no comprehensive review of the literature has been performed for all fat transfer procedures across the body. This study aims to provide novel information on the incidence of complications after fat transfer and is unique in its size and scope. A systematic review of English literature was performed from 01/01/08 to 01/09/24 in MEDLINE, EMBASE, PUBMED and Cochrane Database of Systematic Reviews. Measured complication outcomes included necrosis, infection, induration, oil cysts, haematoma and pneumothorax. A random-effects model was employed to calculate the pooled complication incidence from selected articles. After application of inclusion and exclusion criteria, 42 articles progressed to final analysis with a total of 6268 patients. Major complications investigated were fat necrosis (n=44, 0.7%), infection (n=66, 1%), induration and calcification (n=40, 0.6%), oil cysts (n=7, 0.1%) and haematoma (n=4, 0.06%). Pneumothorax post-procedure incidence was 0.1% (n=6). Overall complication incidence was 4.2%. This study is unique in its scope and size and can be used for counselling patients in the pre-operative setting, providing a benchmark for surgeons to assess their practice with an overall complication incidence of 4.2%.