Gabriel de Almeida Arruda Felix, Felipe Contoli Isoldi, Marcelo Oliveira Mourão Filho, Lydia Masako Ferreira
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引用次数: 0
Abstract
Background: Intramuscular fat grafting has gained popularity in plastic surgery to enhance muscle volume and definition. However, the safety and standardization of this technique remain controversial. This systematic review and meta-analysis aimed to evaluate the complications, safety, and outcomes of intramuscular fat grafting.
Methods: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered with the International Prospective Register of Systematic Reviews (PROSPERO). A comprehensive literature search was performed across multiple databases including EMBASE/Elsevier, Cochrane, Scopus, PubMed/Medline, BVS, SciELO, and Lilacs. This search covered all years and languages. The included studies were assessed for risk of bias using the Risk of Bias in Nonrandomized Studies of Interventions (ROBINS-I) tool to ensure methodological rigor. A total of 36 studies were selected for qualitative synthesis.
Results: The meta-analysis included 27 studies with 208,692 observations and 857 events. Among those specifying the target muscle, 25% injected the gluteus, 8.3% targeted the rectus abdominis, and 5.6% targeted the gastrocnemius and soleus. The pooled complication rate was 6.2% (95% CI: 3.06%-12.13%), with substantial heterogeneity among the studies (I² = 98.3%). The most common complications included fat embolism, infection, seroma, hematoma, fat necrosis, asymmetry, and revision surgery. Fat embolism was the most serious complication, with a mortality rate of 1:3,000 cases of gluteal intramuscular fat grafting.
Conclusion: Intramuscular fat grafting offers aesthetic benefits but poses risks, notably, fat embolism. Advancements like ultrasound guidance enhance safety, but further research is needed to refine techniques and establish evidence-based guidelines.
期刊介绍：
For more than 70 years Plastic and Reconstructive Surgery® has been the one consistently excellent reference for every specialist who uses plastic surgery techniques or works in conjunction with a plastic surgeon. Plastic and Reconstructive Surgery® , the official journal of the American Society of Plastic Surgeons, is a benefit of Society membership, and is also available on a subscription basis.
Plastic and Reconstructive Surgery® brings subscribers up-to-the-minute reports on the latest techniques and follow-up for all areas of plastic and reconstructive surgery, including breast reconstruction, experimental studies, maxillofacial reconstruction, hand and microsurgery, burn repair, cosmetic surgery, as well as news on medicolegal issues. The cosmetic section provides expanded coverage on new procedures and techniques and offers more cosmetic-specific content than any other journal. All subscribers enjoy full access to the Journal''s website, which features broadcast quality videos of reconstructive and cosmetic procedures, podcasts, comprehensive article archives dating to 1946, and additional benefits offered by the newly-redesigned website.
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