Autologous Fat Grafting in Facial Soft Tissue Defects: Application Status, Controversies and Future.

Background: Autologous fat grafting (AFG), which has been utilized in the clinical realm for more than a century, was first introduced to address facial contour deformities stemming from tuberculosis. Subsequently, it has emerged as a prominent approach for rectifying facial defects associated with congenital and acquired diseases, traumas, or postoperative conditions. AFG is widely used in treating various facial soft tissue defects. It features convenience, simplicity, effectiveness, and safety, making it a preferred option for minimally invasive facial defect reconstruction.

Methods: A comprehensive literature search was systematically performed in the PubMed, Embase, and Scopus databases, retrieving studies published up until February 2025.

Results: Recent progress and innovations have been achieved in multiple areas, including clinical application, operative techniques, fat products, additives, assessment methods, and interdisciplinary cooperation, leading to significant improvements and ushering in a new era of diversification and refinement. However, challenges remain in applying AFG to facial soft tissue defects. The volume retention of the grafted fat varies greatly. Investigating the survival mechanism of the grafted fat, preventing and managing severe complications, and determining the optimal surgical timing for progressive diseases are still controversial and challenging.

Conclusions: This review comprehensively summarizes the current application status, existing controversies, and future directions of AFG, aiming to provide a valuable reference for clinical practice and future research.

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