Clinical Application Of Autologous Fat Grafting For Facial Rejuvenation

Objective: It is found that the main causes of facial aging are skin relaxation,subcutaneous soft tissue decrease,volume decrease,deep tissue relaxation leading to facial wrinkles and depressions.For these reasons,orthopedic surgeons often use facial implants to rejuvenate their faces.At present,the commonly used facial fillers in plastic surgery include sodium hyaluronate,collagen and autologous fat granules.The autologous fat granules have been widely used in facial rejuvenation because of its wide range of sources,convenient material collection and no immune rejection.However,no large clinical randomized controlled study has been carried out at home and abroad to verify the efficacy and safety of autogenous fat particle transplantation in facial rejuvenation.Therefore,Meta analysis was used to evaluate the clinical effect of autologous granular fat transplantation in facial rejuvenation by analyzing the postoperative complications,the satisfaction of the patients and the success rate of one injection.Methods: Chinese and English databases including Wanfang Science and Technology Periodical Full-text Database,VIP Chinese Science and Technology Periodical Full-text Database(VIP)and CNKI,PubMed,Cochrane Library,Embase were searched by computer.The time was set from the construction of the library to October 2017.The Chinese key word used was "fat transplant" and "facial rejuvenation";the English key word used was "Fat Graft" and "Facial rejuvenation".Collecting randomized controlled trials,non-randomized controlled trials,case-control studies,cohort studies and case report papers on the use of autologous granular fat transplantation in facial rejuvenation for Meta analysis.We used the statistical software Stata version 12.0 to carry out this Meta analysis.Q test and I2 test were used to test the heterogeneity in the literature,and P < 0.1 was set as heterogeneity in Q test.According to Cochrane manual I2 test,I2 > 50% was heterogeneity.According to the test results,if there is heterogeneity in the literature included,the random effect model is used to combine analysis;conversely,the fixed effect model is used to combine the analysis.In the original data included in the literature,if p is in the range of [0.3 / 0.7],the Meta score was directly performed On the contrary,the double sinusoidal double arcsin method is used to convert the data into normal distribution,and then Meta analysis is carried out.The final results obtained by Meta analysis after data conversion were reduced by P=(sin(tp/2))2 formula.The Begg test was used to evaluate the publication bias of the included literature(P < 0.05).Results: We identified 23 studies including a total of 2852 subjects for Meta analysis.After analysis,the postoperative complication rate was 0.02(95% CI: 0.01,0.04),the satisfaction rate of patients was 0.95(95% CI: 0.91,0.97)and the one-time success rate of injection was 0.79(95% CI: 0.73,0.84).We used the Begg test for publication bias,the incidence of postoperative complications,patient satisfaction,and a single injection.The results of power were P=0.128,0.367,0.270,indicating no obvious publication bias.Conclusion: The incidence of postoperative complications in the application of autogenous fat granules in facial rejuvenation was 2%.According to the literature included,the main complications were inflammation,regional fat nodules of injection,fat overfilling and so on.The satisfaction of this procedure in the application of facial rejuvenation is 95%,one injection success rate is 79%.According to the above evaluation indexes,autogenous fat granule transplantation is effective and safe in facial rejuvenation.And this technology is worthy of clinical application.