【 文献重点摘要 】

Background

Parallel to the steady decline in surgical aesthetic procedures to the face, dermal fillers seem to have gained a more prominent place in facial rejuvenation over the last couple of years. As a dermal, facial filler, autologous fat transfer (AFT) seems to have real potential because of the biocompatibility of adipose tissue besides being a procedure with few and primarily minor complications. This systematic review aims to evaluate the available evidence regarding the safety and effectiveness of AFT for facial rejuvenation.

Method

A systematic review after the Preferred-Reporting-Items-for-Systematic-Reviews-and-Meta-Analysis (PRISMA) statement was conducted. MEDLINE, Embase, and Cochrane Library were searched up to December 2016, with no language restrictions imposed. Case series, cohort studies, and randomized controlled trials (RCTs) reporting on relevant outcomes were included.

Results

Eighteen clinical articles were included, reporting on 3,073 patients in total over a mean follow-up period of 13.9 months. Meta-analysis showed an overall complication rate of 6% (95% CI 3.0–14.0), with hematoma/ecchymosis (5%), fat necrosis/oil cysts (2%), and irregular fat distribution and scars (both 2%) being among the most reported. No major complications were reported, and the overall patient satisfaction rate was 81%.

Conclusion

Although the evidence in this systematic review is still limited and plagued by heterogeneity between studies, AFT seems to be a promising method in facial rejuvenation with fewer complications than other fillers and high patient satisfaction rates. Further large-cohort, preferably multicenter, RCTs should substantiate these results through quantifiable volumetric assessment tools and validated patient questionnaires, while adhering to predetermined nomenclature in terms of complications.

背景

与面部外科美容手术的稳步下降相平行，真皮填充物在过去几年中似乎在面部年轻化中获得了更突出的地位。作为一种皮肤和面部填充物，自体脂肪转移(AFT)似乎有真正的潜力，因为它不仅具有脂肪组织的生物相容性，而且并发症少且主要是轻微的。这项系统性综述旨在评估有关AFT用于面部年轻化的安全性和有效性的现有证据。

方法

对Preferred-Reporting-Items-for-Systematic-Reviews-and-Meta-Analysis(PRISMA)声明后进行系统评价。截至2016年12月，Medline、Embase和Cochrane Library被搜索，没有语言限制。包括病例系列、队列研究和报告相关结果的随机对照试验(RCT)。

结果

纳入18篇临床文献，共报道3073例患者，平均随访13.9个月。Meta分析显示总的并发症发生率为6%(95%可信区间3.0~14.0)，其中血肿/瘀斑(5%)、脂肪坏死/油囊肿(2%)、不规则脂肪分布和瘢痕(均为2%)是报道最多的并发症。无重大并发症报道，总体患者满意率为81%。

结论

虽然本系统综述中的证据仍然有限，而且受到研究间异质性的困扰，但AFT似乎是一种很有前途的面部年轻化方法，与其他填充物相比，并发症较少，患者满意率较高。进一步的大队列，最好是多中心的随机对照试验应该通过可量化的容量评估工具和有效的患者问卷来证实这些结果，同时在并发症方面坚持预先确定的命名。