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Meta-Analysis
. 2021 Apr 1;16(4):e0248505.
doi: 10.1371/journal.pone.0248505. eCollection 2021.

Efficacy, safety and complications of autologous fat grafting to the eyelids and periorbital area: A systematic review and meta-analysis

Fan Yang  1 , Zhaohua Ji  2 , Liwei Peng  3 , Ting Fu  2 , Kun Liu  2 , Wenjie Dou  4 , Jing Li  1 , Yuejun Li  1 , Yong Long  2 , Weilu Zhang  2
Affiliations
Meta-Analysis

Efficacy, safety and complications of autologous fat grafting to the eyelids and periorbital area: A systematic review and meta-analysis

Fan Yang et al. PLoS One. .

Abstract

Background: In recent years, autologous fat grafting (AFG), also known as fat transfer or lipofilling, has been widely performed for periorbital rejuvenation and defect correction, although the evidence regarding its efficacy and safety is still lacking. Besides, with respect to the periorbital region, it is invariably the earliest appearance area of the facial aging phenomenon. Therefore, a systematic review and meta-analysis is needed to evaluate the efficacy and safety of this technique.

Methods: A literature search was performed in PubMed, Embase, and the Cochrane library databases on November 20, 2020, adhering to the PRISMA guidelines, to identify all relevant articles. Then, a data extraction and standardization process was performed to assess all outcome data. Ultimately, the data were assessed using a random effects regression model with comprehensive meta-analysis software.

Results: Thirty-nine studies consisting of 3 cohorts and 36 case series with a total of 4046 cases were included. Meta-analysis revealed a relatively high satisfaction rate of 90.9% (95% CI, 86.4%-94.0%). Frequent complications in 4046 patients receiving AFG were edema, chemosis, and contour irregularity, with an overall complication rate of 7.9% (95% CI, 4.8%-12.8%).

Conclusion: This systematic review and meta-analysis showed that AFG for rejuvenation of eyelids and periorbital area provided a high satisfaction rate and did not result in severe complications. Therefore, AFG might be performed safely for periorbital rejuvenation and reconstruction.

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Conflict of interest statement

No authors have competing interests.

Figures

Fig 1
Fig 1. Flow diagram of the article selection process for review.
Fig 2
Fig 2. Geographical distribution of publications and patients.
Fig 3
Fig 3. Meta-analysis-satisfaction rates of all included studies.
Fig 4
Fig 4. Meta-analysis-patient satisfaction rates of all included studies.
Fig 5
Fig 5. Meta-analysis-patient and surgeon satisfaction rates of all included studies.
Fig 6
Fig 6. Subgroup analysis for the pooled estimates of the satisfaction rate (different indications and fat graft treatment method).
The random effects model was applied to minimize heterogeneity.
Fig 7
Fig 7. Complications reported in the literature following periorbital fat augmentation.
Fig 8
Fig 8. Meta-analysis-complication rates of all included studies for reconstructive purpose.
Fig 9
Fig 9. Meta-analysis-complication rates of all included studies for aesthetic purpose.
Fig 10
Fig 10. Subgroup analysis for the pooled estimates of the complication rate (different indications and fat graft treatment method).
The random effects model was applied to minimize heterogeneity.
Fig 11
Fig 11. Meta-analysis-satisfaction rates of all included studies for aesthetic purpose.
Fig 12
Fig 12. Meta-analysis-satisfaction rates of all included studies for reconstructive purpose.
Fig 13
Fig 13. Meta-analysis-complication rates of all included studies.
See this image and copyright information in PMC

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