FAT GRAFTING VS. SYNTHETIC FILLERS IN FACIAL VOLUME RESTORATION: A SYSTEMATIC REVIEW

Abstract

Background: A significant attribute of aging is the decrease of facial volume which alters the contour forming the depressed and sunk appearance, and deterioration of the skin structure. Two typical ways of discontinuing facial volume include autologous fat grafting and synthetic dermal fillers.

Objective: To make a systematic comparative analysis of fat grafting with synthetic fillers on the basis of their effectiveness, safety and durability, as well as patient satisfaction in restoring facial volume.

Place and duration of study: July 2025 to December 2025 Plastic Surgery Department,  Bolan Medical College / Hospital, Quetta.

Methodology: PubMed, Scopus, Cochrane library databases were used as an organized search, but they were restricted to 2000-2025 years. Keywords were fat grafting, autologous fat transfer, dermal fillers and facial rejuvenation. Included were clinical trials, cohort studies, as well as comparative studies that use human subjects. Outcomes and complication data, as well as patient satisfaction were extracted and analyzed.

Results: Forty-two studies were included. Synthetic fillers had predictable succinct results and low downtime, but had to be used frequently because of short durability (618 months). Fat grafting offered more promising results, lasting many years, and had other regenerative advantages. But the predictability was influenced by variability in the graft survival (3070). Both methods were highly patient satisfaction and safety was acceptable. The rare vascular events came together with complications with fillers, and fat grafting with the morbidity of the donor site and contour anomalies.

Conclusion: Fat grafting as well as synthetic fillers are both effective in the restoration of the face volume. Synthetic fillers are best to be used in transient, minimally invasive fillings but fat grafting would be the choice in long term larger volume corrections. Individualized treatment must be in line with patient requirements and clinical expertise.