Autologous Fat Grafting Versus Facial Fillers in Facial Cosmesis: A Systematic review and Meta-analysis.

INTRODUCTION

Autologous fat grafting (AFG) and facial fillers specially Hyaluronic acid fillers (HA) are widely used for facial rejuvenation, yet their comparative benefits for patient satisfaction remain uncertain.

OBJECTIVE

To compare AFG and facial fillers, using patient satisfaction as the primary outcome.

DESIGN

Systematic review and meta-analysis (PRISMA-aligned).

METHODS

Nine comparative studies (n = 805) were pooled with random-effects models (standardized mean difference, SMD). Heterogeneity (Q, I2) and small-study effects (Egger's) were assessed.

RESULTS

AFG showed higher patient satisfaction than HA (SMD 0.91, 95% CI - 0.32 to 2.14), but results varied across studies (I2=97%); subgroup analyses were directionally consistent but did not explain variability. Egger's test suggested possible small-study effects (p = 0.15), though interpretation is limited with <10 studies.

CONCLUSIONS

On average, AFG provides higher satisfaction, likely due to its greater durability, while HA remains valuable for convenience and reversibility. Findings should be interpreted in light of between-study variability. Well-designed, standardized RCTs are needed.

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