AccScience Publishing / EJMO / Online First / DOI: 10.36922/EJMO025220216
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REVIEW ARTICLE

Comparison of clinical outcomes between autologous fat grafting and platelet-rich plasma–enhanced fat grafting in breast reconstruction

Alaa Hamed M. Hakami1* ,  Osama Ahmed Mobarki2 ,  Amjad Hassan Ibrahim Muthaffar2 ,  Remaz Abdulaziz Alhassan2 ,  Majd Thunayyan Alhazmi2 ,  Ahmed Yahya Najmi2 ,  Rafaa Jameel Jafar2 ,  Khalid Yahya Haroobi2 ,  Suha Ali Ageeli2 ,  Ahmed Yahya Sabi3
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1 Department of Surgery, First Affiliated Hospital of Jazan University, Jazan, Saudi Arabia
2 Department of Surgery, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
3 Department of Surgery, College of Medicine, Jazan University, Jazan, Saudi Arabia
EJMO, 025220216 https://doi.org/10.36922/EJMO025220216
Received: 26 May 2025 | Revised: 1 August 2025 | Accepted: 7 August 2025 | Published online: 27 October 2025
© 2025 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )
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Abstract

Autologous fat grafting is commonly used in breast reconstruction due to its biocompatibility and ability to restore natural contours. However, unpredictable fat resorption often requires multiple procedures. Platelet-rich plasma (PRP) has been introduced as a biological enhancer to improve graft retention, but the evidence regarding its efficacy remains inconsistent. To systematically evaluate and compare the clinical and esthetic outcomes of PRP-enhanced autologous fat grafting versus fat grafting alone in breast reconstruction procedures. This meta-analysis included four clinical studies published between 2011 and 2024, encompassing a total of 242 female patients (108 in the PRP group and 134 in the fat-only group). Data were extracted on tumor grade, prior radiation therapy, number of grafting sessions, fat necrosis, and satisfaction levels. PRP-enhanced fat grafting demonstrated significantly better fat retention, with 66.1% of patients requiring only one grafting session compared to 44% in the control group (p=0.016). Surgeon and patient satisfaction scores were notably higher in the PRP group (p<0.05). However, the incidence of fat necrosis was elevated in the PRP group (39.25%) compared to the control group (24.7%, p=0.006), particularly in irradiated tissues. Subgroup analysis showed optimal outcomes in non-irradiated, centrally located graft sites and patients with Grade II tumors. PRP-enhanced autologous fat grafting significantly improves fat retention and overall satisfaction in breast reconstruction, especially in non-irradiated tissues. Nonetheless, the increased risk of fat necrosis warrants cautious application and further refinement in PRP preparation techniques and patient selection.

Keywords
Autologous fat grafting
Platelet-rich plasma
Breast reconstruction
Fat retention
Meta-analysis
Patient satisfaction
Fat necrosis
Funding
None.
Conflict of interest
The authors declare that they have no competing interests.
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Eurasian Journal of Medicine and Oncology, Electronic ISSN: 2587-196X Print ISSN: 2587-2400, Published by AccScience Publishing
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