Ultrasound-Assisted Facial Autologous Fat Grafting: A Systematic Review of Perioperative Safety and Volumetric Outcomes.

Summary

Across 12 studies (885 patients), HFUS aided pre/intra/postoperative decision-making in facial AFG, enabling safer plane confirmation, filler characterization, and objective retention tracking. One comparative cohort showed larger injection volumes and higher satisfaction without increased complications, with ultrasound-tracked retention stabilizing around 50–70% by 1 year.

Key Findings

• Twelve studies (885 patients) reported HFUS utility for vascular mapping, filler characterization, safe-plane confirmation, and postoperative monitoring.
• In a comparative temple augmentation cohort, ultrasound guidance increased injection volume (22.32±5.19 vs 10.55±2.25 mL) and satisfaction (92% vs 74%) without more complications.
• Ultrasound-measured fat retention declined over 3–6 months and stabilized at approximately 50–70% by 1 year; supplementary grafting improved retention in one cohort (49.4% vs 71.7%).

Clinical Implications

Clinicians can consider HFUS for vascular mapping, identifying prior fillers, confirming cannula planes in real time, and tracking retention to guide staged grafting. Adoption should be paired with standardized ultrasound protocols and training.

Limitations

• Predominantly observational, single-center designs with heterogeneity precluded meta-analysis
• Lack of standardized ultrasound protocols and core outcome sets

Future Directions

Prospective comparative trials with standardized HFUS protocols, operator training, and core outcome sets, including cost-effectiveness and patient-reported outcomes.