Autologous Fat Grafting: Evaluation of Efficacy in Pain Relief

Kara Klomparens, BA; Richard Simman, MD, FACS, FACCWS

Disclosures

Plast Reconstr Surg Glob Open. 2022;10(11):e4543 

In This Article

Abstract and Introduction

Abstract

Introduction: Autologous fat grafting (AFG) has been used in reconstructive plastic surgery for over a century. Although it has obvious benefits to the aesthetic appearance of many reconstructive surgeries, less appreciated advantages of fat grafting have also been shown in potential pain reduction. This can be seen across the board from head to toe with examples ranging from facial nerve injury to pedal atrophy and foot ulcers. The purpose of this literature review is to evaluate the efficacy of AFG for pain relief in various indications and serve as a reference for clinicians to gain insight on potentially beneficial therapies for their patients.

Methods: A broad literature review was performed to analyze the various uses of AFG for pain management by various indications including postmastectomy pain syndrome, scar pain, neuromas, chronic wounds and many more. The PubMed, Science Direct and Scopus online databases were searched using keywords such as "autologous fat grafting," "reconstruction," "pain," and "therapy."

Results: At this point, there is decent evidence to support AFG's role in pain resolution in postmastectomy pain syndrome, neuropathic scar pain, and pedal injury. There is also ample low-level evidence for pain efficacy in autoimmune diseases, neuromas, vulvar lichen sclerosis, burns, and radiation-induced wounds.

Conclusions: While there is a clear lack of higher-level evidence based studies conducted on AFG for all indications, the existing literature shows a definite trend of reconstructive efficacy and pain management that can be clearly appreciated. With the increasing popularity of this procedure for reconstruction, higher-level studies are beginning to take place pertaining to AFG's efficacy not only in reconstruction, but pain management as well.

Introduction

Fat grafting has been used in reconstructive plastic surgery for over a century.[1] Although it has obvious benefits to the aesthetic appearance of many reconstructive surgeries, less appreciated advantages of fat grafting have also been shown in potential pain reduction, although this aspect appears to be slightly controversial. This can be seen across the board from head to toe with examples ranging from facial nerve injury to pedal atrophy and foot ulcers. The purpose of the literature review is to evaluate the use of fat grafting and its effects on pain in various anatomic locations and surgical indications. The authors intend for this work to organize the use of autologous fat grafting (AFG) for pain relief by indication as to give physicians an easy reference when looking for treatment modalities for their patients.

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