Xuan Ma, Zhijin Li, Yuqiao Zhang, Miao Dong, Facheng Li, Xiaojun Wang
Adipose-derived stromal vascular fraction (SVF) is a cornerstone of regenerative medicine, yet traditional enzymatic digestion faces significant regulatory and technical hurdles. This scoping review systematically categorizes mechanical micronization and purification techniques as viable alternatives, following PRISMA-ScR guidelines across PubMed (National Institutes of Health, Bethesda, MD), MEDLINE (National Institutes of Health), and Embase (Elsevier, Amsterdam, the Netherlands). A total of 89 studies were analyzed, identifying three primary micronization techniques: shuffling-based emulsification, rotating blade systems, and filtration bag systems. Furthermore, we summarize four major post-processing purification methods, including filtration, centrifugation, combined filtration-centrifugation, and fluid-washing. Based on these techniques, final adipose-derived products are categorized into two distinct types: mSVF combined with adipocytes, and mSVF concentrates, each offering unique structural and functional properties. Our findings highlight that mechanical processing provides a promising, regulatory-friendly approach that prioritizes the preservation of the adipose niche. This review offers plastic surgeons a comprehensive guide to selecting optimal mechanical processing parameters to enhance clinical outcomes in fat grafting and regenerative procedures. Future advancements should focus on further optimizing these parameters to develop next-generation regenerative products tailored to specific therapeutic applications.