Nanofat in Plastic Surgery: A Systematic Review of Clinical Outcomes, Safety, and Emerging Applications.

BACKGROUND: The beauty industry has seen a shift in standards, with patients increasingly favoring natural and subtle enhancements over dramatic cosmetic changes. In this evolving landscape, nanofat has emerged as a promising tool to plastic surgeons due to its regenerative potential and biocompatibility. Despite its growing popularity, hesitancy regarding its efficacy and side effects persists. METHODS: A systematic literature review was conducted in December 2024 following PRISMA guidelines. Databases searched included PubMed, Embase, MEDLINE, Scopus, Web of Science, and Cochrane Library databases. RESULTS: A total of 18 studies met the inclusion criteria, encompassing 768 patients. Nine studies (n = 512 patients) assessed patient satisfaction, with most patients reporting above-average satisfaction. Eight studies (n = 188) reported outcomes using the Vancouver Scar Scale and Patient and Observer Scar Assessment Scale, all showing significant improvements in scar characteristics. Additional outcomes included collagen synthesis and transforming growth factor beta 1 expression (n = 68), hair density and thickness (n = 9), and histological analysis of skin samples (n = 24). Regarding safety, 12 studies reported no significant complications such as granulomas or cysts, whereas 8 studies noted mild side effects, including erythema, hyperpigmentation, and edema. CONCLUSIONS: Nanofat demonstrates significant potential as a cost-effective, well-tolerated regenerative therapy in both aesthetic and reconstructive contexts. Although preliminary findings are promising, further high-quality studies are necessary to establish standardized methodologies and optimize preparation techniques.