Comparison between autologous fat grafting and synthetic fillers in facial rejuvenation: a critical review of the efficacy, safety, and durability of results

• DOI: https://doi.org/10.22533/at.ed.515722626014

• Palavras-chave: Facial rejuvenation; fat grafting; dermal fillers; hyaluronic acid; cosmetic plastic surgery.

• Keywords: Facial rejuvenation; fat grafting; dermal fillers; hyaluronic acid; cosmetic plastic surgery.

• Abstract:

  Introduction: Volume loss is one of the main determinants of facial aging. Among the minimally invasive strategies for volume restoration, autologous fat grafting and synthetic fillers, especially hyaluronic acid, stand out. Despite their widespread clinical use, controversies persist regarding the durability, predictability, and complication profile of each technique.
  Objective: To critically compare the efficacy, safety, and durability of results between fat grafting and synthetic fillers in facial rejuvenation.
  Methods: Structured narrative review of the literature, including clinical studies, case series, comparative trials, and systematic reviews published between 2005 and 2025 in the PubMed/MEDLINE, Scopus, and Web of Science databases. Outcomes related to volume maintenance, patient satisfaction, resorption rates, complications, and the need for retreatment were analyzed.
  Results: Fat grafting showed greater long-term durability, with variable initial resorption but volumetric stability after six to twelve months. Synthetic fillers demonstrated high immediate predictability, but with progressive degradation and the need for periodic reapplication. The safety profile was favorable in both techniques, with different types of complications.
  Conclusion: Both approaches are effective and complementary. Fat grafting is more suitable for extensive volumetric restoration and long-lasting results, while synthetic fillers remain ideal for localized corrections and fine adjustments, with less invasiveness.
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