Autologous Fat Grafting: Evaluation of Efficacy in Pain Relief

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.

The Efficacy of Fat Grafting on Treating Post-Mastectomy Pain with and without Breast Reconstruction: A Systematic Review and Meta-Analysis

“…With an increased focus on the effect of fat grafting in recent years as a potential regimen for treating PMPS, there is a growing number of promising new evidence and research articles regarding this topic. While two previous systematic reviews have found a reduction in pain following fat grafting after mastectomy, these reviews may have limited power, as they included three and six studies, respectively [8,10]. Furthermore, neither review performed a meta-analysis nor examined complication rates associated with fat grafting.…”

“…However, there remains no standard treatment or recognized clinical guidelines for PMPS [8]. Botulinum toxin, neuromodulation, regional anesthesia, oral analgesia, and injection therapy have provided only temporary relief [9,10]. Autologous fat grafting, a procedure which involves the surgical transfer of adipose tissue from one area of the body to another, is a well-established technique in the field of reconstructive plastic surgery with uses such as for cosmesis and scar irritation [8].…”