REVIEW Fat Grafting Versus Adipose-Derived Stem Cell Therapy: Distinguishing Indications, Techniques, and Outcomes Christina J. Tabit • Ginger C. Slack • Kenneth Fan • Derrick C. Wan • James P. Bradley Received: 7 March 2011 / Accepted: 13 June 2011 Ó Springer Science+Business Media, LLC and International Society of Aesthetic Plastic Surgery 2011 Abstract With adipose-derived stem cells (ASCs) at the forefront of research and potential clinical applications, it is important that clinicians be able to distinguish them from the fat grafting currently used clinically and to understand how the two approaches relate to one another. At times, there has been confusion in clinically considering the two therapies to be the same. This report is aimed at distin- guishing clearly between fat grafting and ASC therapy with regard to the indications, harvesting, processing, applica- tion techniques, outcomes, and complications. Findings have shown that autologous fat transfer, a widely used procedure for soft tissue augmentation, is beneficial for reconstructive and cosmetic procedures used to treat patients with volume loss due to disease, trauma, congen- ital defects, or the natural process of aging. On the other hand, ASCs have been identified as an ideal source of cells for regenerative medicine, with the potential to serve as soft tissue therapy for irradiated, scarred, or chronic wounds. Recent advances in tissue engineering suggest that the supplementation of fat grafts with ASCs isolated in the stromal vascular fraction may increase the longevity and quality of the fat graft. Research suggests that ASC sup- plementation may be a great clinical tool in the future, but more data should be acquired before clinical applications. Keywords Autologous fat transfer Á Fat grafting Á Adipose-derived stem cells Á Tissue engineering Autologous fat grafting is a technique shown to be bene- ficial as a reconstructive and cosmetic procedure for patients with volume loss due to disease, trauma, congen- ital defects, or the natural process of aging. Adipose- derived stem cells (ASCs) have been identified as an ideal source of cells for regenerative medicine with the potential to serve as soft tissue therapy for irradiated, scarred, or chronic wounds. For a clinician, there are important dis- tinctions between fat grafting and ASCs. Fat grafting has been well studied, but less is known about therapy with ASCs or multipotent stromal-derived cells. At times, there has been confusion clinically, with the two therapies considered one and the same [1]. Surgeons have even begun to market ‘‘stem cell face-lifts’’ when in fact the procedure involves merely facial fat injections without a rhytidectomy [2, 3]. Because ASC therapy is an emerging field, it is critical to separate data from anecdote. Evidence-based, well- controlled clinical trials are crucial for differentiating fact from fiction, much better than anecdotal before-and-after photos presented at national meetings. This report aims to distinguish clearly between fat grafting and ASC therapy with regard to the indications, harvesting, processing, application techniques, outcomes, and complications. The authors conducted a thorough review of the current literature on autologous fat grafting and ASC therapy. This review involved a comprehensive search of PubMed and ClinicalTrials.gov to identify and evaluate current literature using the search terms ‘‘autologous fat grafting,’’ ‘‘lipoin- jection,’’ ‘‘autologous fat transfer,’’ ‘‘adipose-derived stem cells,’’ ‘‘fat harvest,’’ ‘‘stem cell therapy,’’ ‘‘lipoaspirate,’’ C. J. Tabit Á G. C. Slack Á K. Fan Á D. C. Wan Á J. P. Bradley (&) Division of Plastic and Reconstructive Surgery, David Geffen School of Medicine at University of California Los Angeles, 200 Medical Plaza, Suite 465, Los Angeles, CA 90095-6960, USA e-mail: Jbradley@mednet.ucla.edu D. C. Wan Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, 900 Blake, Wilbur Drive, Palo Alto, CA 94304, USA 123 Aesth Plast Surg DOI 10.1007/s00266-011-9835-4