Autologous Fat Grafting Versus Facial Fillers in Facial Cosmesis: A Systematic review and Meta-analysis.

INTRODUCTION: Autologous fat grafting (AFG) and facial fillers specially Hyaluronic acid fillers (HA) are widely used for facial rejuvenation, yet their comparative benefits for patient satisfaction remain uncertain.
OBJECTIVE: To compare AFG and facial fillers, using patient satisfaction as the primary outcome.
DESIGN: Systematic review and meta-analysis (PRISMA-aligned).
METHODS: Nine comparative studies (n = 805) were pooled with random-effects models (standardized mean difference, SMD). Heterogeneity (Q, I2) and small-study effects (Egger's) were assessed.
RESULTS: AFG showed higher patient satisfaction than HA (SMD 0.91, 95% CI - 0.32 to 2.14), but results varied across studies (I2=97%); subgroup analyses were directionally consistent but did not explain variability. Egger's test suggested possible small-study effects (p = 0.15), though interpretation is limited with <10 studies.
CONCLUSIONS: On average, AFG provides higher satisfaction, likely due to its greater durability, while HA remains valuable for convenience and reversibility. Findings should be interpreted in light of between-study variability. Well-designed, standardized RCTs are needed.
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