The Effect of Botulinum Toxin Type A in the Autologous Fat Grafting: A Review.

[BACKGROUND] Autologous fat grafting is a widely used technique in plastic and reconstructive surgery for soft tissue augmentation. Despite its advantages, the primary limitation is the unpredictable retention rate of transplanted fat. Recent studies suggest that botulinum toxin type A (BTX-A) can enhance fat graft survival by promoting angiogenesis and muscle paralysis.

[AIMS] This review explores the potential of BTX-A as an adjuvant in autologous fat grafting, providing insights into its mechanisms, benefits, and the need for further clinical validation.

[PATIENTS/METHODS] A literature review was conducted using PubMed, Web of Science, MEDLINE, and Embase. Keywords related to BTX-A, fat grafting, fat graft survival, and angiogenesis were used. Comparative studies reporting histological changes following BTX-A application in fat grafting were included. Exclusion criteria involved case reports with fewer than three animals, reviews, and letters.

[RESULTS] The initial search yielded 108 articles, with seven experimental studies meeting the criteria. These studies demonstrated that BTX-A enhances fat graft retention by promoting vascularization and adipose-derived stem cell differentiation. However, these results are mainly based on small animal models.

[CONCLUSIONS] While BTX-A shows promise in improving autologous fat grafting outcomes, its efficacy and safety in humans need validation through large-scale clinical trials. Translating these preclinical findings into human trials is crucial to establish standardized protocols and optimize clinical outcomes. Future research should focus on optimizing dosage and injection sites, conducting long-term follow-up studies, and performing multicenter trials to verify the findings.