Does adding PRP or SVF help more transferred fat survive?

In fat transfer consultations, many people ask whether adding PRP or SVF will help more of the fat take. PRP (platelet-rich plasma) is made by spinning your own blood in a centrifuge to concentrate the platelets, and SVF (stromal vascular fraction) is a cell component, including stem cells, separated from the fat that was removed. Both are used on the idea that they help transferred fat form new blood vessels sooner and survive in greater amounts. How far has research confirmed this?

The most frequently cited study is a 2013 randomized clinical trial from Denmark. In 10 healthy volunteers, 30 mL of fat was injected into the back of each upper arm, and on one side the fat was mixed with stem cells that had been grown in a laboratory for 2 weeks. When the volume was measured by MRI 121 days later, 80.9% of the original volume remained on the side mixed with stem cells, compared with 16.3% on the side without. The difference is very large, but there were only 10 people, the follow-up lasted 4 months, and above all, the cells had been grown in a laboratory. That is a different method from SVF, which is separated at the clinic on the day of surgery.

Analyses that pooled many studies point in a similar direction. A 2018 analysis of 25 studies (696 people) found a retention rate of 64% for cell-assisted lipotransfer (CAL), compared with 44% without added cells. However, this difference was significant only when less than 100 mL was transferred, complications were higher at 8.4% than without added cells (1.5%), and the rate of repeat surgery didn’t go down. A 2021 analysis of 36 studies (1,697 people) found higher retention rates both with added cells (71% vs. 48%) and with added PRP (70% vs. 40%), with no difference between the two. But when large volumes were transferred, as in breast reconstruction, complications increased with both methods, and neither reduced repeat surgery. A 2021 analysis that looked at PRP alone (11 studies, 1,125 people) also reported higher retention rates, but noted that the right concentration and the long-term effect are still unknown.

There are also reasons not to take these numbers at face value. Most of the pooled studies were not randomized trials, and the method of measuring volume differed from study to study, so the same surgery can yield different retention rates depending on how it’s measured. The researchers all wrote that more well-designed studies are needed.

So I see PRP and SVF not as something that “always makes more fat stay,” but as something that “may help under certain conditions.” What still matters most for retention is how the fat is harvested and purified, how finely it’s divided as it’s transferred, and your weight after surgery. Whether to add them is decided at your consultation based on the amount and the area to be treated, and the cost is explained separately at that time.