Hierarchical approaches and regenerative applications of adipose tissue derivatives

Autologous fat grafting is widely used in reconstructive and aesthetic surgery due to its abundance, biocompatibility, and low immunogenicity. With a history spanning more than a century, it remains a popular option for soft tissue augmentation. Recent advances in understanding the composition and regenerative mechanisms of adipose tissue have led to the development of a range of adipose tissue derivatives with distinct structural and biological functions. Through techniques including physical fragmentation, centrifugation, decellularization, and morphological engineering, a lineage has been established, ranging from cell-composite materials to functional scaffolds. This review systematically examines the preparation principles, structural characteristics, and regenerative applications of diverse adipose tissue derivatives, ranging from cellular and micro-fragmented preparations to matrix-enriched, decellularized scaffolds, and membrane or film-like constructs. It highlights their applications in volume augmentation, wound healing, scar treatment, skin expansion, and tissue engineering, while also discussing challenges related to standardization, mechanistic studies, and regulatory pathways for clinical translation. This review aims to provide a comprehensive reference for the precise application of adipose tissue derivatives and future research directions in this field.