Tehran University of Medical Sciences (TUMS) Academic Journal of Surgery 2423-3218 8 4 2025 12 31 151 156 Farahnaz Zamanitalab School of Medicine and Surgery, University of Trieste, Trieste, Italy 2025 11 26 Autologous fat grafting continues to face a persistent challenge: retention rates that fluctuate unpredictably between 20% and 80%. The stromal vascular fraction (SVF)—a heterogeneous cell population containing adipose-derived stem cells and other regenerative cell types—has emerged as a promising adjunct. By  romoting angiogenesis and supporting tissue regeneration, SVF enhances graft survival [1,2]. This review examines current evidence on the mechanisms of SVF-enhanced fat grafting, the techniques used for its isolation, and the clinical contexts in which it has been successfully applied [3]. Literature published between 2015 and 2025 was analyzed, focusing on studies that investigated SVF-enriched fat grafting in reconstructive surgery [4]. Evidence indicates that enrichment with SVF im proves graft retention, with rates rising to 65–80% compared to 40–65% achieved with conventional methods. Enhanced neovascularization has also been consistently reported [5,6]. Clinically, surgeons are applying SVF-assisted grafting in breastreconstruction, rehabilitation of radiation-damaged tissue, chronic wound management, and facial rejuvenation [7,8]. Both enzymatic digestion and mechanical separation techniques have proven effective for isolating SVF, offering flexibility depending on available resources and regulatory considerations [9,10]. Overall, SVF-enhanced fat grafting represents a significant advance in regenerative surgery. Multiple studies confirm its safety and therapeutic value, underscoring its potential to improve outcomes across a range of reconstructive and aesthetic applications [11,12]. https://ajs.tums.ac.ir/index.php/ajs/article/view/335