Review ArticleStrategic Sequences in Fat Graft SurvivalGuo, Jimmy; Widgerow, Alan D. MBBCh, MMed, FCS, FACS; Banyard, Derek MD, MBA; Toranto, Jason MD; Wirth, Garrett A. MD, MS, FACS; Paydar, Keyianoosh MD, FACS; Tocco-Tussardi, Ilaria MD; Evans, Gregory R.D. MD, FACSAuthor Information From the Department of Plastic Surgery, Center for Tissue Engineering, University of California, Irvine, Orange, CA. Received June 12, 2014, and accepted for publication, after revision, November 11, 2014. Conflicts of interest and sources of funding: none declared. Reprints: Alan D. Widgerow, MBBCh, MMed, FCS, FACS, Department of Plastic Surgery, Center for Tissue Engineering, University of California, Irvine, 101 S City Dr, Orange, CA 92868. E-mail: email@example.com. Annals of Plastic Surgery: March 2015 - Volume 74 - Issue 3 - p 376-382 doi: 10.1097/SAP.0000000000000416 Buy Metrics Abstract Although lipotransfer, or fat grafting, is a commonly used procedure in aesthetic and reconstructive surgery, there is still variability in graft survival and neoadipogenesis from one procedure to the next. A better understanding of the sequential molecular events occurring with grafting would allow us to strategize methods to improve the regenerative potency of the grafted tissue. These steps begin with an autophagic process, followed by the inclusion of stromal vascular fraction and matrix components. By tailoring and modifying each of these steps for a particular type of aesthetic or reconstructive procedure, strategic sequencing represents a dynamic approach to lipotransfer with the aim of maximizing adipocyte viability and growth. In the implementation of the strategic sequence, it remains important to consider the clinical viability of each step and its compliance with the US Food and Drug Administration regulations. This review highlights the basic science behind clinically translatable approaches to supplementing various fat grafting procedures. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.