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Autologous fat grafting is an increasingly popular technique in plastic surgery for volume augmentation and rejuvenation. However, the unpredictability of long-term volume retention limits its clinical application. Various animal studies have documented the positive effects of adipose tissue-derived stem cells (ADSCs) on the acceleration of lipofilling. However, the results have been inconsistent, and there is an insufficient number of high-quality clinical studies to formulate evidence-based recommendations for ADSC-enriched fat grafts. Moreover, related technical standards, such as the final count of harvested ADSCs and the enrichment ratio, have not yet been established. This systematic review included all clinical trials on ADSC-enriched fat grafts in plastic surgery from PubMed in the past 10 years, as well as all registered clinical trials on ClinicalTrials. Gov. To examine the current landscape of ADSCs harvest, we summarize the current applications of ADSCs in the field of plastic surgery and discuss the current barriers to universal clinical use.