The natural process of aging involves multiple tissue factors: Laxity of the skin and soft tissues, Descent of the malar fat pad leading to jowls and Soft tissue volume loss (the most recently recognized factor). A loss of volume results from a reduction in the subcutaneous fat, muscle atrophy and changes in skeletal framework. Such loss of tissue volume compounded with skin laxity leads to the aged appearance especially in the area of periorbital, perioral, cheeks, lower jaw and neck. The lost volume can only be replaced with injectable soft tissue fillers, either synthetic or natural autologous tissue. With the increasing demand for injectable tissue fillers for various indications, autologous fat transplantation (grafting) is a technique which has been growing in popularity during the last two decades. Synthetic filler substances are expensive, mostly temporary and have risk of potential allergy and other adverse reactions. In contrast, autologous fat has several advantages; fat not only acts as filler but has also regenerative capabilities. A properly performed fat transfer has enhanced longevity and stability. It also integrates the fatty tissue into the host tissue so that it is hardly detectable. Large amounts can be transplanted and the surgery can be done in the same session as a liposuction procedure so that patient gets the dual advantage of fat suction from undesired areas and fat transplantation into desired areas. The recent discovery of fat as a source of stem cells has further enhanced its role as a rejuvenating procedure. Fat transplantation is also an effective means of changing not only facial and body contours, but can also be used for augmentations of other body parts like breast, buttocks, penis, vagina, rejuvenating hands, face and neck and revising scars, etc. Because of the above reasons, autologous fat has broad applications in esthetic and dermatosurgery. The authors firmly believe in the potential for long-term fat survival given an atraumatic technique of harvest, centrifugation and careful, deliberate small injections targeted at maintaining the integrity and preserving nutrients. This technique of structural fat grafting has achieved long-term results in many patients. Improvements in skin quality and evidence of tissue repair have been observed in some patients and fat transfer may have more dynamic benefits than volume restoration alone.