Fat grafting through a blunt cannula has been used by plastic surgeons for altering facial contours for 100 years. Autologous tissue is completely biocompatible and is usually the safest choice for altering facial volume or contours. Fat grafts can be placed in such a fashion that they are long lasting, completely integrated, and natural appearing. Only in the past 20 years have advances in techniques and instrumentation allowed us to obtain predictable results that make fat grafting a viable option for soft tissue augmentation. Our understanding of aging and methods of rejuvenation have developed also. We now approach rejuvenation and adjustment of facial proportion with a better understanding of the need for the restoration or adjustment of facial volume.