The transplantation of fat from one area of the body to another is a safe and effective procedure when performed by the hands of a qualified surgeon. Fat transfer requires more than just the action of filling an area with fat tissue and is additionally dependent on the regenerative action from adult stem-stromal cells for survival. The four variables commonly considered important to the overall success of fat grafting include harvesting, handling, transplantation or placement, and preparation of the recipient site. Autologous fat grafting (AFG) meets all of the fundamental criteria for the ideal augmentation material: availability, minimal donor morbidity, and reproducible and predictable results, while avoiding non-autograft disease transmission or incompatibility. The use of platelet-rich plasma (PRP) increases the long-term retention of the transplanted fat cells and increases the rate of re-vascularization and survival of the transplanted cells.